Editor’s Note: This interview first appeared in Path Finders, an email newsletter from the Daily Yonder. Each week, Path Finders features a Q&A with a rural thinker, creator, or doer. Like what you see here? You can join the mailing list at the bottom of this article and receive more conversations like this in your inbox each week.

Doctor Jennifer McKenney is a family physician in her hometown of Fredonia, Kansas, a small town of around 2,500 people where she runs a practice alongside her father. Since returning to Fredonia 12 years ago, McKenney has become president of the school board, the county’s public health official, and started multiple programs to benefit the health of those in town, including the Fredonia Medical Academy, a two-week program for high schoolers to become acquainted with the medical field.

In addition to her contributions to Fredonia, McKenney is the Associate Dean for Rural Health Education at the University of Kansas Medical Center, where she leads programs such as the Scholars in Rural Health and STORM (Summer Training Option in Rural Medicine), both aimed at bringing doctors to rural America.

Since the pandemic, McKenney has been profiled in multiple news outlets including MSNBC, the Washington Post and NPR to bring attention to the challenges faced by public health officials especially in rural areas. Named the 2021 Rural Health Practitioner of the Year, McKenney continues to give back to her community and advocate for equity in healthcare.

Enjoy our conversation about the oft-discussed “rural hometown return,” working with your dad, and how lifting up rural communities will lift up the entire healthcare system.

Dr. McKenney practices family medicine in Fredonia, Kansas, a town of about 2,500 people. . (Photo provided.)

Yasmeen Saadi, The Daily Yonder: To start off, you grew up in Fredonia, so I’d love to hear about your life growing up there, and what made you decide to come back and work as a physician?

Dr. Jennifer McKenney: I was raised here and graduated high school here. I just think Fredonia is a really unique town in that we have a lot of great pride in what we do, we all band together when things get tough, we help each other out.

I left and went to KU for undergrad, and then KU Med for medical school, and then Via Christi in Wichita for my family medicine residency. I actually didn’t think I was going to come back here. I thought I was going to leave Kansas forever. But as I was looking around and interviewing at other places, I felt like Kansas had the best environment for the work that I wanted to do in family medicine and in rural medicine.

When I came back to my hometown, I actually worked with my dad. He’s a 78-year-old general surgeon, he’s been here for 43 years. When I came back here, and I was like, ‘Dad, I’m not sure where I’m going to go to work,’ he told the hospital CEO, and the hospital CEO threw this big party together for me. The owner of the newspaper here pulled me aside and said, ‘You could go anywhere, but no one is going to love you the way that we love you, because you’re our family.’ The people and the ability to practice the type of medicine that I wanted was why I came back. I signed a contract for five years. And now 12 years later, I’m still here and loving it.

DY: Now that you’re back in Fredonia, and you’re working as a physician, I know you’re also really involved with the community, running a lot of different projects and initiatives — for example, being on the school board and acting as the county’s health official. I just wanted to give you the opportunity to talk about what you’re up to right now and what you’re working on.

JM: It’s funny, because rural physicians will often take on a lot of different roles, and we often say yes, because we just want the best for our patients and we know that health care actually is influenced by things outside of our exam rooms. Being on the school board can influence the amount of physical activity that the kids get, and the food that they eat every day, and just being able to provide meals when they can’t have meals otherwise. So it’s just another way to care for our patients that’s beyond what we can do when they come and visit us.

After I moved here, I started the Fredonia Area Community Foundation. It was a way for us to be able to keep money in our community, because a lot of times somebody might move away, and then they might want to give back to the community and they might not know how. We grant money back out to food banks, child care centers in town, the schools, things like that — things that again, influence health in a different way than just in the exam rooms and in the hospitals.

I also created Cultivate Fredonia, which is a community growth organization. We focus on healthy living, beautification, housing and business. And then we have a program that’s called ‘Every Child Deserves a Bike.’ So every second grader every year gets a bike from our organization. We do beautification, cleanup, projects, things like that. And so those have been really meaningful. They’ve been in existence now for about 10 years.

DY: The Fredonia Medical Academy is something I want to hear more about, because that sounds like an amazing opportunity. I was wondering if you could talk a little bit more about the importance of having that rural health pipeline and introducing students to health and the medical field early on?

JM: [The Fredonia Medical Academy is] one of my favorite things. It’s a two week, really interactive program for high school sophomores to seniors. We do field trips, they get certified for CPR, they practice suturing, they practice casting people, they get a visit from the helicopter transfer team, they hear from specialists all over the state. We had a visit from the former Secretary of Health in Kansas; we had a speaker from the CDC.

I really think hitting students with information about health care, about health care careers, about the difference that they can make in their own communities is so important to do in the K-12 sphere. I think as early as kindergarten, we need to be saying, ‘Come visit the hospital, see what people do there.’ Let’s go to their classrooms and talk to them about what we do. And then once we get to the high school arena, whether they know it or not, those students are already setting the path for their future. We’ve seen a lot of students that would get to college and say, ‘Well, I didn’t know the ACT was that important’ or ‘I didn’t know my science grades in high school were that important, so now I can’t get into this program.’ So we’re really trying to get people prepared early on, so that they don’t regret not doing better in school.

