Growing up in Maine, I thought I knew rural. I’m from Androscoggin County, the oldest-by-demographic county in one of the oldest states in the U.S. It can be notoriously difficult to find a primary care provider accepting new patients. Due to these hardships, our urgent care facilities, when available, are nearly always busy, as are our emergency department waiting rooms. In short, it can take a while to see a physician. So, when I had the opportunity to further my medical school training at the Swift River Rural Training Track in Rumford, Maine, a mere hour from where I grew up, I thought I knew what I was getting myself into. I was expecting long waits, frazzled physicians, a full ER, and, in turn, the same hurried care to which I had grown accustomed. My experience could not have been further from my expectations.

Busy environment with adequate time for patients
Every day, the nurses and medical assistants arrived with smiles on their faces. Patients arrived early or on-time; rarely was there a no-call or no-show. Happy staff and compliant, thoughtful patients kept the small, busy clinic running on time. Physicians had the time and energy to sit and truly listen to the patient, keeping the patients’ abilities and interests in mind and making them an active, participating member in their care rather than a passive bystander. Despite seeing the same number of patients in a day as the clinics in larger towns, there was no sense of urgency in the schedule, no rushing to finish. The ER was almost always busy, but because the clinic was able to see acute visits expediently, less acute problems could be addressed without straining limited resources.

Relationships between physicians and patients
Though technically considered underserved, the Rumford area is very well served by exceptional physicians, people committed to providing quality care. The physicians I worked with know many of their patients by name; most of the time they did not need to review the chart or look at a picture to refresh their memories. They are heavily invested in their patients and the patients’ wellbeing. The part of my experience that was most striking, and the part that I was most unprepared for, was witnessing the deep, sincere relationships forged between patient and physician. It was not something I had born witness to as a medical student. There was one couple who had called to tell us that they would be late for their young child’s wellness visit; we saw them when they arrived. Turns out, they had walked close to 5 miles on a 95+ degree day to make their appointment. Their physician and I not only stayed late to see them, but the physician paid for their cab fare home. Another physician, already on call for 2/3 of each month because he is the only OB/GYN physician for an hour in all directions, regularly comes in on his days off to deliver his patients because he wants them to have a familiar face in the room on such an important day.

Patients were so incredibly grateful for the time and care they received; it was clear that a simple trip to the doctor was much more than that for this population. Likewise, rural medicine is so much more than a job for the physicians and staff. I got more hugs from patients that month than I probably had in the previous year. I feel blessed to have been a part of their care, to be welcomed into their lives so openly, and I have a feeling I may be returning to that “neck of the woods” to practice once my training is complete.