{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/qb9v11wz33/manifest","type":"Manifest","label":{"en":["Dr. Stacy Dashiell"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. 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All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. 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So would you please state your full name for me?\n\nStacy Dashiell, MD: Stacy Dashiell.\n\nMorgan Weiler: Okay. And then your present title?\n\nStacy Dashiell, MD: I'm a family medicine physician at Sterling Medical Center and Rice County District Hospital.\n\nMorgan Weiler: Great. And then where did you go to medical school?\n\nStacy Dashiell, MD: I went to medical school at the University of Kansas in Kansas City.\n\nMorgan Weiler: Okay. And then where did you go to residency?\n\nStacy Dashiell, MD: I did residency at Research and Medicine in Kansas City, Missouri.\n\nMorgan Weiler: Great. Are you from Kansas city?\n\nStacy Dashiell, MD: Nope. I grew up in Cottonwood Falls, Kansas. Just a small town.\n\nMorgan Weiler: Okay. Can you speak a little bit about your current positions, and what you do on a daily basis?\n\nStacy Dashiell, MD: Sure. I practice full scope, rural family medicine. So I have an office based practice, which is owned by our hospital, which is a rural critical access hospital. So I see patients of all ages in clinic. I do OB, and then also cover the emergency room on weekends and some evenings. I manage and round on my own inpatients. I care for nursing home patients when I'm on call. We are also the county coroner. I am the medical director for the emergency management services, so EMS for the county. I am a volunteer medical director for Sterling College, which is here in town. I also work part-time for Kindred Hospice as a medical director for them, and wear various other small hats now and then.\n\nMorgan Weiler: Yeah. Wow. Not busy at all.\n\nStacy Dashiell, MD: Just a few little things.\n\nMorgan Weiler: And then when you tell me, you already did, but about the patient population you treat, and your community?\n\nStacy Dashiell, MD: Sure. So I live in Sterling, Kansas, which has a population of about 2,500, I believe. And then we care for, there's four physicians in all of Rice County, which has a population of just under 10,000. So there's one hospital, which is a critical access hospital, and then two clinics, one in Sterling and then one in Lyons, which is about 15 miles from us. So we care for all ages, literally cradle to grave. And lots of patients from Rice County, but we have a fair number of patients who drive in from surrounding counties to see us as well. And everything from uninsured to lots of Medicare, Medicaid, to the privately insured. So pretty broad patient population.\n\nMorgan Weiler: Yeah. So we're going to talk a little bit about COVID now. So-\n\nStacy Dashiell, MD: [crosstalk].\n\nMorgan Weiler: Right. So the first question is honestly silly, but has COVID-19 impacted your current work?\n\nStacy Dashiell, MD: Yes.\n\nMorgan Weiler: All right. What unique challenges do you and your practice face with COVID-19?\n\nStacy Dashiell, MD: I think every one has been affected deeply, and in many ways. For our rural community, there has been the challenge of just, there's four physicians for the county, and so we serve all the different roles and meet all the different needs. There's also been, as has been pretty well recognized in the media and that sort of thing, a general distrust in the rural communities for medical professionals and public health recommendations. And so I would say probably my biggest challenge has been that a lot of the things that I have worked to recommend and put into place have been fought against by those that honestly I, at times, considered friends and acquaintances, and it's made the public health piece pretty hard at times in our small community.\n\nMorgan Weiler: Yeah. Can you give some examples of some of the things that received a lot of pushback?\n\nStacy Dashiell, MD: The mask wearing was of course the most violent, maybe that's too strong of a word, but just a very strong reaction from much of the public regarding that. The stay at home orders and some of those other things have, of course, not always been well received as well. But there has just seemed to be something in rural America that has been very anti-mask, a lot of feelings that no one else should be able to tell me what to do, or what to put on my face, and misunderstandings and disbelief that it was effective or necessary. Those have been some of the greatest challenges.\n\nMorgan Weiler: Yeah. And then any barriers or obstacles, you mentioned the pushback, but were there any barriers outside of that with having to deal with COVID and implementing certain policy or other?