6
doc • Summer 2014
Kentucky
Attracting Staff to Rural
Medicine
Fiona Young-Brown
Urban: Large teaching hospitals and
research centers; new medical breakthroughs; cutting edge technology; vast
potential for career advancement.
Rural: small, poorly equipped hospitals;
monotony; career stagnation.
If the above descriptors summarize your
opinions of urban v. rural medicine, you
wouldn’t be alone in your way of thinking.
Rural hospitals and medical practices struggle to recruit to the brightest and the best.
I look at how some rural health services are
working to recruit highly qualified staff, and
I talk to one doctor who decided to try small
county medicine and found an immensely
rewarding and challenging career.
As more small county hospitals close, unable
to meet their daily financial demands and
struggling with competition from nearby
city med centers, those hospitals that do
remain open find themselves working overtime to attract qualified staff. At the same
time, those counties without a hospital need
medical professionals willing to combine the
challenges of often being the only doctor for
miles with relocating to often isolated, poor
communities.
One physician who found unexpected
career rewards in a rural area is Dr. Thomas
Karelis. After completing a medical residency in South Carolina, Karelis had every
intention of moving back to Lexington,
his childhood home. Plans to work as a
hospitalist fell apart when he learned of the
move to compensation based on production
rather than a salary. Several local physicians
confided that their patient volume was not
reaching sufficient capacity to match previous salaries. Like Lexington, Louisville and
Cincinnati were saturated with newly qualified docs entering the career market, and so
Karelis and his wife began to look further
afield in Kentucky for a place to relocate.
Eventually, they chose Hazard, where his
wife had family. The move was one which
would ultimately be “challenging, but
rewarding.” Karelis says, “I walked into a full
practice. I was seeing 30-40 office patients a
day plus 10-20 hospital patients a day. Pretty
busy. The bucks were actually better in
Hazard than Lexington for me.”
Not only were the personal and financial
benefits higher in Hazard; so were the
professional rewards. Karelis explains, “We
don’t have as many medical specialists as
Lexington which adds a level of complexity