Before I went to medical school, I spent a year researching and writing about the patient-centered medical home (PCMH) and how such a program would affect rural areas. When I first read the definition of a PCMH, I thought to myself, “Isn’t this the standard of care?”  I grew up in a small town and experienced first-hand the benefits of rural family medicine. My family’s doctor knew and cared for everyone in my family, including my grandma. He cared about my health, but also about how well I played in Tuesday night’s basketball game and how I was doing in school.

This is what I knew about medical care. If my doctor referred me to a specialist, he was sure to follow up regarding the referral. In practice, his skill set was so wide-ranging, the only specialist I ever saw was an orthopedic surgeon. I soon learned that few patients experienced this type of comprehensive, coordinated, accessible care.

From fragments to excellence
I began medical school in Kansas City, completing my basic sciences curriculum and doing a small amount of precepting. My limited experiences led me to believe that few patients had a primary care provider, let alone one who knew their health history and their socioeconomic reality. After completing second year, I spent six months at the Wichita campus. Again I met patient after patient receiving fragmented care, seeing a different provider every time they had a new health problem. This approach isn’t the fault of the provider or the patient. It’s simply the way the system is set up and I, along with many others, believe it must change.

To my pleasant surprise, when I began my rural training track in Salina, Kansas, I observed many patients receiving the type of care that I experienced growing up. Admittedly, Salina isn’t all that rural, especially by Kansas standards. Its population is nearing 50,000 and it has both Wal-Mart and Target, which earn it “big city” status in my mind. However, it has a small town feel, and this culture carries over to the medical community.

For the first four weeks of my family medicine clerkship, I spent time with the faculty and residents of Salina Family Healthcare, a federally qualified health center. To get a better idea of the aspects of the practice, I spent time in the outpatient clinic, the emergency room and the inpatient service. I was amazed by the preventative care and services offered to patients, how well providers knew their patients, and how well the transition from outpatient to inpatient and back to outpatient went for patients who needed to be admitted. This was helped by the clinic’s EMR, but more than anything, it was the providers’ expectations of excellent care.

Continuity in a Small Community
Now I’m completing my second four weeks in a private practice clinic and, once again, I am amazed by this provider’s dedication to her patients. Even when she is not officially consulted, she makes a point to see her patients in the hospital. She knows her patients thoroughly, and in many cases is providing multi-generational care. Her patients love her because she is willing to delve into the difficult stuff: everything from family drama and bad habits to why they haven’t been exercising regularly.

She’s accessible by personal cell phone to many of her patients. It is a common occurrence for her to make a house call if she knows that the patient will have a difficult time making it to her clinic. She’s brilliant, caring, loves a challenge, and has fun at what she does. She, too, is a patient-centered medical home. She goes above and beyond, and if someday I am half the provider she is, I’ll be doing great.

Jenna Kennedy is a third year medical student at the University of Kansas School of Medicine. She is one of four students in the rural training track in Salina, KS, and is completing her family medicine clerkship.