The joys of practicing rural emergency medicine

From Edwin Leap, posting on the Kevin MD blog:

I practice in the rural, northwest corner of South Carolina, also known as “The Upstate.” It is a place of expansive lakes, white-water rivers and the mist covered foothills of the Blue Ridge Mountains. The area includes thousands of acres of Sumter National Forest. The natural beauty is breathtaking. Sumter National Forest and our various parks are laced with hiking trails, which are lined with unique plants and trees, some found nowhere else. Fish and game abound. In fact, our wooded hospital grounds support a flock of at least 30 wild turkey. And last deer season, the only deer I saw were the three does grazing at the end of the ED driveway one night, spotlighted by two of our paramedics.

But, as physicians in a rural area, we pay a price. Because we have to endure a certain stigma. The stigma is this: if you practice in a small, rural hospital, you must be less than competent. Because if you were competent, you’d practice in a large, urban teaching/trauma center.