\n\nStacy Dashiell, MD: We've had a lot of challenge from the public health perspective. We have a small health department that, actually our health department director, the nurse director retired just a couple of months into the pandemic. And so we brought a new director on board who we as a medical staff did not feel was well qualified for the job. She also serves as the public health officer for our county. Our county commissioners were very, just really difficult to work with, and at one point referred to the physicians and the hospital leadership as the medical cartel.\n\nStacy Dashiell, MD: So my partner and best friend was serving as the physician medical director for the health department, and was so poorly treated, and honestly verbally abused by our County commissioners, and felt so strongly about the lack of qualification of the person that they wanted to put in the director and public health officer position, that she actually resigned. And then our commissioners got a medical director from an adjacent county who is completely absent and essentially just is the name to put on the paperwork.\n\nStacy Dashiell, MD: So that has really left a big gap of leadership. I have then become the physician leader of our COVID committee for our hospital, which, being the only hospital in town, and then without a lot of leadership from our health department or from our commissioners, has served then as the guiding ship for COVID for the community. So in that role, then, I have become the, without any official title, the Health Department Director, Public Health Officer, I'm the go-to person for all the questions and the final decisions and all of that. But that's been very interesting because I am not the Public Health Officer or the Health Department Director, but have chosen to just serve in that role as needed because of the void of anyone else in that role currently.\n\nMorgan Weiler: Yeah. So background is, most health departments are administering the vaccines right now from a logistics standpoint. Has that been difficult because you're transitioning through leadership, and that's how administration of the vaccines go? Can you talk a little bit about the challenges with that?\n\nStacy Dashiell, MD: Yeah, I would be happy to. This is actually, of course just happened more recently, as we're nearing a year into this pandemic and really I've started just doing vaccine work over the last couple of months. We had, very thankfully, an election, and two of the three county commissioners, we just have three in the county that had been just very negative and difficult to work with were not reelected, which then has put in place a change in guard. And one of the new county commissioners happens to be a retired EMS medical director. He's a paramedic. And he has chosen to take charge of the coordination of the vaccine, from a standpoint of uniting the health department, and the hospital, and the Council on Aging, and the various entities in the County.\n\nStacy Dashiell, MD: So it has been challenging, but right now I'm feeling very encouraged. All of those entities have come together and we're using our, the big gathering or event center that we have in the county, and are doing a mass vaccination site once a week. We've been getting about 100 to 200 vaccines a week, which has gone much slower than people would like it to, but we're at least gradually working down the list, and I've had a pretty good community team effort, which has felt really lovely at this point in the pandemic, after some struggles in that area leading up to it.\n\nMorgan Weiler: Yeah. Well that's good news. Good news there. So going back, how did you manage in the first part of this pandemic, your professional life and the personal life?\n\nStacy Dashiell, MD: It was really hard. The good thing was, because everything shut down in life, although life outside of my home was really busy and I was attending and leading lots of meetings and listening to every webinar I could find time for, and of course just implementing all sorts of new policies and changes, and infection control and all of those things. So life at work was very busy, but then when I came home, there was nothing. So I have four children, but all of their activities were canceled. We didn't have music programs, or sporting events, or ... And so in that regard, the simplicity about life at home somewhat helped to balance the craziness of life outside.\n\nStacy Dashiell, MD: One of the biggest challenges, which is continuing, and I think will always change the way that I feel and I practice in this small town, was just the sometimes personal attacks that I received, and my partner received, as we tried to encourage the county and the schools. And at one point early in the pandemic, I think I was consulted by what felt like every entity in the community, the daycares, the schools, the grocery store, the coffee shop, everybody wanted to know what I thought we should do. And often my opinion was not well received. And so I have broken friendships, I have been personally attacked on social media, and some of those sorts of things have been very isolating, and then have made the professional, personal balance really difficult to maintain.\n\nMorgan Weiler: Especially in a town with 22, 23, 2,400 people.