Only 18 miles separate the small city of Huntington, W.Va. (pop. 49,000), from the rural town of Wayne, W.Va. (pop. 1,105). But there is a much wider gulf in the character of the two communities, said Daniel Whitmore, ACP Member, who divides his time between both.
“Patients in bigger cities can be more demanding, but my rural patients are very trusting in me,” said Dr. Whitmore, who sees patients at Valley Health clinics in Wayne and Huntington, as well as Cabell Huntington Hospital. “They think I am the only doctor they should ever see; they don't want to get sent to a specialist. I see a lot of complex, challenging cases as a result, and it helps me keep my skills up.”
It is this enthusiasm for rural medicine, coupled with a desire to share his experience with medical students and residents, that won Dr. Whitmore the Outstanding Rural Clinician of the Year award from Marshall University School of Medicine in May. Dr. Whitmore volunteers as an unpaid mentor to Marshall medical students in Huntington, as well as to students from the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, W.Va.
Inspired by his own rural mentors as a resident at Geisinger Medical Center in Danville, Pa., and as a medical student at WVSOM, Dr. Whitmore knew early on that teaching would play a major role in his career as a physician.
“To this day, I can tell you which three or four attending physicians developed me into the physician I am today,” said Dr. Whitmore, who is director of internal medicine and pediatrics for Valley Health in Huntington. “As a medical student, I made up my mind that once I got licensed and became a practicing physician, I would go on to do the same things they did, because they helped me out so much.”
Dr. Whitmore especially appreciated the mentors who made time to talk with him every day about the pathologies they'd seen during rounds. It's a practice that he's passed along to students like Sarah Roesch, a third-year student at WVSOM who spent a month with Dr. Whitmore in September.
“Even though his day was jam-packed with seeing patients, Dr. Whitmore would talk to me every day, either as new clinical things came up while we were seeing patients, or to tell me what it was like to balance being a doctor with having a family,” Ms. Roesch said. “These can be hard things to learn in a class.”
Dr. Whitmore has mentored a new student or resident nearly every month for the past four years. They accompany him to the two clinics and to Cabell Huntington Hospital, where he spends one week per month managing hospital care.
“The students I mentor get a taste of hospital medicine, and a taste of what an in-town population is like compared to a rural country population. When they see all this, it helps them decide what fits their life,” Dr. Whitmore said.
In the beginning of the mentorship, Dr. Whitmore will have the student or resident watch as he's examining a patient, all the while explaining what he's looking for and thinking about. He then moves on to having the student examine patients while he supervises. The final part of the rotation has the student examining patients alone, then coming back to Dr. Whitmore and discussing what he or she saw and did. Student and mentor then go back into the exam room and see the patient together.
“Wherever we were and whatever the setting, it was a constant learning experience,” said Ms. Roesch. “Even though I wasn't used to being in a hospital, he let me do histories and physical exams there, as well as in the clinics. He didn't want me to just hurry up and get done with the rounds; he wanted to teach me.”
One of Dr. Whitmore's main goals is to stimulate interest in primary care, since fewer students are choosing to go into that area, he said.
“I feel I have a responsibility to try to keep the profession going,” Dr. Whitmore said. “If students are undecided and they hear all the bad things about primary care and how difficult things are, it can pull them away. So if you can connect with them, it gives them a little bit of encouragement.”
The internist also enjoys showing students and residents the unique joys of doctoring a rural population—like the fact that you tend to know a patient's entire family, and quite a bit about his or her life as well, he said. Treating rural patients can be especially rewarding for those budding physicians who grew up in rural areas themselves, he added.
“When a patient comes in and gives me a hug, or wants to take me outside to show me the six-point buck he got during hunting season, the students see that medicine can be personal and subjective. Nowadays it can seem like medicine is more about business, but when you go to this rural setting where people appreciate you, the students see how it can bring a lot of satisfaction,” Dr. Whitmore said.
For Ms. Roesch, the rotation with Dr. Whitmore didn't completely clarify the kind of medicine she wants to practice—whether internal medicine, pediatrics or specialty—nor the setting in which she wants to practice it. But it did clarify the kind of doctor she wants to be.
“What I learned from him was how I wanted to treat my patients. He took the time and effort to know the patients and their families so well,” Ms. Roesch said. “It made me want to be a better doctor—and a mentor someday, too.”