OAKLAND - On four hours of sleep after a late-night emergency C-section, after resuscitating the newborn who wasn't breathing, Dr. Ken Buczynski is back on the maternity ward at 7:30 a.m. with another woman about to deliver.
Before the end of the day comes 14 hours later, he'll leave and return several times, to administer the epidural himself and later to bring dark-haired Miley Welch into the world. He will visit a hospitalized elderly man who is having part of his foot amputated. And he'll see more than two dozen other patients in his office, from a 6-month-old with a bump on his eyeball to a 62-year-old struggling to control her diabetes.
Such is the hamster-wheel life of the country doctor in Garrett County, Maryland's largest county by area but smallest by population. Here, in the wooded mountains at the tip of the state's panhandle, where the physician shortage is felt every day, there are no obstetricians and very few specialists. Instead, there are a handful of doctors such as Buczynski who consider treating the rural poor a calling - otherwise, they might not be able to put up with the extreme hours, isolation and loss of anonymity that come with the job.
Unrecognizable to many on the East Coast, the cradle-to-grave care that Buczynski, 35, and his colleagues deliver is slowly disappearing as a way of practicing medicine. Still, he says, it has its benefits.
"Our patients' care is not being fractured by seeing an endocrinologist for their diabetes and thyroid and the cardiologist for their high cholesterol, their gynecologist for their Pap smear," says Buczynski.
"When you start seeing all those doctors, oftentimes the left hand doesn't know what the right hand is doing. In our community, that patient with those problems is likely coming to their primary care doctor 90-plus percent of the time ... and if specialty care is required, we help patients get that. I think that's a good model."
Good or no, it's the only model they've got.
Buczynski was in his family medicine residency in rural Kansas five years ago when he saw an advertisement seeking a "Christian doctor" for an established practice in a rural community first designated with a physician shortage by the federal government three decades ago. The description of Oakland struck him as just the kind of place he was looking for - and a place that clearly needed someone like him.
