Living and Practicing In a Rural Town

by Jarrod Shapiro, DPM
Joined Mountain View Medical & Surgical Associates of Madras, Oregon July 2008
John Mellancamp may have been born in a small town, but I wasn’t. I’ve lived in large cities for the majority of my life (New York, Phoenix, San Francisco, Detroit), so moving to a rural town is quite a change. Many of these changes are positive, and some of them require some “getting used to.” As you may already know, rural medicine has become an increasingly common choice for physicians. However, choosing this type of practice requires some research and understanding both about the place you’ll be practicing and about yourself. Rural town life is not for everyone. With this in mind, I’d like to review some of the pros and cons about living and practicing in a small town, with the goal that I can stimulate some thoughts for those of you who may be considering this option.

As I’ve mentioned previously, I moved to a small town in Central Oregon one month ago.
Madras has a population of 6585 people with the nearest “larger” town being Bend, Oregon (45 miles away, pop. almost

78,000). Prior to moving here, I researched the local census and growth information, which was very positive. Bend had exploded in population over the last few years, and the local smaller towns subsequently received the spillover. Growth in the area had been between 4% and 10% (before the economy plummeted). I additionally spend time in a satellite office in Prineville, Oregon (pop approx 10,000). Between the two areas and surrounding towns, I should have enough patients for the short term with a stable long-term estimated growth.

Here are some of the BENEFITS of living in a small town: (Remember, some of you may consider some of these benefits to be disadvantages. If you dislike the concepts listed below, then small town life is not for you.)

Everyone knows you eventually.  There’s no such thing as anonymity in a small town.  For example, I’m renting my house from the fire chief.
Short drive time to work with little to no traffic.  My primary office is 5 minutes away, while the satellite office is 30 minutes.
You will see your patients and coworkers outside the office For example, one of my patients is a local restaurant owner.
Natural beauty with various outdoor activities.  The Central Oregon area if full of lakes, hiking, biking, and fishing opportunities, as well as beautiful rugged vistas.
Quiet. 
$5000 tax credit for physicians in rural areas.

Since nothing is perfect, here are the DISADVANTAGES to small town life.

Everyone knows you eventually. There’s no such thing as anonymity in a small town.
Spartan services. The town is conspicuously absent a book store, movie theater, good grocery store, clothing stores, and a nice restaurant. I look at these as potential future business investments. The nearest Wal-Mart is 25 minutes away, and the closest Target is 45 minutes away.
More expensive services. Small towns are usually afraid of having large “big box” companies set up in their areas for fear of destroying competition. As a result there are many small businesses with good services, but with more expensive prices. Less competition makes for higher prices.
Greater effects when the economy turns down.  Many small towns rely on one or two larger employers.  For instance, Madras has a lumber processing plant that employs a good number of people. 
Quiet.  For some who’ve grown up listening to car horns and the bustle of city life, the quiet of rural areas may be difficult to tolerate.

So, the city boy has now become the country doc. I’m very happy with the move I’ve made and feel the advantages clearly outweigh the disadvantages. A piece of advice many of us have heard is to practice in a place you want to live. I have to echo these sentiments. For those of you in practice in small towns or rural areas, write in with your experiences. The rest of us would benefit greatly from your perspective. Best wishes.


Jarrod Shapiro, DPM
PRESENT New Docs Editor
[email protected]

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