Can you go home again? How to practice medicine where you grew up

Setting up shop in your hometown can be rewarding and successful, if you set rules and learn to cope with awkward situations.

By Carolina Procter, AMNews staff. July 9, 2007.

Family physician Alan DeWitt, MD, returned to his hometown of Snowflake, Ariz., right after residency to start a practice with three other doctors. He'd always wanted to practice in the small town of 6,000 but found himself unprepared and a little uncomfortable one day when he looked at his appointment list and saw the name of an ex-girlfriend.

"It felt like it would be a little strange keeping the professional distance," Dr. DeWitt said. "Those embarrassing conditions do come up, and the idea of having old girlfriends as my patients [was uncomfortable]. I referred her to my partners."

Awkward as it may be, such situations often are unavoidable for physicians practicing in their hometowns. For some doctors, the prospect is so daunting that it dictates where they locate their offices. Medical schools often hear it from students as an excuse not to practice in their hometowns and sometimes as a reason to avoid the medical field altogether.

But experts, as well as physicians who have returned home, say that once you get over the initial discomfort of treating people from your past, the experience can be fulfilling and successful if you set ground rules that protect your personal life and ensure that you're compensated correctly.

Doctors who grew up in small towns are likely to return there or a place like it after residency.

A study by the Indiana State Dept. of Health and Indiana University found that doctors of all specialties who came from a non-metro hometown were 4.7 times more likely to locate their practices in a non-metro location, said Terrell Zollinger, DrPH, one of the study's authors. The study, published in the April Family Medicine, followed 2,400 Indiana medical students over 10 years.