Physicians and their families have a lot to consider when looking for that ideal place to move. For many of them, small towns and rural cities are the answer. 

Take Walhalla, North Dakota, for example. There’s convenience, plenty to do, and is paradise for those who enjoy winter activities. In Juneau, Alaska, physicians and their families enjoy spectacular beauty, seclusion and diversity. Meanwhile, the small town of Berea, Kentucky, is perfect for those who love to get outdoors and appreciate small-town charm. Manchester, New Hampshire, offers a big town with a small-town feel and the ability to travel easily to top vacation destinations. 

Every spring, PracticeLink Magazine’s Live & Practice column features four small towns and rural cities ideal for physicians looking for new opportunities. To explore previous areas, visit PracticeLink.com/Magazine. 

Walhalla, North Dakota 

Walhalla, North Dakota, sitsonthe Pembina River 5 miles south of the Canadian border with a population of about 900. As one of the earliest communities in North Dakota, it developed the services and trade necessary to support the region’s agricultural activities. Today, Walhalla still functions as a trade center and is one of the most viable communities in the northeastern part of the state. 

For families who cherish the outdoors, there’s hiking, horseback riding, mountain biking, bird and wildlife viewing, camping, downhill or cross-country skiing, snowboarding, tubing and snowmobiling. The Pembina River offers excellent canoeing alongside a secluded landscape. 

If you are looking for a unique experience while hiking a nature trail, you’ll want to visit Tetrault Woods State Forest. Along with appreciating nature there, you can enjoy spectacular views from the two scenic overlooks that stand high above the river valley. For those who like to golf, the Walhalla Country Club offers a scenic 9-hole grass green golf course. The nearby Frost Fire Park is a popular ski area. 

Sam Okwudili, M.D., is a primary care physician with Langdon Prairie Health about 30 minutes from Walhalla. Though Okwudili has only lived in the area for a few months, he is used to the winter weather, as he was raised in Winnipeg, Canada. 

Langdon Prairie Health has been part of the community since 1939. They have a 20-bed facility and offer 24-hour emergency services, comprehensive laboratory services, general inpatient services, intensive and cardiac care units, pediatric care, swing bed services and respite care. 

Langdon Prairie Health also offers a wide range of important outpatient services including rehabilitation services; physical, occupational and speech therapy; skin procedures; wound care and pain management. In addition to the hospital, Langdon Prairie Health operates outpatient clinics in both Langdon and Walhalla. 

“What drew me to the hospital is that I get to do multiple things, so I had an interest not only in the clinic aspect of medicine but also the inpatient aspect,” says Okwudili. “I also get to practice a little bit of emergency health. That sparked my interest as a family medicine physician. It was a great fit for me. The staff and the administration are great. They are receptive to listening about how improvements can be made. As a provider, I like that. Physicians want to be in a place where they are heard and changes are implemented.” 

There are several things Okwudili likes about the area. He explains, “Having formerly lived in Connecticut and big cities—Manhattan, New York, for example—you have to plan around getting from one place to another. Going grocery shopping, to the mall and post office are what I would call events. Here in the Langdon/Walhalla area, the convenience of grocery shopping, mall and post office can be done in a matter of 20 to 30 minutes. 

Then, I have the time to spend on things that are of importance.” 

He finds the people in the community welcoming. “I’m enjoying getting to know how the town operates. People here have a can-do attitude and are strong workers. They really motivate me. It brings out my best and [inspires me] to try my hardest, so I really like that,” he says. 

“We are family friendly,” says Rebecca Davis, executive director of the Walhalla Chamber of Commerce. “There are summer rec programs for kids to participate in, and we have club sports at school. North Border Walhalla has approximately 200 students in grades K-12; we co-op with other districts for some sports. We have small class sizes in our schools. Those interested in hockey or ice skating can take lessons in Langdon.” 

Okwudili played a lot of soccer growing up. “I played on all different levels up to semi-pro,” he says. “My goal was to make it professionally in soccer. But along the way, I had new experiences and my mindset changed. Around age 16, I had a keen interest in the sciences. I also did a lot of volunteer work in my community. Being involved in the community was something I was very interested in. Midway through my first year of college, I made the decision that medicine was something I wanted to pursue. Also, being part of the community in the sense of providing a service.” 

For physicians looking for smaller towns with plenty of activities, the Walhalla/Langdon area is certainly worth considering. 

“I think the charm of this area is really the small-town feel, but you also get certain amenities you wouldn’t get in a larger town,” says Okwudili. “I think a lot of people are distracted when they come to bigger hospitals. I see how well-equipped Langdon Prairie Health is and have heard others say they didn’t expect this in such a town. I hope to get more graduates and residents interested in rural health. …It is of real importance to have well-qualified providers in these rural areas.”

Juneau, Alaska 

Juneau is a perfect combination of small town with a big town feel according to Cate Buley, M.D., a primary care physician and Chief Medical Officer at Southeast Alaska Regional Health Consortium (SEARHC). “Juneau is the state capital—and the legislature is in session, so we have a lot of politics going on. Also, there’s a significant amount of arts and entertainment for a small town of 30,000,” Buley says. 

Downtown Juneau is easy to get around, even on foot if that’s your preference. It has unique historic sites such as buildings that contain Alaska’s Native heritage, multiple museums and an art center. Just 13 miles from downtown Juneau is the Mendenhall Glacier. Kayakers enjoy Mendenhall Lake (in front of the glacier) and can view icebergs, mountains and waterfalls. Juneau has more than 250 miles of hiking trails, and there are opportunities for all different skill levels. 

