Seemingly every “doctor drama” TV series has the same premise: big-city providers managing their big-city patient cases. Apparently, most TV producers don’t frequent small-town primary care health centers. 

“We get some really strange cases that you typically wouldn’t see elsewhere. I’m talking a lot of alarming, often times end-stage kind of stuff,” says Adam Marks, a physician assistant and clinical director at Family HealthCare Network (FHCN) in Visalia, Calif.

Making up for shortages

Physician assistants (PAs) like Marks are often the sole provider for miles, and it is not unusual for them to run federally qualified health centers (FQHCs) in rural areas with a primary care physician shortage.

FHCN has an expansive network of FQHCs serving mostly rural and largely underprivileged areas of central California. Access is a challenge for many of its residents. Services offered at FQHCs like the one Marks works at support patients that otherwise might postpone necessary treatments — or avoid them altogether — only to end up facing a more severe diagnosis and an expensive trip to the hospital.

“Some days are definitely more challenging than others, but it’s all worth it.”

Making it easier for patients

One of Marks’s former patients stepped on a rusty nail while working on a farm. Instead of getting immediate medical attention, the patient waited several days until he was drooling uncontrollably. That’s when he finally went to Marks’ clinic and was treated for tetanus.

Taking time off of work to travel to see a provider is not easy for many of Marks’s patients, especially farmworkers. For the PA, helping to improve access to care is a top priority so potentially severe or life-threatening cases can be diagnosed and treated sooner. 

Before Marks found success as a PA, he was halfway through graduate school in a public administration program that he found uninspiring. He began shadowing a family friend who worked as a PA in a rural practice.

A burgeoning market

Nearly every day for more than a year, Marks watched how this PA consistently developed and maintained a unique bond with each one of his patients, and he knew he wanted to create similar experiences that would impact people’s lives.

“Becoming a PA and working in a rural practice has been the best decision I ever made because I feel like this is where I truly belong, helping the people in these communities,” Marks says. “Some days are definitely more challenging than others, but it’s all worth it. I can’t imagine being anywhere else.”