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Profile of a Rural FP: Risha Raven, MD
Dr. Risha Raven with twin daughters Hana and Nora (born the same day as NASA's Mission to Pluto launched -- See http://pluto.jhuapl.edu/education/plutoPals for more pictures).
Name: Risha Raven, MD (Polo, IL)
Clinic: KSB Medical Group - Polo Office
Years an FP: 8
Years a Rural FP: 8
HPSA-designated Community? Yes
Critical Access Designated Hospital? No
What prompted you to become a rural family physician?
I never expected to do rural medicine when I was training. My residency was urban, but in a small community hospital. It taught me how to care for a broad range of issues, while allowing me to refer those that were beyond the scope of our resources. When a recruiter told me about the job in rural Illinois, I was curious. I loved camping and visiting the country. When the urban offerings were compared with the rural one, the choice was obvious. The people out here were open to suggestions and allowed me to make my patients my priority. The fresh air and lack of traffic jams were a major bonus.
I never expected to do rural medicine when I was training. My residency was urban, but in a small community hospital. It taught me how to care for a broad range of issues, while allowing me to refer those that were beyond the scope of our resources. When a recruiter told me about the job in rural Illinois, I was curious. I loved camping and visiting the country. When the urban offerings were compared with the rural one, the choice was obvious. The people out here were open to suggestions and allowed me to make my patients my priority. The fresh air and lack of traffic jams were a major bonus.
Leah, Given, Hana and Nora
Community
My office is in Polo, a community of 2,500. The entire town is the same population as my high school back in Chicago. The hospital is 15 miles away through corn and soy fields with a detour through an even smaller town. There are no stop lights in town and no stop signs on the main street. I know this because my daughter was hit by a car crossing it in a rush one day. Her leg healed just fine. When my twins were born, people really did bring us meals... people I hardly knew. The community really does try to look out for each other. There are three schools (one for each level), one library and the senior center. An abandoned school in disrepair and the average number of for sale signs in town shows we haven't escaped the economy completely. We couldn't quite support the day-care we tried to open, but the need is significant. There are a lot of young families, retirees, farmers, factory workers, students and professionals, as well as the occasional camper. We have a nursing home in town. In addition to my office, a dentist's office and an office with a doctor from the other nearby hospital, Polo also has rotating physical and speech therapists and two chiropractors. So as far as "rural" goes, I feel we have reasonable resources.
My office is in Polo, a community of 2,500. The entire town is the same population as my high school back in Chicago. The hospital is 15 miles away through corn and soy fields with a detour through an even smaller town. There are no stop lights in town and no stop signs on the main street. I know this because my daughter was hit by a car crossing it in a rush one day. Her leg healed just fine. When my twins were born, people really did bring us meals... people I hardly knew. The community really does try to look out for each other. There are three schools (one for each level), one library and the senior center. An abandoned school in disrepair and the average number of for sale signs in town shows we haven't escaped the economy completely. We couldn't quite support the day-care we tried to open, but the need is significant. There are a lot of young families, retirees, farmers, factory workers, students and professionals, as well as the occasional camper. We have a nursing home in town. In addition to my office, a dentist's office and an office with a doctor from the other nearby hospital, Polo also has rotating physical and speech therapists and two chiropractors. So as far as "rural" goes, I feel we have reasonable resources.
Dr. Risha Raven in her Polo, IL office.
Clinic
My office is a satellite of the hospital in Dixon. After-hours and weekend calls are answered personally unless one of the other doctors in our group is covering. I see prenatal, pediatric, adult, geriatric and nursing home patients. We do preventive care and keep appointments open for urgent needs when possible. There is a prompt care office near the hospital and the ER that patients are referred to when needed. The office occasionally has to reschedule patients if a birth or critical patient calls me away. We recently started converting our charting to computerized, so we are closed to new patients, except for family members of established patients. Most people in our town are relatives of patients of mine in some way. I do get asked often when I will open up again to new patients, and hope to do so soon.
My office is a satellite of the hospital in Dixon. After-hours and weekend calls are answered personally unless one of the other doctors in our group is covering. I see prenatal, pediatric, adult, geriatric and nursing home patients. We do preventive care and keep appointments open for urgent needs when possible. There is a prompt care office near the hospital and the ER that patients are referred to when needed. The office occasionally has to reschedule patients if a birth or critical patient calls me away. We recently started converting our charting to computerized, so we are closed to new patients, except for family members of established patients. Most people in our town are relatives of patients of mine in some way. I do get asked often when I will open up again to new patients, and hope to do so soon.
Hana and Nora with the goats.
Typical Day
A typical day for me starts with checking the computer to make sure no loose ends are needing my attention. I rarely get calls at home overnight. If the hospital is quiet, I enjoy watching the sun wake up with the kids before heading off to the office. My office currently sees an average of a dozen patients daily. I'm the only doctor in the office, however I see others regularly when I work with the FP residents and at hospital meetings in Dixon. Preventive care and enough time for a good encounter are priorities. With learning the EMR and trying to sort through years of paper information, it can take a great deal of time. Some of my partners who still use paper charts or are more experienced with the EMR probably see triple my load. If no patients go into labor or need hospital care during the day, after hours I get to go home to my farm and check on the kids and the animals. We try to grow our own food, a luxury not available to omnivores in the city. A birth in the middle of the week is a great break from household nightly chores. If I am tied up at the hospital, coming home to sleeping kids and eggs in the hen house can be a nice end to the day too.