Michael Crowder, recruiter for SEARHC, says Juneau is a great place for physicians to work. “SEARHC has the benefits that other employers have, but one of the things that sets us apart is the experience of getting to work in Alaska.” He adds: “There’s a reason cruise ships stop here in Juneau, Sitka or other Alaska communities. It’s spectacularly beautiful…breathtaking every turn of the road.” 

Juneau stands on one of the largest wilderness areas in the United States. It’s in the middle of the northernmost rainforest in the world. “It’s startling for physicians who are not from a rainforest and haven’t experienced mountains next to the ocean to come, see and experience this environment,” Crowder says. 

Along with its numerous outdoor recreational activities, Juneau also offers arts and culture. During “Celebration,” the Tlingit, Haida and Tsimshian people gather in Juneau for dancing and scholarship. Perseverance Theatre is nationally recognized, as is the Juneau Symphony, Juneau Lyric Opera and other companies. There are also annual events like the Alaska Folk Festival, the Juneau Jazz & Classics Festival and the Wearable Arts Extravaganza. 

Due to the rugged terrain that surrounds Juneau—water on one side and towering mountains and glaciers on the other—it is not accessible by car. There are no roads to connect Juneau to other parts of Alaska. However, Juneau has a local road system that residents and visitors use for daily commuting and exploring the area. 

“Juneau is just the size that you don’t feel landlocked even though you are,” Buley says. “There’s 30,000 people, lots of opportunities and enough roads you can drive. We get to see orcas, humpback whales and bears. The scenery is just amazing every day.” If families feel the need to get away, Seattle, Washington, is only a 2.5 hour flight away. 

Berea, Kentucky 

Berea, Kentucky, 40 milessouth of Lexington, is known for its art festivals, historic restaurants and buildings and is home to Berea College, a private liberal arts college founded in 1855. 

Today, Berea continues to attract tourists with its many festivals, trails, parks and performances. Red River Gorge, inside the Daniel Boone National Forest, has everything from rock climbing to mountain biking and is a little more than an hour outside of Berea. 

Art lovers enjoy the Berea Public Art Tour. There are several stops on the tour, including the Mitchell Tolle Building, Saint Joseph Berea Hospital, Draper Building and Phelps Stokes Chapel, to name a few. 

Berea is a small town, but there is no shortage of restaurants for families to enjoy. Nichole Stewart, enterprise director for healthcare recruitment for UK HealthCare, lives in close- by Lexington. She mentions that a lot of the staff at UK HealthCare live in towns outside of Lexington, including Berea. “Berea has that small-town charm,” says Stewart. “It has its own flavor. The students who go to Berea College go for free, as they all learn a trade. They make and produce things to cover the cost of their tuition. Many people go to Berea to buy wares. It’s a lovely area.” 

UK HealthCare is the system of the University of Kentucky. It consists of 9,000 people: physicians, nurses, pharmacists and other health care professionals. 

“It’s really a create-your-own-adventure story for a physician,” Stewart says. “They can come and pick the pieces that fill their cup and do the things they love to do. It doesn’t have to be full-time clinical practice. They get a voice into what their work looks like, and I think that matters to them.” 

The core campus in Lexington has approximately 945 licensed beds spread between Chandler Hospital, Kentucky Children’s Hospital and UK Good Samaritan Hospital—and the system is expanding. UK HealthCare is recruiting for all specialties. 

Manchester, New Hampshire 

Manchester, NewHampshire, islocated in the heart of New England about an hour from Boston and not far from many other vacation destinations in Maine, Vermont and Massachusetts. 

Manchester has beautiful parks throughout the city. Lake Massabesic offers boating, kayaking, fishing, picnicking locations and hiking and biking trails in addition to pristine clear water. Trails in Derryfield Park lead to the 19th century Weston Observatory. Skiers enjoy fresh powder in the winter for skiing and snowmobiling and join the thousands who flock to McIntyre Ski Resort. History lovers will enjoy Palace Theatre, an 850-seat historic theater in downtown Manchester, and a riverwalk with renovated mill buildings. 

Manchester has a convenient central location, a strong economy, short commutes, walkability and easy access to beautiful surroundings. 

Fran Lannan is the physician recruiter representative for Dartmouth Health Manchester Clinics. She says, “Manchester has great shops, from unique boutiques to shopping malls and outlets. There is no sales tax in New Hampshire. Manchester is one of the most affordable places in New England, and we have no state income tax.” 

Eric Shessler, M.D., is chair of Dartmouth Health Children’s Manchester/Bedford Primary Care Pediatrics, Primary Care Committee, and associate medical director of Dartmouth Hitchcock Manchester/Bedford Clinic. 

Shessler did medical school at McGill University and residency at Dartmouth Hitchcock Medical Center. Growing up, he was a swimmer. He says, “When you’re a swimmer, you can do two things: You can either teach swim lessons or you can be a lifeguard. …I knew I liked to teach kids how to swim, and I knew I liked working with kids. I also knew I liked science, puzzles and problem solving. One of the ways of combining all of that together was to be a physician, a pediatrician to be specific.” 

One of the things Shessler likes best about working at Dartmouth is the support offered. “When you’re working in a smaller area in general, you don’t always get access to that direct connection to a research-based, evidence-based academic medical center,” he says. “We have the affiliation with Dartmouth College and Dartmouth Hitchcock. So, we have all of the research things that physicians might be interested in. If you’re interested in doing a combination of research, clinical, and want a good work/life balance, this is a great place to get all of those things.” 

Lannan says, “We always want to recruit for primary care. As our city gets larger, we need access to primary care—so family medicine, internal medicine, behavioral health (especially post COVID), rheumatology, neurology and pain management are all specialties we recruit for.” •