Kodiak Island

Kodiak Island is BEAUTIFUL. I have been to many a pretty place in my life, and this may be the prettiest place I've ever been. It's a mixture of the dramatic mountains of the Pyrenees, the lush green of Guatemala, the coastline of the San Juan Islands, plus the wildflowers of Idaho. It's pretty in comparison to Alaska, which is saying a lot, since Alaska is, well, gorgeous.

I've just begun to explore Kodiak, but already I can tell that it runs on "island time." In other words, it's mellow. But more than that, it's got the energy of a community whose rhythms, at least to some extent, are determined by mother nature's. Things like the tides, the weather, migration patterns of fish all impact the days, weeks, months, and years of the people who live here. I like living somewhere where the local radio station includes the tide with the weather and both are significant beyond mere interest. The population of Kodiak wanes and waxes as the fishing boats and the Coast Guard patrols depart and return. Turnover is high - the hardship of fishing and the maximum of a 4 year station make for impermanence.

One week done and I really do love it here. Family Practice is back on the very short list. Folks here are so incredibly nice. The docs here love to teach and care for their patients in this calm, relaxed way that puts the patients at ease. 15 minute appointments are rare, so nothing is ever rushed. Being an FP doctor here would mean practicing primary care the way it should be practiced - more than a mere gateway, you are the center of your patient's care. You handle the things you are qualified to handle (and maybe a few that you aren't, out of necessity) and refer the very complicated things. In the lower 48, it seems like most FPs refer everyone and everything they are expected to and they can. Malpractice is on everyone's mind and no one general is given agency to make decisions they at one point were qualified to make. The primary care profession is leeched of confidence (and thus competence)

Up here on Kodiak, you build relationships with specialists in the big city (Anchorage) and call on them when you need help or advice - and they eagerly (and non-possessively) give it because they understand that in Alaska, referring to a specialist is not always possible. You deliver babies (maybe do c-sections if you are trained), work in the ER, and see patients in clinic. You tailor your practice both in the patients you see and the hours you work. And at KIMA, your fellow health care providers are amazing, inspirational people. This is one of those seductive practices (like Alaska Women's Health Services) that lures you into the field (family medicine in this case) by fooling you into believing that all practices are like this.

The separation of practice versus profession. How much of what I like about being an FP is dependent on location? What about with pediatrics?

I'm quite thankful I don't have to make my decision tomorrow (yes more loans, I knew there was a reason I signed on to you).