My own experience with rural environments began in Nowata, OK as a Code 9 physician. Back then I was more familiar with the Area 99 insurance coding given to all such areas in Oklahoma where physicians were paid the lowest fees for their services. At the time I did not comprehend such discrimination. I only knew that I was called to go to Nowata. I began a solo practice, borrowed some money from the hospital to equip the office and lived off of my part time $20 an hour job teaching at Bartlesville at the family practice residency.
My wife and I were recovering from an ectopic pregnancy and it was too late to find employment for her as a teacher. She helped start the office.
Particularly difficult was knowing that I could get paid $4 to 8 more per visit if I had an office only a few miles away.