Fresh from the bright neon lights of Las Vegas, the new physician assistant at Challis Area Health Center, Max Smith, and his family are looking forward to life in the much slower city of Challis.
Smith, 35, worked in Las Vegas, with a metro area population of nearly 2 million, for the past six years and since early June has been enjoying the rural, scenic mountain setting of Challis, with a population of just over 1,000.
“Getting out here to experience a different speed of life and quality of life than you’re exposed to in a metropolitan area really appealed to me,” Smith said.
Like many small world experiences, his introduction to Challis was through a friend, fellow PA Chad Banks. The two attended graduate school together and got their master’s degrees in physician assistant studies. When Nurse Practitioner Deana Andrews resigned earlier this year due to family reasons, Banks told Smith about the opening in Challis and urged his friend to apply.
Smith joins fellow physician assistants Chad Banks, Miles Haeberle and Danny Fife, the rest of the staff at Challis Area Health Center and volunteers on the Challis ambulance crew. He was wrapping up his second rotation of being on urgent care duty for the ambulance and after-hours and walk-in clinic duty when he sat down for an interview July 25. The PAs also cover regularly scheduled appointments for two weeks at the clinic and have one week off per month before their rotation begins again.
“It’s a great team,” Smith said. “Everyone really helps each other.” His colleagues at the Las Vegas clinic came to feel like family, Smith said, “So to come here and have a really great work environment where everyone is kind and friendly to each other is great.”
Challis Area Health Center secured a renewable $650,000 three-year federal grant in August 2015 and designation as one of 15 community health centers in Idaho, which has allowed the clinic to keep four mid-level providers on staff instead of just one or two as in the past and to hire a counselor and expand services to include mental health care.
“The services being offered here are amazing,” Smith said. “Some of the access to health care here is better than in Las Vegas. The quality of health care here is amazing. It’s really neat they have that for us,” he said of the grant.
Challis has a program in which each of its four mid-level providers ride along with the volunteer drivers and EMTs on all emergencies for one week a month. That’s something Smith has seen nowhere else.
“I think that’s really great because it’s helping expand access to care. Everything I see here is about expanding care.” Having physician assistants out in the community with the ambulance volunteers is different but similar to the good old days of doctors making house calls. The relationship with the ambulance volunteers has been “fantastic and synergistic,” Smith said.
Smith didn’t always plan on a medical career. He grew up in Orem, Utah, and was majoring in French and business at Brigham Young University in Provo when the Church of Jesus Christ of Latter-day Saints sent him on a two-year mission to Mexico City.
“I studied seven years of French and they sent me to Mexico,” Smith said. There he learned to speak Spanish, which has served him well, since Spanish is more useful to him as a health care provider in the U.S. He’s been able to communicate with Spanish-speaking patients in their native language, which helps an under-served population gain better access to medical care.
He’d always been interested in the complexity and mechanics of how the human body works and was first exposed to health care at a job as an assistant at a plasma donation center in Orem while he was working on his bachelor’s degree at BYU Provo. He helped patients who passed out or were in some kind of distress while donating plasma and started thinking about medicine as a career.
It was in Mexico City that Smith decided to change career paths and go into medicine. He was visiting a fellow LDS church member in a Mexico City hospital when he got the idea that he should go back and go into medicine. He changed his major at BYU and graduated with a bachelor’s degree in neuroscience. That degree exposed him to a blend of psychology, physiology and chemistry. The next stop was earning his master’s degree in physician assistant studies at Touro University in Vallejo in the San Francisco Bay area in California.
Smith enjoys general family medical practice where as a primary health care provider and Jack-of-all-trades he gets to “see it all and take care of it all.” The career field for physician assistants and other health care providers is growing rapidly, with a shortage of providers in the U.S. as many physicians near retirement age.
Smith doesn’t see himself getting an M.D. and becoming a specialist. After he’s been in practice long enough, he likes the idea of becoming a professor and teaching the next generation of physician assistants.
Contrary to popular belief, most people don’t go into medicine for the money. Although specialist M.D.s may earn a lot, student loans take a long time to pay off, and costs such as malpractice insurance are high. “You really want to be there to take care of people,” Smith said. That’s what motivates him and most of the mid-level provider colleagues he’s worked with.
Smith and wife Brityn have three children, two of whom will enroll in Challis schools this fall: Madeline, 9, in fourth grade and Malcolm, 6, in first grade. It will be a couple of years before Sam, 3, starts school. The family is renting a house in Challis.
They enjoy camping, fishing and hiking and have enjoyed exploring places like Bayhorse and Stanley lakes. “It’s just fantastic. This is a gorgeous place to live,” Smith said.
Smith’s full name is Stephen Max Smith. He started going by his middle name after his grandfather Max passed away to honor him. Smith, the youngest of six siblings, is the first member of his family to go into medicine. His grandfather was handyman sort of guy and ran a ranch and a hotel. His father was in computer software marketing.