In seriousness, I think that rural medicine in general is the only place you are going to be pushed to the limits of your training and feel the need to use all those skills regularly. The more you practice within a community of specialists and a certain culture, the more you will feel the pressure to practice like other members of that medical community. When you go against the grain, you not only risk significant liability but I find that morally it is difficult to justify treating a complex condition yourself if another provider is available and has more experience with said condition. If you have no choice, then assuming the risk of treatment of the complex is much less an issue.
