Rural Otolaryngology Experience

[UncleMinnie]

I was at a job fair recently and started to talk to some recruiters and doctors present that were working for rural practices and rural hospitals. I left the experience feeling decently sold about potentially going a bit rural (3-4 hours from a large airport) after residecny. It seems like the medical communities in many of these locations are tight-knit (for better or for worse) and it seems like it would be easier to be a generalist out there (I can let them know that I'm comfortable removing their thyroid lobe or performing their primary tymp/mastoid for cholesteatoma, but that they also can choose to drive 4 hours to see someone that almost does that one thing exclusively). If anyone has some experience to share, personal or what they've heard from others, I would love to hear it. My spouse and I grew up in a mid-sized city, but feel open to being rural, where we might be able to get out of debt and become financially independent much faster with the low cost of living and higher advertised incomes. We're not sure how it would be good or bad for our kids exactly, but I know plenty of weirdos and plenty of charmers from either urban or rural locations, so I'm sure they'd be as good as they're gonna be either way. Anyhow, I would love to hear from the audience.

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[HighPriest]

I’m about in that range, maybe 2 hours from a major airport. I think there’s a huge benefit for all the reasons you have mentioned. I do think that you can get so far away that it can work against you as well. Patients don’t want to drive 2 hours to a major tertiary care center where I am, let alone 4. They will do it if they have to do it, but there can be a lot of pressure to not send something away. Which is -great- if you want to do it, but kind of a PITA if it’s something you don’t want to do. I realize that is mostly an ego thing, but I have to stop myself sometimes from doing things that I know I’ll regret having done.

But definitely the pros outweigh the cons, for me.

Plus, you don’t get sidetracked into a crumbs and leftovers practice as a generalist like you sometimes can in a city. If there are three head and neck guys, two neuro-otologists, five rhinologists, two laryngologists, and 30 facial plastic surgeons within a two mile radius of your practice, you can end up being the guy who does mostly in-house trach management and neck abscesses on heroin addicts. No one wants to be that guy.

 

[Pir8DeacDoc]

I've always practiced in rural America- though not quite as removed as you are mentioning (1hr or so to local airport and 2hrs to major airport). Your thoughts seem on track with my experience. You can dabble in whatever you want and send along the rest (since I've never been 4 hours from an academic hospital it's not prohibitive to refer). Downside of rural America is lack of other docs. You can easily become the de facto dentist because nowhere has dentists on call. Hard to get patients to rheumatology or pulmonology. But overall I've found it a very rewarding way to practice.