Especially in rural areas, recognizing that we need more [doctors], we kind of start growing our own that will then come back, hopefully, to our rural communities and take care of our patients and replace us later on.

DY: What are some of the challenges you’ve seen affect rural communities, especially when it comes to healthcare and medicine? And what do rural communities need to overcome those barriers?

JM: I think what rural communities need is system-wide change. There’s nothing that we can do in a rural community, isolated, that will help rural communities. It has to be a joint venture between urban, large facilities, schools, universities and everything else before we can actually see significant change. Here’s an example. At the University of Kansas Medical Center, if all of the attendings there say ‘Well, that’s Dr. McKenney, a rural doctor. What do they know down there?’ then we’re never going to get more rural doctors to come down, because that’s the culture that’s being set. If they’re saying, ‘Yes, that’s Dr. McKenney, they do so much in rural communities. They do everything they can, even with limited resources,’ then we’re going to get more rural doctors. And if we’re only applying grants to urban centers and we’re not spreading some of those resources, money and everything to the rural communities, then again we’re not going to see any growth.

One thing we learned through the pandemic was just that every piece of the healthcare system and beyond is connected. When we were finding in our hospital that we couldn’t take care of a patient anymore, they needed to be on a ventilator, we had to start calling different hospitals. We once called up to 120 hospitals around the country. And so when those hospitals are full, then we are not able to care for our patients the way we’re supposed to. And vice versa, if our rural patients are taking up all the beds at the urban hospitals, they’re not able to take care of their own patients either.

Dr. McKenney returned to her hometown in rural Kansas where she runs a practice right alongside her father. (Photo provided.)

Everybody recognizes that rural people, rural communities should have the same excellent care and access to care and resources that anybody in an urban community should have. It can’t be done on an island, it can’t be done one community at a time, it has to be a system-wide change, where we all understand how we’re all intimately connected, and how lifting up rural communities will lift up the entire healthcare system.

DY: You’ve done interviews about the backlash you and other public health officials received when the pandemic first began with enforcing regulations and mask mandates. What is it like to have that reaction from people you’ve lived with and grown up with?

JM: It was hard for me. It was one of the most, if not the most challenging and hurtful and heartbreaking times in my career so far. I hope that’s the worst it gets. We always talk about public health, and it seems like this kind of umbrella concept of taking care of these crowds of people, but in fact, in a rural area public health is personal. It’s more personal, I think, than sometimes even one-on-one in an exam room. And so, just knowing that people that I’ve taken care of for my 12 years that I’ve been here — they trusted me with their diabetes, with their hypertension, with their parents — didn’t always trust me when I said, ‘You should get vaccinated,’ that was hard. You yourself, as a physician, are practicing the same medicine, doing the same research, doing the same due diligence of making sure everything you’re doing is evidence-based and research-backed. But then doing those same things was not enough. They weren’t enough to combat the politics and the social media and misinformation out there. It was really just disheartening.

In the end, there really were truly more supportive people out there than the opposite. But the people who are against what you’re saying are the louder ones. It’s hurtful, it’s very personal. And it’s rural. I hear when people are calling me names or saying that I’m trying to use my position for whatever reason. It’s not like it may be in an urban area where somebody says something and it never gets back to you. It all gets back to you, you hear every bit of it.

DY: What was the extent of the reactions you had? I know you had both positive messages along with the more negative ones.

JM: While I was doing interviews, I started getting these letters from people I’ve never met before all over the country. People are really really thoughtful. And my own community members, they were almost protective of me. There was a point where the county commissioners were trying to fire me, and so people heard about it, and they wrote letters and they showed up to the next meeting. It was really amazing to have that kind of support.

So that was the good stuff. One of the worst, I think, was when the county commissioners wanted to have a hearing and then they said we’re gonna go ahead with a mask mandate. Everybody stormed out and they were super angry. And then the sheriff’s deputy came up afterwards and said, ‘Hey, whenever you’re ready, you know, let me know, I’ll walk you to your car. There’s just a lot of angry people here.’ It really was the first time in my life that I was like, I feel unsafe in my own hometown, and that was a really really really bad feeling.

The thing I remind myself all the time is people are scared, people want to be okay. And even if that’s misguided and even if the way they express that is in a negative way, or a hurtful way, it’s all based on people wanting to be okay and wanting their loved ones to be okay. They’re just scared, they want answers, they don’t know what the future holds.

DY: For the future of Fredonia, in terms of health care, do you have an end goal or vision for what you want to see within the town?

JM: If I had my ideal situation, we would have more doctors here, we’d have more nurses here, we’d have more dentists, we’d have more behavioral health people. I would like to take what you would find at one of the bigger hospitals, condense it down, and place it in Fredonia so that our patients are as able to be cared for as any other person in the state or in the country. I just hope that we continue to grow, we continue to bring in great people or our great people continue to return back here to practice. And that we have people who will take care of our people well into the future.

This interview first appeared in Path Finders, a weekly email newsletter from the Daily Yonder. Each Monday, Path Finders features a Q&A with a rural thinker, creator, or doer. Join the mailing list today, to have these illuminating conversations delivered straight to your inbox.

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