Physician in Small Iowa Town Admits to Being a Rare Breed, Hasn’t Heart to Leave

He calls himself a dinosaur, part of a dying breed, an old fogy, when really, he’s just a doctor making a go of his own practice in small-town Iowa.

“You get to feeling like you made a decision nobody else is making,” Dr. Craig Thompson says with a laugh. “I think people have called this ‘a non-viable practice.’ ”

Thompson, 41, has been the doctor in Strawberry Point--population 1,400--since July 17, 1979. A partner has come and gone, but he is sticking with it.

“One evening before I came in here, I was talking with a chest surgeon about my plans to go into private practice. He said, ‘Man, that takes guts.’ I said, ‘What are you talking about? You’re a chest surgeon.’ But he said, ‘If I get a problem with heart surgery, I can call in the cardiologist. You’re out there on a dirt road by yourself.’

“There are times you feel like that,” Thompson added. “But you learn, I guess, that you work with a slightly different team than what you’d work with in a metropolitan area.”

The statistics say Thompson shouldn’t be in Strawberry Point. The number of doctors in Iowa has been increasing since 1977, but they’re not being evenly distributed. The latest numbers from the University of Iowa show that 60 Iowa towns with populations of 2,500 or less lost their family doctor between 1978 and 1993.

Nationwide, about 20% of the U.S. population lives in rural areas, but only 9% of the nation’s physicians practice there.

Thompson says the problem comes down to simple numbers. As the farm crisis of the 1980s drove people from rural Iowa, and eventually 130,000 people from the state, doctors followed them.

“There are nights you do go home and think, ‘Am I just incredibly dense?’ But you develop bonds with people,” he said. “That’s not to say you wouldn’t go or you couldn’t go, but you get woven into people’s lives and it’s hard to rip that fabric all apart.”

Strawberry Point, about 50 miles directly north of Cedar Rapids, is a place where everybody knows your name.

A 15-foot metal strawberry on a post painted with vine leaves stands just a few yards from the town’s only stoplight. Men in seed caps wave as they drive along main street in pickups. Folks at the Citgo gas station warn about approaching storms as they ask how far you’ve got to drive.

Locals laugh about their town’s unusual name and recite its origin: Soldiers plowing a road between Dubuque and the old Fort Atkinson kept track of their progress with mile markers called “points.” Wild strawberries grew each spring around one of those points, and when folks settled near there, Strawberry Point was born.

Turn right at the stoplight, drive about a block, and among the town’s historical, two-story buildings, you’ll find a state-of-the-art, glass-encased medical clinic, with a row of skylights down the middle.

St. Luke’s Hospital in Cedar Rapids built the $500,000 building for Thompson in 1988 during its push to reach new customers. Thompson admits the building is one of the main reasons he stayed in town; St. Luke’s proposed the clinic just as finances were forcing him to close a satellite clinic he’d run in Lamont.

“I was doing a lot of soul-searching. I prayed, ‘I need a vision here. Should I stay or go?’ The thing from St. Luke’s fell into place at the right time,” he said.

But while having a clinic equipped with seven examination rooms, a helicopter landing pad and $200,000 in emergency equipment has helped him treat patients, it hasn’t cut down his long hours. A father of four boys, with another baby on the way, he works at least 70 hours a week and admits he has sacrificed family time.

His efforts haven’t gone unnoticed. This summer, Strawberry Point established a Health Enhancement Foundation to give an extra push to Thompson’s efforts to bring in help.

Local folks have contributed more than $50,000, although the fund is still about $5,000 short of its goal. The money is being given on a month-to-month basis to Marcy Fadness, a physician’s assistant who has joined Thompson’s staff. The $55,000 will cover the debt from her medical education.

Earl Swales, owner of Swales Concrete Inc. and a member of the board of directors at the local Union Bank and Trust, helped arranged the financing.

“We’ve been a one-doctor town, and he works terribly hard. And he certainly needed the help,” Swales said. “The town was concerned about this--his long hours along with the long waiting lines at the doctor’s office.”

Every physician’s assistant coming out of school gets about eight job offers, Fadness said, so every community, and especially every small town, needs to offer incentives to set themselves apart.

Fadness, who grew up in Osceola and wanted to work in a small town, said all five communities she interviewed with last year offered a loan repayment plan. With the heavy debts built up by medical students and the severe shortage of health care workers in rural areas, that’s becoming almost a requirement, she said.

“Especially when you consider small towns, because most people would like to live in a big city or at least close to one,” she said.

Thompson remains convinced he’ll be able to bring in a doctor who will want to continue the practice after he’s gone. He knows it will take a special person: someone who appreciates the closeness of small-town life, who is willing to work long hours taking care of friends and neighbors, and who will start at a lower salary than many big-city clinics offer.