Words: Alex Branch
Photos: Jill Johnson
Design: Carl Bluemel & Mike Brown
CLIFTON, Texas — Dr. Kevin Blanton rises at 4:30 a.m., makes his coffee and breakfast and fires up his computer to glance at patient charts, lab results and X-rays.
Soon, he climbs into his GMC Sierra pickup and makes the 5-minute drive from home across the two-lane bridge over the Bosque River, past grazing cattle and groves of cottonwood trees to the Clifton Medical Clinic.
Inside, he passes a wall covered in photographs of children he has delivered during his 11 years in this small central Texas town. A shelf in his office is stocked with medical books about countless specialties: Radiology. Pediatrics. Geriatrics. Cardiology. Colonoscopy. Public Health Emergencies.
A good country doctor is prepared to handle it all.
“You never know what’s going to be behind the next door,” Dr. Blanton said. “You see a 2-day-old in this room and a 102-year-old in the next.”
Since its beginning, the Texas College of Osteopathic Medicine at UNT Health Science Center has trained and prepared physicians like Dr. Blanton (TCOM ’02) to practice medicine far away from the sprawling medical complexes and countless specialists in the city.
UNTHSC’s Rural Osteopathic Medical Education (ROME) of Texas program is crucial for the state’s underserved rural communities. There are 35 counties in Texas without a practicing physician, according to a 2015 study by the consulting firm Merritt Hawkins. At least 80 Texas counties have just one to five physicians.
Today, you can find UNTHSC rural scholars on clinical rotations in the piney woods of East Texas, the arid mountains out west, border towns along the Rio Grande and prairies in the Panhandle.
At each stop, students learn to provide critical health care services to people who may otherwise go without. They also get insight into the life of rural medicine, said John Bowling, DO, Professor of Family Medicine and Assistant Dean of Rural Medical Education.
“There is a common misperception that the lifestyle of a rural physician is less desirable,” said Dr. Bowling, who founded the program. “The truth is that it offers many physicians the opportunity for a financially successful practice and to make a very rewarding impact on their community.”
Kevin Blanton, DO
Dr. Blanton found his path to rural medicine later in life.
In his 30s, working as a purchasing officer for a company in Denton, he was tasked with finding a new contractor for company first-aid kits. One of the companies he interviewed offered a first-responder course for medical emergencies, and he signed up.
“It just lit me on fire,” he said.
He quit his job, returned to school and graduated from TCOM. Today, he is a family medicine physician at the Clifton Medical Clinic in a town of 3,442 about 90 minutes southwest of Fort Worth. Some of his patients travel two hours from West Texas for care.
But that’s not all he does. His other duties include:
Not to mention he’s the father of three children.
In those roles, he treats folks from town with coughs and fevers, performs C-sections at the hospital, clamps the wounds of bloody farmers in the emergency room and confronts public health issues – such as the time he diagnosed two locals with dengue fever.
Like all country doctors, he must improvise. He advised a cash-strapped mother that she can buy the same ointment he would prescribe for her children’s skin condition for a better price at Clifton’s feed store.
“The closest specialists are almost an hour away in Waco,” Dr. Blanton said. “Even if you tell a patient they need to go directly to a specialist, often they won’t go. It takes time and gas to make the trip. A rural doctor has to stay flexible.”
Dr. Blanton removes a skin lesion from a patient’s neck at Clifton Medical Clinic.
Medical student Russell Stanley will spend 20 weeks learning from Dr. Blanton.
Russell Stanley, a fourth-year medical student at UNT Health Science Center, spent three months in Clifton in 2015 working under the supervision of Dr. Blanton, and he will spend eight more weeks there in 2016. He came to TCOM with an interest in rural medicine.
When UNTHSC’s rural medicine track was first developed, TCOM students were recruited into the rural program after they arrived on campus. Today, the program recruits students before they are accepted to TCOM, looking for candidates genuinely interested in rural medicine.
Dr. Bowling personally interviews prospective students, considering factors such as their hometown zip code, altruistic characteristics and parental income. UNTHSC’s rural scholars come from all over; the 2015 class graduated students who hailed from Texas, Oklahoma, Iowa, Minnesota and Maryland.
Research shows that students who grew up in rural areas are more likely to return there to practice medicine. Students whose parents are both professionals are less likely to practice in rural communities.
“Of course, there are exceptions to all the rules,” Dr. Bowling said. “Sometimes you just trust your instinct.”
Dr. Blanton often makes the short drive from his clinic to his children’s school to eat lunch.
Rural medicine students such as Stanley spend their entire third and fourth years of medical school on rotation in rural communities. Dr. Blanton is one of dozens of UNTHSC preceptors across the state and beyond who welcomes TCOM students for training and supervision. Preceptors include surgeons in Crockett and Plainview, obstetricians in El Paso and internal medicine clinics in every corner of Texas.
Accommodations at rotations vary. Some students sleep in beds at hospitals where they work. In Clifton, Stanley stays in a 1,100-square-foot garage apartment attached to Dr. Blanton’s house.
He eats breakfast and dinner with Dr. Blanton. If the hospital emergency room summons Dr. Blanton at 2:30 a.m., the medical student is minutes behind in his own car.
Karen Duong, fourth-year TCOM Student
Like other Clifton residents, he enjoys shows at Tin Roof Theater and, on special occasions, black angus ribeyes at Mitchell’s Grille downtown. He often makes the short drive with Dr. Blanton to Clifton Elementary School, where the doctor eats lunch with son Teage, a third-grader, or daughter Bryn, a kindergartner.
“I can’t imagine many city doctors can zip over to the kids’ school at lunchtime,” Stanley said. “It’s a great experience being out in town and getting to know the people you care for. It creates a special relationship.”
Those relationships are built at rotations across the state. Karen Duong, a fourth-year rural medicine student in TCOM, plans to practice psychiatric care. At least 185 Texas counties don’t have a single psychiatrist.
She did her first rotation in summer 2014 in the Panhandle town of Hereford, about 375 miles from Fort Worth. She was the first UNTHSC student ever to train in the “Beef Capital of the World.”
While there, she joined a church, a Bible study group and formed an exercise group with friends. She was no longer a visitor; she was part of the town. Before long, residents lobbied hospital administrators to hire her after she completes her residency.
“In April, I’m getting married in Fort Worth, and all the great friends I made on rotation are making the trip here for it,” Duong said. “I tell other students interested in rural health that it’s a lot of extra work, but the experience is invaluable.”
Those relationships mean a lot to Dr. Blanton. At some point during the 11 years he has spent in Clifton, the town became home. He has no plans to leave the open roads, friendly people and freedom he enjoys as a country doctor.
“I found what I wanted right here,” he said.
Learn about TCOM student Karen Duong and her experiences in Hereford, Texas.
Featured on NPR, by Lauren Silverman.