Tim Shafer moved to Vermont in 1984 to serve as a National Health Service Corps physician in a medically underserved area. After completing his residency in Pennsylvania, he wanted to return to New England, where he’d grown up and where he’d attended medical school. He’s lived in the West River Valley ever since.
Practicing rural medicine has been full of surprises from day one, when Tim attended a man who’d been struck by lightning. When Tim showed up at the scene, the man greeted him with a sheepish grin: his socks had been fried, but he was otherwise unscathed.
In the early days, Tim delivered babies, attended Well Child Clinics, and served as a Regional Medical Examiner in addition to seeing patients in the clinic and covering the Emergency Room at Grace Cottage Hospital every other night.
With just nineteen beds, Grace Cottage is Vermont’s smallest hospital. When Tim first arrived there, he had to take any x-rays he needed – and develop them himself. He had to run the few tests the lab was equipped to provide, and sometimes, he rode to the scene in the ambulance, which was a retired hearse. When he accompanied a sick patient to Dartmouth for more sophisticated care, he’d sleep in the empty gurney on the ride back.
Medicine has changed a great deal since 1984, and Grace Cottage now has state-of-the-art imaging and trained staff to run it. The same goes for the lab. Tim’s role has changed, too. He’s no longer the Regional Medical Examiner, though he’s still Town Health Officer in two towns. These days, Tim’s mostly a clinician, seeing patients in the office and sometimes in their homes.
For all the fol-de-rol of diagnostic testing and computerized record-keeping, Tim still visits with patients, exchanging news about family and work – finding out what’s going on in his patients’ lives. These conversations help Tim put a person’s medical complaint in context, especially since he’s known many of his patients a long time. He’s now caring for the children of babies he delivered. He often knows a family three generations deep, sometimes four.
In the spirit of full disclosure: Tim and I met shortly after he arrived in Townshend, married, and raised a family here. It’s a great place to live, and we enjoy cross country skiing and mountain climbing in their seasons. The seasons also dictate our activities around the homestead, where we keep chickens, raise vegetables and grow fruit. Tim takes special pleasure in splitting our firewood by hand.
We’re homebodies by nature and necessity. Tim’s practice often makes it hard to get away. This was especially true during the years when we were in business together: I managed the medical practice so he could provide the medical care. But not only has medicine changed during the thirty-odd years Tim’s been practicing; so has healthcare administration.
In 2003, we closed the door on the private practice, and Tim became a salaried physician at Grace Cottage Family Health. I’ve written about our story, which illustrates the changes in the delivery of primary care over the past thirty years. [Read it here.]
I’ve also written about the graying of primary care physicians in Vermont and the impending doctor shortage as Tim’s generation of rural doctors retires. [Read or listen here.] More recently, I’ve suggested a way Vermont might be able to attract new country doctors to the state. [Read or listen here.]
Hopefully, a new family practitioner will choose to hang a shingle in Townshend before Tim retires in a few years. For Tim, it continues to be a rewarding career. As he’s fond of saying, “It’s a good life if you don’t weaken.”
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