\n\nStacy Dashiell, MD: Yeah, yeah. And I've been here for, this summer will be 11 years. And so I really felt like I was part of the community, and then it really, I guess, reminded me and made me feel like an outsider often, I guess. And that was difficult.\n\nMorgan Weiler: Yeah. What have you learned through the pandemic, and still learning?\n\nStacy Dashiell, MD: Well, that's a great question. Of course it's opened up a whole nother world of public health work that I, in general, have not done. I have worn lots of hats in the leadership realm, but not as much ... This is the first time that it ever really was to the extent and to the county level that it is now. So I have learned a lot about public perception of public health, I've learned a lot about what it takes to communicate with the public about difficult things.\n\nStacy Dashiell, MD: I have really learned that, if we don't have a unified message as a medical community, or as a government, that that is so detrimental to the public. And seeing that, there are times that I was furious with people who were attacking me or those that were just blatantly refusing to wear a mask when they walked into our little grocery store, and the clerk asked them to put a mask on. But then I had to remind myself that the leadership that they were seeing from the national level down, was one of not wearing a mask, and of being really anti-science in many ways. And that, I think, gave me some empathy to realize that just the common person that is gathering their information from social media, or just a passing news source, can't be expected to understand and appreciate the nuances of this ever-changing public health recommendation if they're getting mixed messages from the very top down.\n\nStacy Dashiell, MD: [inaudible] interesting, just watching how people respond in times of stress. And that would be another source of empathy for me, or patience when I was trying to struggle to understand how people's views could be so different from mine, or how people could have just blatant disregard for what we were suggesting as a medical, scientific community. And I realized I watched, and still do, but watched a lot of coping mechanisms of denial. If you just pretend like it's not real, or pretend like it's not as big of a threat as it is, and you really choose to believe that, then that makes things a lot less scary. Because there have been times over this last year that have been really scary. So ... Sorry. I just had a call come in.\n\nMorgan Weiler: That's okay.\n\nStacy Dashiell, MD: So anyways, that has been ... There's been lessons, of course, on COVID and science. And I know so much about this virus and treatments, and the true just medicine of it all, but there's been a lot of other lessons besides that.\n\nMorgan Weiler: Yeah. I'm curious about some of those research, and how many, I don't really know the name of it, but the social research and just seeing how people react. I think that's a really interesting point. So what did you feel you did right during the pandemic?\n\nStacy Dashiell, MD: I'm proud of my leadership, and my choice to dig deep and continue to fight the good fight, and try to educate, and show empathy, and continue to try to find common ground. There were definitely times that I really thought that I might have to just step back from it all for my own mental health, and the ability to continue to just do other day-to-day functions, because it was just exhausting and intense. My husband has said that some of the hours and the time that I've put in, in the weeks, have been reminiscent of a first year of residency. Just, it's all the time and it's never-ending. And there were times that it felt like maybe it wasn't worth it. But in retrospect, I think it was. And it would have just left a gigantic void had I not chosen to continue to lean into that.\n\nStacy Dashiell, MD: But then I'm also proud of, I think, my ability to learn how to take care of myself too, even when the demands were great, and it was hard to say no. We, as a family, went on two or three camping trips, and we found a friend's cabin in Colorado in the middle of nowhere, and we have gone there twice. I have read more novels over the last year than I have probably in the 10 years before that, and have really found good rhythms of yoga, and quiet time with my faith, and things like that, that have allowed me, or I've come to a place where I'm able to balance the great demands, I feel like, in a pretty healthy way. So I'm proud of that.\n\nMorgan Weiler: Good. So what changes brought by COVID-19 do you think will be permanent?\n\nStacy Dashiell, MD: This question intrigues me. I have a good friend who is a public school teacher, and she said they actually had a meeting. Their principal brought them together with that question of, \"What changes would you like to move forward with?\" Which I thought was a really nice, positive spin on all of the things, all the changes that have been asked of public school teachers, and to be able to have them focus on the things that they are thankful for, or the new light that they've seen things in.