I love catching healthy babies and watching a new mom and baby learn to breastfeed. Being able to do OB is a big reason I like rural medicine. In the city, specialists drive generalists out of some fields like OB. Out here, they are glad to share the business. I remember one July 4th when the OB and I delivered four or five within hours. She would be downstairs sewing up mine that she c-sectioned and I would run up and catch hers that couldn't wait. She was shocked that her patients didn't need episiotomies when I was there. Really, it was great fun!
A typical day for me starts with checking the computer to make sure no loose ends are needing my attention. I rarely get calls at home overnight. If the hospital is quiet, I enjoy watching the sun wake up with the kids before heading off to the office. My office currently sees an average of a dozen patients daily. I'm the only doctor in the office, however I see others regularly when I work with the FP residents and at hospital meetings in Dixon. Preventive care and enough time for a good encounter are priorities. With learning the EMR and trying to sort through years of paper information, it can take a great deal of time. Some of my partners who still use paper charts or are more experienced with the EMR probably see triple my load. If no patients go into labor or need hospital care during the day, after hours I get to go home to my farm and check on the kids and the animals. We try to grow our own food, a luxury not available to omnivores in the city. A birth in the middle of the week is a great break from household nightly chores. If I am tied up at the hospital, coming home to sleeping kids and eggs in the hen house can be a nice end to the day too.
I love catching healthy babies and watching a new mom and baby learn to breastfeed. Being able to do OB is a big reason I like rural medicine. In the city, specialists drive generalists out of some fields like OB. Out here, they are glad to share the business. I remember one July 4th when the OB and I delivered four or five within hours. She would be downstairs sewing up mine that she c-sectioned and I would run up and catch hers that couldn't wait. She was shocked that her patients didn't need episiotomies when I was there. Really, it was great fun!
Challenges
The greatest challenge of rural medicine is referrals. The distance to specialists when you really want help is an issue as is the closeness of the community. A phone consult is the quickest remedy when you want a specialist in a crunch. We have to ask patients to drive to consults and transfer inpatients to tertiary care when needed. The challenge of the community closeness is that you need to draw the line between professional and personal. Patients easily become friends here, and it's hard not to answer medical questions and give advice outside of the office. Patients usually understand that keeping a good record of needs can be important and care outside of the office can lead to forgotten preventive care. When I feel that there is a real conflict between my role as a doctor and as a friend, I sometimes refer them for care and act as advocate and remind them to go to their appointments and follow their new doctor's advice.
The greatest challenge of rural medicine is referrals. The distance to specialists when you really want help is an issue as is the closeness of the community. A phone consult is the quickest remedy when you want a specialist in a crunch. We have to ask patients to drive to consults and transfer inpatients to tertiary care when needed. The challenge of the community closeness is that you need to draw the line between professional and personal. Patients easily become friends here, and it's hard not to answer medical questions and give advice outside of the office. Patients usually understand that keeping a good record of needs can be important and care outside of the office can lead to forgotten preventive care. When I feel that there is a real conflict between my role as a doctor and as a friend, I sometimes refer them for care and act as advocate and remind them to go to their appointments and follow their new doctor's advice.
Rewards
The greatest reward is knowing that you make a difference in people's lives. Even in the middle of nowhere, patients can choose to go to other doctors or go without. I get referrals from midwives and natural medicine types and other doctors as well as current patients. When people are willing to work with my schedule and refer others to my practice, it says I must be doing something right.
The greatest reward is knowing that you make a difference in people's lives. Even in the middle of nowhere, patients can choose to go to other doctors or go without. I get referrals from midwives and natural medicine types and other doctors as well as current patients. When people are willing to work with my schedule and refer others to my practice, it says I must be doing something right.
Advice
Rural medicine is an area that is unknown by most but ideal for the family physician. Rural family physicians get to stay involved in all aspects of patient care. You see the oddities that the city doctor misses due to the easy access of urban specialists. You see the girl who grows up and starts her family. You see her grandma in the nursing home. You see the entire family. Additionally, you develop relationships with your office staff, the hospital and nursing home, the local pharmacies and medical supply providers and the larger community. Overall, you get the autonomy to develop your own style within the culture of a larger group.
Rural medicine is an area that is unknown by most but ideal for the family physician. Rural family physicians get to stay involved in all aspects of patient care. You see the oddities that the city doctor misses due to the easy access of urban specialists. You see the girl who grows up and starts her family. You see her grandma in the nursing home. You see the entire family. Additionally, you develop relationships with your office staff, the hospital and nursing home, the local pharmacies and medical supply providers and the larger community. Overall, you get the autonomy to develop your own style within the culture of a larger group.
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