JOHN DAY – A visiting resident doctor and medical student are giving patients their caring touch while on assignment at two local clinics.

Dr. Josh Gepner is at Dr. Robert Holland’s office as a resident doctor, and Rachel Seltzer, a medical student, works with Dr. Andrew Janssen at Strawberry Wilderness Community Clinic. Both are receiving their training through Oregon Health Sciences University in Portland.

Seltzer applied and was selected for the Oregon Rural Scholars Program which combines family medicine, rural medicine and an elective rotation.

She arrived in early December and her stay will last through mid-March.

John Day, Seltzer says, provides a good opportunity to learn comprehensive rural care education, and people in this area have the same medical issues as people anywhere.

The one difference:

“There is no easy access to specialty care so it’s up to the health care team here to manage the health of everyone in the community regardless of complexity of diagnosis,” she said, adding that the local providers handle it “elegantly.”

Gepner began work with Holland Jan. 10 and stays through the end of February.

So far, he says he’s seen a normal cross-section of health problems at the office and hospital.

Of greatest concern to him among patients he’s seen is metabolic syndrome.

This health problem is a combination of high blood pressure, high cholesterol, insulin resistance and overweight or obesity, as well as other factors, which set a person up for heart disease and diabetes.

“It’s a disease that we as a culture have made over the years,” he said.

Gepner added that when a restaurant plate of 1,700 calories is set in front of people, they tend to do what they’ve been taught: clean the plate.

“We eat too much,” he said.

He doesn’t have a specific diet he recommends, just less fat, more vegetables, less meat (smaller servings), fewer calories and exercise.

“Smoking is another huge risk factor for heart disease,” Rachel added.

Both said it can be hard to quit, especially if another member of the household smokes; however, it can be done.

Seltzer said seven times is the average number of tries it takes before someone quits for good.

On the flu season, Seltzer and Gepner both recommend that people of all ages get vaccinated for influenza.

Seltzer noted that the H1N1 virus, which made it’s first appearance last April, is predicted to make future comebacks.

One argument against the vaccinations that they hear is that some people come down with flu symptoms when they receive the shot.

The point of getting the shot Gepner reminds, “is to convince the body that you have the virus, tricking the body into thinking that you’re sick, and it builds up antibodies.”

“The body is responding to the bug, working to fight off the illness,” Seltzer noted, adding, “No one has died from getting the shot.”

Both Seltzer and Gepner say they chose the medical profession, in part, as an opportunity to give back to others, and they enjoy their time working with patients in John Day.

“It’s been a pleasure getting to know the community,” said Gepner.