Shelley Stiltner hopes to make a difference in the lives of people who grew up like she did — whether that’s treating them as a patient, or inspiring them to become a doctor.
Stiltner, who graduated from the University of Kentucky’s (UK) College of Medicine Rural Physician Leadership Program on May 13, said she wanted to return to her rural roots and practice medicine, specifically obstetrics and gynecology (OB/Gyn).
That passion to serve in rural communities is desperately needed, experts said.
According to data from the U.S. Health Resources & Services Administration, 72 of Kentucky’s counties lack a dedicated OB/Gyn. In Rowan County, where Stiltner did her internship, only 3 OB/Gyn doctors provide services for a county of nearly 25,000 people. In fact, none of the counties immediately surrounding Rowan County have dedicated OB/Gyn doctors, and only 10 of the 23 counties in eastern Kentucky — a total of 33 doctors for more than 500,000 residents.
Stiltner grew up in Elkhorn City in Pike County, Kentucky. For her, helping women in rural communities, especially those suffering from opioid use disorder is what she’s drawn to. She’s seen opioid addiction first-hand, she said, and wants to help those who need help the most.
“Pregnant women who are addicted to opioids, a lot of the time, do not seek care because they’re ashamed of it or scared and that we are going to look down on them or immediately take their baby away,” she said in an interview with The Daily Yonder. “Our goal as doctors is to take care of mom and baby and we need to do our due diligence whether they are addicted or not.”
Stiltner grew up amidst poverty in a coal-mining family. Her father was injured in a mining accident that left him depressed and disabled, she said. His injury affected the family’s finances. Eventually, her mother had to return to work, and Stiltner started working as a waitress at the age of 14 to help the family make ends meet. But those experiences, and the encouragement of those around her, pushed her toward a career in medicine.
After a guidance counselor encouraged her to apply for college financial assistance, Stiltner was able to attend UK on a full-scholarship, the first in her family to ever attend college. Her rural background, she said, helps her understand what rural patients go through.
After graduation, she is headed to the University of Tennessee for her residency. She hopes to return to eastern Kentucky to establish her practice when she’s finished.
Being from a rural area will help her better communicate with and help rural patients, said Dr. Rebecca Todd, associate dean of the Rural Physician Leadership Program campus in Morehead, Kentucky.
“People like Shelley are just amazing to have in medicine because she comes from a culture that doesn’t necessarily trust our current healthcare system because of what’s happened to them in the past,” Dr. Todd said in an interview with the Daily Yonder. “Not only does she have that upbringing which has allowed her to empathize and relate better to the patient population, she also is an example to them, of someone from their community who went into medicine. They’re more likely to trust anything that she recommends.”
Todd said getting physicians like Stiltner to live in rural areas is a challenge.
“I’ve been practicing here in Morehead for 11 years and we’ve only been able to recruit one other full-time, female physician and she’s one of our former students,” Dr. Todd said. “We’ve got a lot of people going into OB/Gyn, but they’re not willing to live out in these communities where the need is greatest. It’s hard to recruit physicians to actually be part of these communities… They want to serve underserved communities, but they’re not necessarily wanting to live in the underserved community.”
The physician shortage extends beyond just OB/Gyn care, studies show. In 2013, the Commonwealth of Kentucky Health Care Workforce Capacity Report found that by 2025 the state would face a shortage of nearly 1,000 primary care physicians, the third-greatest shortfall in the country. Nearly 61% of Kentucky’s shortage will be in rural counties.
And the problem isn’t just related to Kentucky. According to the American Hospital Association, more than 2 million women across the country who are in their childbearing years live in “maternity care deserts” – where they lack access to a hospital with maternity care, or an OB/Gyn provider.
For Stiltner though, returning to a small town to become an important part of a community is what draws her to rural medicine. Everyone knowing everyone else is part of the appeal of living in a rural area, she said. And when her patients know where she’s from, it helps them to trust her, she said.
Stiltner said she also hopes that her story will attract others from rural communities to become doctors and return to their roots.
“That’s important to me – to show these rural students, hey, somebody can do it, somebody did it and they can help you too,” she said. “Because I think that that’s how we’re going to get rural students into medicine and to become doctors… Rural students are statistically more likely to practice in rural areas… We need rural physicians. Let’s get rural students (into medicine) who are likely to come back there, likely to start their families there, plant their roots and get them back to practice there.”
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