Hot, homemade huckleberry pie sitting on my desk at the office on my birthday with birthday cards wishing me well. Running into one of my patients and his mother on a day hike on the Rocky Mountain front. Non-medical conversations with patients at the grocery store, fair, gas station, and introductions to my family.
Great Falls, Mont. is tiny enough to feel like a small town, but large enough for two hospitals and specialists. Located at the base of the Golden Triangle, one of the largest wheat producing areas in the United States, it has been a very good spot to practice, as I perceived 23 years ago when I started an internal medicine private practice. With a low cost of living and very hard working and loyal patients, this area has been a dream come true.
There has been no shortage of work, having a largely complex Medicare patient base, I simplified my practice several years ago transitioning to primary-care outpatient only. Having hospitalists in both hospitals and nursing home directors, I have been able to focus on improving care in the office setting by fine tuning the integration of the EHR and health CRM (customer relationship management) software systems. I have realized the EHR should be used at the point of care as an educational visual tool, to help, not hinder care. One very good nurse who knows every patient and is outfitted with the easy to use CRM and EHR, has been instrumental in having about eight hundred patients actively using their portals.
Being located between Yellowstone and Glacier National Parks and very close to one of the largest wilderness areas in the lower 48 states, the Rocky Mountain front was my vacation spot this past summer. Instead of taking a block of a week or two at a time, I decided to take every Friday off this summer and spent most weekends relaxing and exercising in some of the most beautiful, scenic, rugged parts of the country.
I married into a local farm family and one of the advantages is the opportunity to expose the kids to critical thinking, learning how to work, and be responsible. My son has spent the last several summers on the family farm being an integral part of the harvest, driving the John Deere tractor and grain cart and "dumping on the run." As the three combines thrash out the wheat, he collects the wheat in the grain cart, to keep the combines moving to minimize downtime, and increase the likelihood of getting all of the wheat in the bin in a short time frame.
The shopping scene may not be the best and the liberal arts may not compare to a metropolitan area, but if one wants easy accessible hikes into the Rocky Mountain wilderness area to balance a rewarding internal medicine practice, this place is hard to beat.
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James Legan is an internist. He goes by @jimmie_vanagon on Twitter and has a blog describing how he turned the EHR into a visual interactive tool at the point of care, work-life balance blogs describing his day hikes into the Rocky Mountain front.