Rural Medicine and Rural Ministry
Anne, a high school classmate of mine, has settled in the Vermont countryside, where she raises her two daughters and indulges her love of horses and motorcycles. We keep in touch on Facebook, where she linked to this recent article about rural health care — more precisely, about the challenge of finding young physicians with the gifts and passion (one might even say the call) to work in a rural area.
The article profiled Sarah Carricaburu, a young doctor participating in the National Health Service Corps. This federal program gives incentives to recent medical school graduates who agree serve as primary care doctors in rural communities. In exchange for three years of service in a rural clinic, Sarah will receive $50,000 to use toward relieving her med school debt.
It seems unlikely Sarah will stay beyond that three-year minimum. Rural life doesn't seem to suit her. The dating prospects for young single people are not so hot. Shopping and cultural amenities are too scarce for her liking. Professionally, she is frustrated by the poor Internet access and other technological limitations in her rural Virginia clinic.
Likewise, the community has been a little slow to warm up to Dr. Sarah. It's nothing personal, but patients have felt burned before by doctors who treated their community as a stepping stone on the way to a bigger, better-resourced place to live and work.
My friend Anne highlighted this story to illustrate her frustration with the caliber of medical care in her area. She has struggled to find a doctor she both likes and trusts — someone who combines competence with people skills suited to a rural practice. Her experience is a common one, no doubt. But to me, it sounds like the situation that a pastor in a small congregation often faces, whether he or she is right out of seminary or“newly new” in a new conference appointment.
To arrive with the attitude of a savior, who knows what's wrong with the community and how to fix it, is to invite failure. The new pastor needs to be humble, to do more listening than speaking, to appreciate the assets that do exist in the community, to learn the local story, and to discern how God might fit him or her into the story.
For its part, a faithful community should welcome newcomers, mentor them, and model the ways to live and work in that place. Many congregations would do well to study the example of the staff and leadership of Southern Albemarle Family Practice. The staff supports Dr. Sarah with genuine care and wisdom. Alongside Dr. Sarah in the rural clinic are two more veteran doctors. They've found the way to balance their personal lives and professional lives, make do with the resources at hand, and find joy in rural living as well as in the practice of family medicine, as routine as it often is. The marriage of worker to workplace may not succeed in the case of Dr. Sarah, but in the practices of hospitality, mentoring, and modeling, this clinic has kept faith.
The National Health Service Corps is reminiscent of the Duke Divinity School program Thriving Rural Communities, which offers full-tuition fellowships for ministry students who pledge to serve a certain number of years pastoring in a rural congregation. As with Dr. Sarah, told by one of her med school professors that she was “too smart” to practice family medicine in a small community, there exists a stigma about rural ministry in some corners of the institutional church, a stigma that Thriving Rural Communities seeks to remedy.
Even with the best spirit and best intentions, though, the umbrella institutions that resource and support rural life can be clumsy. Dr. Sarah has some legitimate gripes with the help offered by the Service Corps. Even where the Corps has named the issues correctly, it may not have found the right means to deliver assistance. The“mother ship” often has a faulty understanding of conditions on the ground. Even more than the individual newcomers, the institutions need to be humble and constantly seek the wise input of its end users, the rural caregivers, whether in ministry or medicine. They face the greatest challenge.
John James, M.A.
Clergy Health Initiative