Physician’s innovative deal provides a real shot in the arm for 6 small towns inMaine.

It was a typical day for Roger Pelli. Up before dawn, a quick breakfast with his wife and two children, off to nearby Presque Isle for hospital rounds, then back to Ashland for the day’s appointments--16 in all, with the complaints ranging from cold sores to skin cancer.

With luck, he might get home on time for dinner--although the odds were rapidly worsening. At noon, he was already running an hour and a half behind schedule. After dinner, there would be the customary calls to return, medical histories to dictate, professional journals to catch up on.

The life of a doctor in the logging country of northern Maine is not easy. But Pelli isn’t complaining. He asked for it, prayed for it.

In fact, in a unique arrangement that an admirer described as a combination of “I Have a Dream” with “Let’s Make a Deal,” the 38-year-old Rhode Island native contracted with six rural communities to act as their doctor in exchange for their aid in financing his medical education.

His story is an unusual tale of one man’s perseverance in pursuit of his life’s ambition and of the faith he inspired in the people who helped him reach that goal.

It also reflects the innovative steps rural communities are taking to combat the severe shortage of doctors willing to practice in such localities. According to a 1988 federal study, there is a shortfall of almost 1,300 physicians in rural America--more than twice the deficit in the nation’s inner cities, another troubled spot.

Part of the problem is competing for doctors lured to lucrative urban posts. In North Dakota, for example, several communities have raised money to offer $100,000-plus annual salaries to physicians willing to relocate.

But Pelli’s case falls into a class by itself.

Ever since he was a child and “operated” on his sisters’ dolls with his toy medical kit, Pelli wanted to be a doctor. Those dreams were dashed after his graduation from the University of Vermont in 1973, when his applications to medical schools were turned down.

He entered Dartmouth University’s program for physicians’ assistants, graduated in 1975, and later went to work in Ashland at the Aroostook Valley Health Center.

In 1982, encouraged by the doctors he worked with, Pelli once again applied to medical school and was accepted by the University of New England College of Osteopathic Medicine in southern Maine. What turned the trick this time, he said, was his novel addition to the application form--a stack of petitions signed by hundreds of area residents stating that they wanted him back as a physician.

Getting accepted was one thing, however. Finding the $100,000 he needed for tuition and expenses was another. He figured that he could raise $40,000 through student grants and loans, but that still left a staggering $60,000.

So once again he turned to the residents of Ashland, Portage, Masardis, Garfield, Nashville and Oxbow--this time with a proposition. If the communities would pay the $60,000 through an increase in their property taxes, he would return to the area and serve as a doctor for at least eight years--two years for every one year of schooling the towns would help finance.

On the day that Pelli’s proposal came up for a vote at a town meeting in Ashland, the largest of the six communities and the first to act on the measure, members of the town fire department came in uniform and filled up the first three rows of seats in a show of support.

“I was in tears from the testimony that was given,” Pelli said.

In Portage, Pelli’s skills were already admired. Acting Town Manager Sharon Rafford remembered that Pelli, while working as a physician’s assistant, had once examined her son Patrick, who was stricken by a rare ailment that was choking off his windpipe. His diagnosis and quick action may have saved the boy, she said.

In the end, all the communities took him up on his offer. The cost was nominal--about $5.75 per person per year if averaged out over the more than 2,600 residents in the six communities combined.

At medical school, Pelli’s blood pressure shot up. His family life went to pot. He spent almost all his waking hours in class or studying. He managed to graduate second in his class, but his wife, Lynn, says: “It’s one of those experiences I’m glad is behind us.”

When he completed his residency, a Portland hospital offered him an emergency room position. It was tempting. “It would have paid $60,000 a year, plus expenses and malpractice insurance,” he said. “I would have worked 14 12-hour shifts a month. That’s two weeks on and two weeks off.”

He could have taken the Portland job and paid off the loan to the six towns. But he didn’t want to go back on his word. He also looked forward to being a family practitioner.

“I like knowing my patients,” he said. “I like putting my arm around somebody who’s crying because of the loss of a loved one. I like seeing a child in the nursery and talking to his mother after delivery, and then watching that child grow up.”

Since his return two months ago, it is hard to say who is the happier: Pelli or the people of Aroostook County who backed him.

His homecoming was the occasion for a civic celebration. When he and his family drove into Ashland, they were greeted by a big sign with blinking lights in front of Jud’s Cash Market on Main Street that said: “Welcome Back, Dr. and Mrs. Pelli and Family.”

“I’ve enjoyed being back,” confides Pelli, who is now the medical director of the Aroostook Valley Health Center. “I’m working my tail off, but I’ve achieved something I’ve always wanted. It feels great.”