Growing healthcare locally
A lot of attention has been paid lately to the health and economic benefits of locally grown fruits and vegetables. But at least one local doctor is interested in growing a different kind of local crop: healthcare professionals.
"I recognized-through my training, my residency, through other doctors that I know-that the way to get our healthcare needs filled, is by growing up our own healthcare workers," said Dr. Sarita Bennett.
Bennett grew up in Green Bank at a time when there really wasn't a full-time doctor in the community.
"Mostly I remember relying on Jane Hamed," Bennett said. "She was the public health nurse-Nurse Jane. She was the one everyone relied on. And we all knew that if you needed somebody, she was the woman you called when there was a crisis or when you needed advice. I can remember her coming to our house in the middle of the night, more than once."
With Hamed's work serving as an inspiration, Bennett herself went into healthcare. But if it wasn't for her love of her community and the resources that she already had here-family ties, a husband who had carpentry skills help to set up an office-Bennett isn't sure she could have made it as a doctor in Pocahontas County.
As she has worked to recruit younger practitioners to take over her clinic, her own struggles to get started have been at the forefront of her mind.
"I knew as a private practitioner who didn't have anyone to help me with my student loans or set me up into practice-that didn't have anyone to make it easier for me-I knew what that took," Bennett said. "I know the responsibility level of it, and I knew the struggle of it. I couldn't really see that we would expect most people to do that."
In particular, the burden of student debt has become a hurdle to new medical school graduates who might consider setting up practice in a rural area.
"When you graduate from any kind of health sciences program, especially medical school, you're so far in debt, there is no way you can come into a rural area, unless somebody helps you," said Bennett. "In 1998, when I graduated, average debt was $120,000."
When she attended a medical school graduation in 2009, Bennett learned that average debt load had grown to $200,000 for four years of medical school.
"You can't come into Pocahontas County, set yourself up to practice and pay the payment for that and live," she said "You just can't."
"So they have to go somewhere," Bennett continued. "The problem is they go somewhere and they don't come back."
The solution: find young practitioners who already have strong roots in Pocahontas County and help them find ways to pay down their med school debt.
So far, Bennett has brought two recent Pocahontas County High School graduates into her clinic as physician assistants. She's also working to bring two more Pocahontas County natives back as family practice physicians.
"The young ladies that I've worked to recruit-all but one of them is married to a local fellow," Bennett said. "At least two of them are already farmers, so the spouse is already here. They grew up here. They're ready to stay here. They want their children to grow up here. They have family connections. But we have to be able to afford to get them back here."
For that last part, Bennett recently partnered with Tri-County healthcare, which is today Community Care of West Virginia. As a Federally Qualified Health Center, CCWV enabled Bennett's clinic to tap into student loan forgiveness and a higher salary scale.
Rachel Wayne Taylor, who works with Bennett at the clinic in Durbin, said the student loan forgiveness made all the difference for her to be able to come back to Pocahontas County. She has been practicing under Bennett after graduating from the physician assistant program at Alderson Broadus College in 2009.
"I was looking around at jobs at other places," said Taylor, "but I knew I wanted to come back here and raise my family."
"I always wanted to return here, because I enjoyed growing up here," Taylor continued. "I don't think you can find any better people out there. I wanted to be able to give back to the community that brought me up."
Through her work with Bennett and Community Care of West Virginia, Taylor's country is now giving back to her. Through the National Health Service Corps, healthcare professionals like Taylor can receive up to $50,000 in student loan forgiveness if they commit to serving in an underserved area for at least two years.
Taylor's counterpart at the Marlinton clinic, physician assistant Valarie Monico, is also thankful to be able to practice medicine in the community where she grew up. Monico graduated from Alderson Broadus and started with Bennett a year ahead of Taylor. While she hasn't been able to take advantage of the student loan benefits, Monico said she, too, plans to stay in Pocahontas County.
"Having my family and everything I know and love here really helps," Monico said. "I really like the people here, and I think I relate really well with them because I'm from here."
While Bennett has worked hard, in partnership with Community Care of West Virginia, to recruit physicians assistants like Taylor, Monico, and two physicians who are in the process of coming back to the community, she sees the schools and the county hospital as important partners in growing the next generation of local healthcare providers.
With the recent change in management, Bennett said she sees the hospital making the right steps toward both keeping the hospital running and recruiting the kinds of medical professionals who will stay in Pocahontas County.
The schools, she said, are critical in cultivating good study habits and critical thinking skills. But Bennett said she'd like to see more opportunities for one-on-one mentorship with young professionals who graduated from PCHS and have returned to the community. As a community, Bennett said she would like to see Pocahontas County set higher expectations for its youth.
"What I see from when I graduated, to when my children graduated, is that kids in Pocahontas County often do not realize what they are capable of," she said. "Yes, you are smart enough to be a dentist. You are smart enough to be whatever it is you want to be. Sometimes you need to improve your study skills, but I think we underestimate our kids by not having high enough expectations."
In addition to education and recruitment, Bennett feels there is a third component to growing the local healthcare community: making it possible for a woman to deliver a baby in Pocahontas County.
In West Virginia, Bennett explains, a physician assistant can enroll in a Masters of Midwifery program and become a midwife, without being a nurse first.
"In a low-volume area like this, you need workers who can cross-train and do more than one thing," Bennett said.
But how does delivering babies in Pocahontas County, versus Lewisburg, build up the healthcare community here? According to Bennett, some important decisions are made immediately after a child's birth.
"When a woman goes to Greenbrier Valley to have a baby, the nurse doesn't ask, 'What family practice doctor in Pocahontas County are you going to take your baby to?" Bennett said. "They ask, which of our pediatricians would you like to schedule your child to see?'"
From a purely economic standpoint, Bennett said, this question contributes to the outflow of money from Pocahontas County.
"It's not just that we lost the healthcare dollars from that birth and all the shopping dollars from all the times they went to Lewisburg for their prenatal care," said Bennett. "Now we've lost the healthcare dollars from that child, who goes to Lewisburg to see the pediatrician, when we have family practice people here in this county, well-trained to take care of pediatrics."
"Yes, there's a limit to what any of us should do before we transfer them on," Bennett added, "but well-child visits and taking care of a new baby? We can do that in Pocahontas County."