3 Voices from Rural Primary Care
Bethel has a population of 1,942; Chelsea, 1,233; and Rochester, 1,099.* Together, the people who live here—across 143 square miles, along branches of the White River, on mountainsides and farmland—make up less than 1 percent of Vermont’s total population. Life is quiet here, and it’s rural.
Many who live here receive health care at Gifford clinics on the main streets of their hometowns—from doctors, nurse practitioners, and physician assistants who likewise have chosen a rural life. Here, three Gifford providers tell us what brought them here and why they stay.
Gifford: Why do you choose to provide care in a rural area
Ryan Heney, MD, Bethel: Because this is where we wanted to live and raise our family, and I wanted to take care of my neighbors and my community. I did not get to experience that during medical school or residency, but when I took my first job in northwestern Rhode Island, 10 minutes from our home, I found this to be one of my greatest joys. I learned that for me, the anonymity that comes with practicing in a more densely populated urban setting was very unfulfilling. When we were looking to relocate to Vermont, I knew I wanted to continue to practice close to home. Working in a rural setting helps me maintain a broad skill set and scope of practice, and I feel that it also helps me to better understand my patients as we exist in the same context.
Melanie Clark, FNP, Chelsea: I like being able to provide care and educate people who do not have access to care otherwise. I enjoy staying educated so that we can do some procedures and care that usually would need to be provided by a specialist. I enjoy nature, and love Vermont.
Brigid Meehan-Brese, DNP, Rochester: I investigated life pretty deeply … and had several careers before I was a nurse or nurse practitioner. (Fun fact: Brigid is a former opera singer, ski instructor, and political campaigner.) I knew I wanted to work in a rural setting. Access to care is a huge issue. I felt I could be a good solution for that. I first became a nurse and worked in Springfield, Vt., at another Critical Access Hospital. I kept seeing patients who desperately needed access to Primary Care, but because they didn’t have that access, they didn’t get what they needed, which only worsened their conditions.
Gifford: What is most personally rewarding about providing care in the community you serve?
RH: Far and away the most rewarding part of my job is taking care of entire families including seniors, parents, and their children.
MC: I love getting to know the patients and appreciate hometown medicine. I think the human connection is rewarding. I actually worked in an inner city as a PCP, and found it less personal, with way more patients than possible to provide care for in one day.
BMB: I appreciate Vermont’s focus on communities, and part of that is supporting rural health care and making sure our communities can be sustainable. And I really enjoy relationship-building. Working in rural health care seems like a natural fit for me.
Gifford: What would you say to someone who is considering practicing Primary Care in a rural setting?
RH: My advice would be to try a rural setting. A huge majority of medical training occurs in cities at the major academic centers, which have a particular function and flavor. For some, it’s where they decide to spend their entire career. The scope and size of these hospital systems provides ample opportunity for trainees, but our training very often does not expose us to any different settings. Often, you have to seek out these opportunities through electives or away rotations, but there is no substitute for actually doing the work to help you decide where you belong.
BMB: If you want a career that’s rewarding, and lets you give back into your community, and allows you to have good relationships with your patients, you can get a lot out of providing health care in a rural community. You get to meet all kinds of people, and meet them where they are. It may not be the most glamorous specialty, but it’s vitally important. It’s important that we have providers who know how to take care of people where they are.
*Source: 2020 Decennial Census, U.S. Census Bureau
