Charles Johnson
First Week at Custer

Week one for rehps in Custer was very pleasant. Besides getting a great meal from Mike the Custer Clinic Manager at nationally famous Burger and Bun, Cheri treated us to the best BBQ at Mac’s in Hill City that I have had in a decade!  And yes, I have had BBQ in Kansas City in the last 10 years.

The hospital/clinic spent a great deal of time showing us the various parts of the medical operation. I wish I would have been presented with that opportunity on my very first rotation, because I was hard pressed to show patients where to go for labs, radiology, etc.

We also were taken to the Chamber of Commerce where we were shown about 1000 activities that are available in the local area. I have spent a lot of time in Custer, and I learned a lot more about interesting things to do locally. Everyone in the Clinic and hospital has done everything they could possibly do to make us feel welcome. We got into clinic on the first day with Drs. Faulkenberg and Brown. They are excellent medical teachers who obviously have a lot of experience teaching medical students.

On Thursday afternoon we toured Custer State Park, took pictures of Buffalo, and visited Lake Sylvan and Lake Legion.  On Sunday, Kiel and I climbed Mt Harney.  Being in shape is helpful, and it was a beautiful day with beautiful views from the top.





Second Week
The second week was as good as the first at Custer.

We had one day with Dr. Graber in the Custer walk-in clinic. The MD that works walk-in is also responsible for the emergency room. I think Dr. Graber saw 40 patients that day between the two places. He had me suture a split knuckle, which I did pretty clumsily. We also had some reasonably large work-ups for cardiac and abdominal pain in the emergency room.

Tuesday was with my preceptor, Dr. Lisa Brown, in her regular clinic. The patient population in Custer spans OB to geriatrics. After having done rotations in specific kinds of medicine, it was interesting to see everything combined in one clinic.

This week, we had a tour of the Custer Senior Center. It is operated by the Custer hospital, so there is continuity between the medical care at the clinic/hospital and the senior care facility. Regional Health also runs an assisted care living center, so continuity between the patients and the providers is also good. If you are on the staff at Custer, (or a student there), you can order an evening meal from the Senior Center. (That is a pretty good deal for a guy like me that is not good at cooking, and is living away from my spouse.)

Thursday, we went to the clinic in Hill City, which is also under the umbrella of the Custer Medical operation. Zach Peterson is the PA we worked with. We, again, saw a variety of patients, and Zach had me inject some corticosteroids into hip bursas. We got a picture of the Hill City Staff that works with Zach every day. Picture is attached.
At Hill City

Week Four
Kiel and I had a great last week!

We were able to see Drs. Custis and Kretschmar work at Destination Dentistry in Custer. Oral healthcare has much to do with overall health, and we learned it is not very well covered in most insurance plans. We were also able to spend a couple of days at the walk-in clinic with Dr. Brown and Dr. Falkenburg in Custer.

On Wednesday, we worked with Dr. Preuss at a satellite clinic in Hot Springs. This clinic consists of only Dr. Preuss and a small staff. No lab, no imaging, nothing outside of an exam can be done that day. That is serious rural medicine, and she serves people locally, and from Nebraska and Wyoming as well.

On Thursday, we met with Katie Wiederholt, who is Director of Wedgewood Senior Care. Wedgewood is an assisted living facility in Custer. It was a learning experience for me, because it showed me some options that are available for the geriatric population, a population that seems to be in abundance in this rural setting. There seems to be an abundance of geriatric patients in many rural settings! That may be worth looking into for future employment in rural areas.

Kiel and I were given a day to prepare our REHPS presentation, which was nice. We presented it on June 10th, and many of the people we had met and followed were there to see it. It was not ‘high pressure,’ so don’t let that stop you from applying for the program. An added benefit was that Cheri brought a complete meal for everyone that came to the presentation.