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Holzer Clinic pops into view as you round the bend to Pomeroy on Hiland Road, the low slung building rising to the right, its parking lot merging into the road itself with a stop sign signaling the entrance. As the main provider of primary care for those living in Meigs County, the clinic serviced over 30,000 patients last year. Google rural and underserved, and the AI overview explains the Health Resources and Services Administrationā€™s definition of places like Pomeroy, areas and populations with unmet health needs due to factors like a shortage of primary care providers, high poverty rates, and other challenging realities.

When Scott Smith, D.O., walks into the waiting room, itā€™s with the stoop of a man used to ducking doorways. The breadth of his frame is at odds with his unpresuming manner and the soft measure of his voice. He asks if he needs to speak up as I turn my recorder towards him for our interview and I reassure him no; weā€™re speaking in a small exam room after all, a fitting space to ruminate on a long career as a rural family practitioner. Heā€™s a month away from retirement after serving 28 years at Holzer and he touches on the reason, his eagerness to spend time with his parents and take care of their needs as they age in place in their home on the east coast.

A graduate of the Class of 1989, he felt a personal calling to practice osteopathic medicine due to its wholistic approach, and a need to pay it forward by volunteering as a preceptor for the Heritage College. After many years as a clinical faculty member, he still councils students interested in family medicine to exam their approach to patient care. Could you treat the patient that walks in as you would treat your sister, or father? Could you turn away a patient in need of care, if your first priority is to treat them like family?

Smith shakes his head as he answers that question for himself, then smiles slightly as he explains how poorly that outlook paired with the mathematical realities of operating a rural private practice. He was simply unable to turn sick patients away, and unable to advocate for better reimbursement rates for those able to pay, and he took no income for 18 months before filing for bankruptcy. Landing at Holzer seems, in that light, a dual blessing. Finally, a partnership allowing Smith to provide the care he wanted to his rural community while the clinic advocated on his behalf for higher rates, provided colleagues to lean on, and ready formed partnerships with his alma mater, enabling him to mentor the next generation of doctors.

One of his former students, Soeun Jeon, D.O. (ā€™23), recalls the impact his mentorship had on her development as a physician.

ā€œHe always has such a good rapport with his patients, and the patient-provider relationship he has is something I strive to achieve as a future practitioner myself,ā€ said Jeon. ā€œDr. Smith has been one of my most significant preceptors Iā€™ve had the pleasure to work with during my clinical years in medical school.ā€

Retirement for Smith isnā€™t quite retirement ā€“ heā€™s applied for an Interstate Compact License so he can practice in his parentsā€™ state. He tells me heā€™s joining a critical access hospital, the Monadnock Community Hospital in rural Southwestern New Hampshire, so he can continue to help in his new community. Then a glance at the clock confirms the end of his lunch hour and the end of our interview, though he has four more hours until he ends his day.

As he walks me back to the lobby and thanks me for my time, thereā€™s a faint feeling, of timeā€™s passage, not celebrated out loud but whispered about, and a sense of nostalgia that resembles loss. It lingers as I snap a photo of him in the lobby, smiling, waiting for his next patient.