\n\nStacy Dashiell, MD: I think that Zoom meetings are lovely. So living in a rural area, even to go to the hospital is a 15 minute drive. And often it's nice to ... I would have always left my clinic and driven to the hospital to be in on a noon meeting. And now we do almost all of our meetings on Zoom, so I can just sit in my office and save 30 minutes of drive time. And obviously there are times that meetings need to happen in person, but I think we're going to all utilize this type of meeting platform a lot more in the future.\n\nStacy Dashiell, MD: And then the same with being able to connect with other health department medical directors in this manner, being able to listen in to webinars. And I was able to hear the experts from KU Med and University of Colorado, and all these places, just very easily in an earbud in my ear, while I was maybe doing something else too, that I would have never been able to do pre-pandemic times. So making the medical world a little bit smaller in that regard, I think is something that I hope that will continue.\n\nMorgan Weiler: Yeah. That's how we're able to do this.\n\nStacy Dashiell, MD: Exactly.\n\nMorgan Weiler: So how do you see COVID impacting the learning of students and residents in family medicine?\n\nStacy Dashiell, MD: I think that has been definitely one of the detrimental pieces of all of this. I know just this last month, my partner and I were supposed to have a student, and she was given the option to do her rotation remotely, which meant she didn't do anything with us except she asked some questions about rural family medicine. And I think that's a huge loss. There's so much to be learned that even missing one, two, three rotations, you can't replace that.\n\nStacy Dashiell, MD: And there's always been, over the last several years, lots of discussion about that family medicine residency needs to be longer, because there's more to learn than there is time to learn it. And I know in many regards the residents continued to work and function, but there were opportunities that were not available to them because of COVID as well. So it's going to have a lasting impact. I know we've already seen things like nurse's aide shortages, because for nine months no one was doing in person nurse's aide classes. And just those seemingly small things at the moment have really lasting impacts in a healthcare system that is already experiencing shortages in a lot of these areas. So ...\n\nMorgan Weiler: Yeah, that's interesting about the nurse's aides. I didn't even think about things like that. What is your sense of where family medicine is going in the future?\n\nStacy Dashiell, MD: Well, family medicine, I'm super proud to be a family physician. I think we just offer a type of approach to medical care that is exactly what our country needs. I think at least I can speak to rural America, the leadership that family physicians have provided in this pandemic is just incredible. When I am a part of health department medical directors Zoom call, almost all of them are family physicians. And that's just really amazing to me. So I think it has to continue to keep family medicine at the forefront of exactly what is needed and necessary for healthcare in our country.\n\nMorgan Weiler: Yeah. So any views on important issues in the specialty related to COVID-19 that we have not addressed, or that you'd like to share with us? You've shared a lot, and what you've shared is great, but if there's anything else that you'd like to add ...\n\nStacy Dashiell, MD: I don't think so. I think the unique piece for me as a rural family physician has been just that COVID-19 and all that it has brought with it has changed every aspect of my life, because it's the professional piece, it's of course the fact that my kids have been doing virtual school at home during all that, it's the fact that my friendships and relationships within the community have been affected. One of the social media posts attacked my, how could I tell others to wear masks when I was not even wearing a mask myself? And it was ridiculous, and very clearly showed this person's misunderstanding of when masks were supposed to be worn.\n\nStacy Dashiell, MD: And it was a very careful mask wearer, and was ... But the result of that, she was able to name multiple places that I had been and times that she had observed me, and then others chimed in with other attacks. And the results of that was that I still don't feel comfortable being social in our town, even in a COVID appropriate way. So I still will not have coffee at our coffee shop, even socially distanced or with someone else within my own household, where it would be appropriate to be with them. So that aspect has been, I think, unique to the rural family physician, that it has really reached every single aspect of my life.\n\nMorgan Weiler: Wow. Well, I'm going to stop recording now.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/105305/file/205881#t=0.0,1778.12"}]}]}]}