My Own Private Montana (continued):
by J. B., PA-S

While in Montana, I primarily worked with Karin Johns-Kooy, at the Bull River Medical Clinic in Noxon. When she went on vacation, I spent most of my time with Randy Mack in both Noon and at Clark Fork Valley Hospital and Clinic in Plains. I even spent a day with Al Shear at the Hot Springs Medical clinic. All f my preceptors were physician assistants (PAs), so I was lucky enough to see first-hand how important the role of a PA can be in a rural community.

I had no idea what to expect when I signed up for this oration. I guess in my mind I was picturing small clinics with 1970s hand-me-down tables and equipment. Instead, the clinics seemed very modern and were well-stocked with supplies one would expect to find in any primary care setting; structure, local anesthetics, splinting and casting materials, autoclaves, centrifuges, etc. The sample medications stocked were a good mix of the usual suspects: antihypertensives, hypoglycemcis, antibiotics, antidepressants. The computer systems allowed quick access to lab results and diagnostic tests (turnaround often less than a day), and a unique tape recorder allowed dictations to travel through the computer to the transcription, who had them ready to print the next day.

The clinics are all models of efficiency. Patients are scheduled in a realistic fashion, meaning a newly diagnosed diabetic is given more time than a routine sports physical. Schedules are never jammed with patients, leaving room for the inevitable complication or emergency. The most patients we ever saw in one day was 22, and I feel that each of these patient was given an adequate and appropriate amount of time and care. The PAs were all very thorough overlooking no aspect of the patient’s all-around health. Adding to the unhurried style was the attitude of the individual patients, none of whom ever complained about having to wait for care; no one ever felt that their circumstance was more dire or acute than that of the patient we were currently treating.

My community project was with the girls at Clearview, a home for high-risk teens in Heron. I made lunch and gave a talk on good nutrition, and did one-on-one nutrition counseling with those who requested it (I’m a registered dietitian). At the time I set up this project, I guess I didn’t realize all these girls were from other parts of the country. Upon admission to Clearview, they were brought to Bull River Clinic for physical exams, and that’s how I got to know a few of them as well as one of the directors. I thing a project for future students that would better serve the “community” would be a series of lectures for local high school students, with topics including nutrition, exercise (including how to keep fit in the winter months), alcohol and drug awareness, and sexual health (STD prevention and family planning).

Everyone I met in Montana – from preceptors to coworkers to patients to people around town – was exceptionally nice and helpful. I had a fabulous time kayaking, hiking, and checking out all the festivals and specialty stores I the surrounding communities during my days off. The rural areas in Montana are pure without being primitive. They have preserved the true spirit of community. Healthcare providers here are not only professional, but friends and neighbors. Karin belongs to quilting and book clubs, and also sits o n the Thompson Falls school board. I would encourage anyone who may be frustrated with the increasingly impersonal “healthcare mills” of bigger cities to try working in one of these communities. There’s no bigger satisfaction than coming home every day feeling like you’ve made a difference.

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