Growing up in small town western North Carolina, I had a childhood that is enviable nowadays, complete with afternoons at Grandma’s house and sliding down miniscule waterfalls carved out of the shallow mountains on our garbage can lids. There were no video games, iPads, or cellphones – not because those things didn’t exist, they just didn’t exist in our lives; and we were never worried about our lack of exposure to these things. It wasn’t until I got a little older that I realized the same nostalgic beauty shared by my rural grandparents’ lives and the lives of small, rural areas all over the US also had many uncomfortable parallels in their states of public health and preventative care.
As I got older, my pride of place never waned, but my knowledge of the shortcomings of healthcare and its challenges in rural settings became more present. I absolutely love being from the rural south, and after attending a fancy college, graduate school, and ultimately getting into medical school, the question was never, “Will I return to small town North Carolina?”, it was, “How will I become the most useful physician possible to suit the specific needs of small town North Carolina?”. I discovered early on in med school, if not before, that I was bound for a passionate advocation of full-scope family medicine for both myself and others who are hoping to take their talents to rural areas of America and make a difference. It was after hearing a doctor on faculty at my medical school speak about his journey to starting his direct primary care (DPC) office that I realized DPC was my missing piece. I knew I wanted to practice full scope, but having grown up in a small rural town, I also knew that my main fight for keeping people healthy wouldn’t be just with the people already plugged into a primary care practice, it would also be with those that never make it to any practice. My fight for true full scope care in rural NC would be with the financial stigma of access to care and the battle of prevention for many who are uninsured and would rather visit the ER in dire scenarios than pay premiums they can’t afford to potentially only visit a doctor two hours away once every couple of years.
After that initial foray into the ideology behind direct primary care, I have been able to meet many more people in the movement. These people have successfully built or are planning to build clinics where people can pay a monthly fee and be seen by their doctor, a doctor they know well and at a rate of about 75-80, sometimes 90% less than what insurance premiums cost. I know that my work in medical school, learning everything I can about pathology, prevention, and the different aspects of care would all be for naught if, upon completion, no patients believe they can still reasonably visit a doctor for more than emergencies. I now know that with the direct primary care model, I can help carve a space in my hometown and other rural areas in North Carolina for the sanctity of the country doctor, one whose services were affordable; and in achieving that, edging the pendulum closer to the triumph of preventative health in places where people deserve the best quality of care and of life that I can bring.
Claire Lockman is an M2 at Liberty University College of Osteopathic Medicine. She is currently the President of LUCOM’s American College of Osteopathic Family Physicians Chapter and serves on the Board of Directors for the Virginia Association of Family Physicians as Student Director.