A breath of fresh air

Pre-med student Tammy Luoh with Dr. Robert Holland at Dr. Holland and Lindsay Madden's office in John Day.<I><BR>The Eagle/Angel Carpenter</I>

JOHN DAY - There is little doubt that locals are benefiting from the influx of resident doctors and pre-med students who come to Blue Mountain Hospital (BMH) and local clinics, but where do they come from, how do they end up here and what is their perspective on rural health care?

Hospital CEO Bob Houser said that BMH and the local clinics have a contract with Oregon Health and Science University which brings the resident doctors here for a month to six weeks at a time for a rural rotation.

"From time to time we'll have a resident who also did a rotation here as a medical student. It's nice to see how they've developed and matured on their way to becoming a physician," he said, noting that the doctors like it because it gives them a chance to teach.

Resident doctor Safina Koreishi of Buffalo, NY, who worked with Dr. Robert Holland, said that working in a rural area is a requirement for those in the OHSU family medicine program in their second year. Each year, six residents spend time in John Day and another six go to Enterprise.

She has returned to Portland, and said she had an "amazing personal and medical experience" in John Day.

"It was such a breath of fresh air," she noted.

"We have an amazing opportunity to experience what it is like to be a 'traditional' family physician," she said. "In the city there are often turf battles, and family medicine residents and physicians at times do less medicine than their counterparts in a rural area, because there is a plethora of specialists. Also, in many rural areas, family docs do ER which is very different than the city, admit their own patients and follow them in the hospital. The continuity is much better. Patients don't get lost in the shuffle."

Tammy Luoh, who is currently working side by side with Dr. Holland, is a student who has just completed her first year of pre-med school. She was awarded the Laurel G. Case Scholarship at OHSU, which is now known as CARE, Case Award for Rural Experience.

Dr. Case was a rural doctor before he started the family medicine program at the university, she said. Holland noted that it is quite a competitive process to receive the scholarship.

The Oregon Academy of Family Physicians matched her with Dr. Holland.

"It's neat having students who are interested in a rural experience," Holland said. He hopes that some of them will consider returning to the area.

Since coming to John Day, Luoh hasn't had much spare time to explore the area, but she has visited the Kam Wah Chung Interpretive Center and hopes to hike a trail in the Strawberry Mountains and see the Thomas Condon Paleontology Center.

Originally from Taiwan, Luoh has resided in Portland the last nine years. She, like Koreishi, sees the difference between the city and rural medicine experience.

She said that having specialists readily on hand is not an option here, creating a broader spectrum of care for the doctors to cover.

"Rural doctors do a lot more and take care of a variety of diseases," she said. They "provide a continuum of care from the unborn baby to geriatrics."

In this small community, everyone is more connected to each other, and that makes a difference, she said. "People are just really nice to each other."

Koreishi expressed concern about the decrease in doctors pursuing family medicine careers "in favor of more lucrative specialties."

"This greatly affects not only rural areas, but the entire U.S. health system," she said. "I am concerned that the scope of family medicine practice may continually decrease, as it is more difficult to train family doctors in the full scope because of the amount of specialists, and this makes them less ready to enter a rural area and work."

Both Luoh and Koreishi had nothing but praise for the opportunity to work with the hospital staff and Dr. Holland.

"The medical care in John Day is great," Koreishi said.

"The hospital and nurses are amazing, and Dr. Holland is the most talented, wonderful doctor with whom I have ever had the good fortune to work," she said.

"My time in John Day confirmed my desire to work in a rural area. I want to try and affect a community. Change starts small."

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