Loan began working toward her goal four years ago as one of 10 graduating students who participated in UK's Rural Physician Leadership Program, where she believes her roots in Greenup County prepared her for a future responding to medical emergencies in rural Kentucky, Adams reports.
Loan told Adams that her earliest experiences in emergency medicine were watching her mother, Elizabeth Loan, respond to accidents in the farming community because she had an associate's degree in nursing and was the most educated health care provider within a 10-mile radius of the Loan farm.
Her daughter recalled that when the neighbor's son went into a diabetic coma, her mother rushed to their house to administer sugar. Another time, her mother administered CPR to a farmer who was pinned under a tractor until the emergency responders arrived.
"There have been a lot of instances when my mom was the sole health care provider," Loan said.
Loan told Adams that she understands cultural characteristics that influence health in rural populations, such as an attitude of self-reliance that results in attempts to self-medicate or postpone visits to the doctor. It's often difficult for doctors from urban environments to appreciate those cultural variances.
"I get why people don't go to the doctor—rural people are raised to take care of themselves," Loan said. "Before they come to the doctor, they've tried a few things."
Loan told Adams she also understands first-hand some of the health challenges found in rural communities. Her father, a longtime tobacco farmer and user, suffers from chronic obstructive pulmonary disease.
Kentucky has the nation's highest rate of COPD, 9.3 percent of the population, according to the federal Centers for Disease Control and Prevention. Tobacco use is the primary cause, but air pollution and genetics can also play a role.
Loan told Adams that growing up in a rural area isolated from hospitals fueled her desire to deliver more efficient emergency medical care to rural communities. She said she "enjoys the challenge of being the first doctor on the trauma scene and 'Macgyver-ing' her way through emergencies with limited resources."
"I love the fact that patients who come to the emergency department are the sickest patients you are going to see," Loan said. "You lay your eyes on them; you have no previous notes—you are the person who has an hour before the patient crashes to figure out what's going on."
Loan's experience in the Rural Physician Leadership Program allowed her to gain more hands-on experience with patients because of the hospital's smaller medical staff and fewer residents in the program, Adams reports. She has delivered more than 10 babies, assisted attending physicians with bowel surgery and helped stabilize a coding patient in the emergency department.
During her stint, Loan participated in a clerkship and lectures at St. Claire Regional Hospital in Morehead. Dr. Phillip Overall, the emergency clerkship director at the hospital, told Adams that Loan has already demonstrated the calm and decisive qualities needed in an emergency-room doctor.
"She is able to think very quickly on her feet and subsequently provide excellent patient care," Overall told Adams. "We take care of critical patients on a daily basis, and she is absolutely able to step back and assess the entire situation calmly and come up with a plan to take care of the patient."
The assistant dean who recruited Loan to the Rural Physician Leadership Program, Dr. Anthony Weaver, said that rural practices and hospitals need physicians who are committed to living and working in small towns. Loan's closeness to her family and ability to "have conversations with anyone about just about anything" made her an ideal candidate for the program, he told Adams.
"Ashley Loan has the intelligence and drive to succeed as a physician, but more importantly, she cares about her family and her neighbors," Weaver said. "Improvements in the health of rural Kentucky will come from people like Ashley."
Loan also received a certificate in health systems leadership upon graduation from medical school and will work toward a master's in business administration during her medical residency, which she is also completing at UK. Loan aspires to serve as the director of a rural emergency department.
Loan was once a high-school girl who wanted to escape rural Kentucky. Now, she not only has committed to practicing medicine in rural Kentucky, but she and her fiancé Ryan Brown have bought an 87-acre farm in Greenup County and built a house there. She plans to raise beef cattle when not practicing emergency medicine in a nearby hospital or responding to emergencies, Adams writes.
"I'm definitely a small-town person," Loan told Adams. "I feel an obligation to come back and serve the people who have really believed in me for so long. It makes my day when someone says, 'You are coming back here?' I'm Ashley—I'm the girl who sold corn with her dad on the side of the road—they trust me, and I like that." (Read more)