AUA graduate Dr. Kate Schmitz was featured in the Daily Record News about her work in rural areas, where the physician shortage is at it’s highest and are needed the most. More about her work below:

Some doctors are the kind patients see when they have a specialized issue. A patient might drive an hour or more to a big city and see the doctor a few times. Then there are the doctors patients see for checkups, laryngitis, and their kids’ ear infections.

Neuroendocrinologists or interventional radiologists are important to modern medicine, but they probably won’t provide the kind of medical care that most patients need on a daily basis.

Doctors Kate Schmitz and Vaughan Bulfinch entered Community Health of Central Washington’s Family Medicine residency program to train in the kind of medicine people need every day, and they’re doing a lot of that training here as the Yakima-based health care provider’s first residents in its rural family medicine residency program in Ellensburg.

Residency is the last part of physician training following medical school and prior to specialty certification and entry into independent practice.  Community Health of Central Washington, which has a clinic in Ellensburg, has had a residency program in Yakima for some time. It was able to expand to Ellensburg with money from the Affordable Care Act for family care residency programs, creating two slots here for rural-focused family practice training.

The residents work monthly rotations in different specialties related to family practice. Some of those rotations are at the KVH Hospital in Ellensburg or at Yakima Memorial Hospital. They also do regular shifts working at the Ellensburg clinic with other primary care physicians. During their residency, they will receive training in obstetrics, integrated behavioral health, osteopathic manipulation medicine, procedural training, and inpatient pediatric and adult medicine.  

Specialized training

While medical schools teach a broad range of medicine, new doctors spend several years working in residency alongside more experienced physicians to get specialized training in a specific field. In Family Medicine, doctors learn how to handle all kinds of different, but common, maladies for patients of all ages.

Schmitz and Bulfinch started in July. Over the next two years, four more residents will join the program, bringing the total number of doctors cycling through the three-year program to six.

“Everybody has a different idea of What does it mean to be a doctor,” Schmitz said. She’d like to be the kind of doctor working in the thick of things helping patients.

“I’m the kind of person who liked all of my rotations in medical school,” Schmitz said. “I really enjoy pretty much every aspect of medicine, and so that is why family medicine appealed to me, even more so rural medicine, because I like doing stuff hands-on.”

Some doctors, she said, even if they do a family medicine residency, might never put in a chest tube or even deliver a baby. That’s not the case in this program, she said, since there could be so many different cases to handle and not many other providers in a rural area.

She said she sometimes thinks it might be interesting to specialize in obstetrics or surgery.

“But then I always kind of come back to center and remember, well, you know, if you did that, then you would never get to do pediatrics or you would never get to do the stuff that you see in the clinic, which is a wide variety of things. You never really know what you’re going to get in this clinic,” she said.

“I would never get to pull off another toenail,” she said. “If you specialize in toenails, then you’d get sick of toenails.”

A doctor of family medicine will be able to refer most special cases to another provider, she said.

Labor and delivery, earaches, pneumonia and the like, “That is your bread and butter medicine and that is what happens to most people,” she said.

“If you know how to deal with common things then you’re going to satisfy more of the needs of most people.”

Bulfinch agreed, and said he’s glad he gets a jack-of-all-trades range of skills, and can do it in a less densely populated area.

He grew up in Anacortes and went to college at Central Washington University, and he prefers small town life, he said. He wants to work in Central Washington when his residency is complete, because that’s where he said he’s needed.

“It would mean that I was able to help a patient population that, in my opinion, is more needing of help. They don’t have the access to medical care that people living around larger cities do,” he said. “It would allow me to do the greatest amount of good with my time.”

He met his wife in college, and they have a son and a home in Yakima. Working in a smaller market for doctors means he won’t just see patients at work, he said, but at the grocery store or at the movies.

“You become part of the community,” he said.

Rural providers

Most doctors tend to get jobs near where they did their residency, said Dr. Don Solberg, chief medical officer at Kittitas Valley Healthcare. Although it’s not the primary goal of the residency program, there’s hope it will create a group of practitioners who are interested in rural medicine and their area.

“And are therefore more likely to stick around,” he said.

Beyond the West Side, Washington looks more like Idaho or Montana as far as physicians per 1,000 people, and any extra hand can help, said Dr. Russell Maier, Community Healthcare Central Washington’s residency director.

For a while, there were fewer than 20 doctors in any year of any residency program in both Yakima and Spokane, he said.

He said Pacific Northwest University of Health Sciences in Yakima has been a boon for training more doctors locally, but even if it was the biggest medical school in the county, it wouldn’t necessarily mean there would be more doctors serving Washingtonians east of the Cascades.

“Med school doesn’t create practicing physicians,” he said.

Still, even if residents don’t stay where they trained, health care providers have a few extra doctors on hand while they’re around.

Solberg said the staff at KVH has been excited to start having the residents around. KVH offers rotations to students in different areas of study, like nursing or paramedic programs, but hasn’t had post graduate residents for around 20 years, he said.

“It usually makes us better at what we do when we’re teaching,” he said.

Original article featured in the Daily Record News.