By Timothy Lemaire, DO, MPH, Norton Sound Health Corporation, Nome, Alaska
There is no place like Nome. That’s what they say anyway. But it’s true. I am an osteopathic family medicine physician in Nome, which is located in rural Alaska. After graduating from the A.T. Still University School of Osteopathic Medicine in Arizona, I moved to Alaska for residency. The breadth and depth of training available attracted me to the state. Upon graduating from my residency program, I moved further into Alaska for adventure.
The challenges of delivering health care in a small town like Nome, accessible only by air, are unique to say the least. I work in Nome for the Norton Sound Health Corporation, a non-profit hospital that provides critical access care to the Norton Sound region of Alaska. We cover 15 villages over 23,000 square miles populated by about 10,000 people of Alaska Native and non-native descent. Each village has a small clinic staffed primarily by health aides who are trained in basic first aid and work through algorithms to diagnose and treat common complaints. Anything emergent from the villages gets flown to Nome for further evaluation.
One of the great things about Nome is that I get to practice full spectrum medicine. I rotate through the ER, manage our 20-bed inpatient wing, practice prenatal and obstetrical care, work in the outpatient clinic, and make trips to the villages to see patients in their homes. Many of the villages have challenges you might not expect in America in 2019. Often, folks don’t have running water and use an outhouse or honey bucket. Most have electricity and heat sources, but heating oil is very expensive. Each village has a small store, stocked with highly processed foods like what you might find in a convenience store, where everything is about three times the normal price. Most people supplement their diet by hunting and fishing because jobs are scarce. Needless to say, there are great opportunities for public health projects.
The student loan repayment options are good in such an underserved area, but the challenges associated with navigating the loan repayment landscape remain. I find myself on the FedLoan website more often than I would like, trying to constantly make sure I qualify for the federal Public Service Loan Forgiveness and income-based repayment programs. The resources published by AACOM have been instrumental in helping me stay on track and up to date.
The experience I gained as a former AACOM Council of Osteopathic Student Government Presidents member and during advocacy days on Capitol Hill not only provided an early introduction to health policy and political advocacy, but have also been the foundation for my advocacy efforts throughout residency, when I started a street medicine outreach program. Serving as a founding member of the AACOM Residents and Fellows Council has helped me stay up to date on current issues facing osteopathic medical education. Now, as a new physician working in an area with such unique health care needs, I am partnering with the state office of public health to track tuberculosis cases and individuals experiencing homelessness.
Without the help of federal student aid, my desire to give back to my community as a physician would have remained just a dream. The importance of advocating for ourselves and our patients cannot be overstated. Without national government support, either in the form of loan forgiveness or funding for our clinics and educational institutions, we could not provide the care our communities need. Join me in committing to take one step toward increasing your advocacy footprint. Read the AACOM Washington Insider and write your legislators. A personal note can go farther than you think.
The views and opinions expressed are those of the author(s) and do not imply endorsement by AACOM.