Small towns make a big impact.”
I applied to the REHPS program in hopes to learn more about rural health and that is exactly what I experienced. I was placed in Platte, SD a town of about 1,200 people and I stayed with a local family in their guest house. My preceptor was Tia Hanes who graduated from the USD physician assistant program about 8 years ago and has worked in Platte since. I traveled to other small communities nearly every day to provide health care. I traveled to White Lake, SD and Geddes, SD. Those small clinics are where I learned the most. In those clinics, I had to use more clinic-based medicine in order to diagnose and treat patients because they did not have imaging or lab in the clinic. At first, I was hesitant to not order labs and imaging on patients because that was all I have been used to in larger towns. However, I am grateful because I learned how to rely more on my patient interviewing skills and their history to make diagnoses and treatment plans. In the end, the small clinics made me a better student because I learned that a lot of lab and imaging are unnecessary. I was taught in school that if I order something, I need to know what it will show and what I am going to do with the results. For example, if someone came into the clinic with a cough and congestion, I would diagnose off the interview and physical exam. Tia would tell patients if they were not better in a week or symptoms worsen then she would order labs and imaging. I will incorporate what I learned into my future practice. During my time, I also found that small towns are really small. You may see your patient at the grocery store in the afternoon and then again later at the gas station. Learning how to be friendly and not break HIPPA rules was tough but was absolutely doable. Knowing you helped that person earlier in the day was rewarding. The other REHPS student was a nursing student. Part of the program was also to learn about the other’s career. As a future PA-C, a nurse is everything. They truly are a great and needed asset. We would go for walks after work and talk about something new we learned each day. I will never forget my time here in Platte, SD and I am grateful and thankful for this opportunity to be a part of the REHPS program.