40 Clinicians

Ryan Smith Image

The most remarkable thing about Ryan Smith, a Physician Assistant and recent National Health Service Corps (NHSC) Loan Repayment Program alum, is not the incredible work he has done with the homeless population in Coeur d’Alene, Idaho. It’s the humility and selflessness he exudes when he talks about it. He never misses an opportunity to give credit to one of his colleagues or praise someone else’s contributions.

But, it really is Ryan who has turned around the Dirne Community Health Center’s approach to helping the city’s homeless population. Dirne had a walk-in clinic that catered to homeless populations, but it never really got much traffic. Two years ago Ryan’s CEO came to him and asked him to improve the program. Ryan was sent to the National Healthcare for the Homeless Conference in San Francisco where Ryan learned the key to success with this population is a go to them. “When I got back, I talked to the CEO and said, ‘Why are we sitting in here waiting for them to come to us? Let’s go to them!’”

With that conversation, “Street Medicine,” was born. Ryan would load two fishing tackle boxes full of medical supplies into his car and drive around with a nurse and outreach worker to churches, encampments, and parking lots to see patients. “Before we would get some people coming into the clinic, but it was really hard to get them to trust us- and trust is huge with this population. When we started getting out to where they were, it created that trust, which also vastly improved follow-up care.”

Word got around the community about the work Ryan was doing, and before he knew it, he had people asking to come along to see his work firsthand. The Director of the local Health District was so impressed that she made a presentation to the Coeur d’Alene Rotary Club which resulted in a $15,000 donation to the purchase of a motor home for mobile operations.

The Dirne Mobile Medical Clinic is currently being utilized twice weekly with both patients and staff loving it. The vehicle provides much more privacy and also the ability to complete a more focused examination. It is also equipped with computer to utilize Electronic Health Records and the ability to print off patient education materials for their various issues.

Ryan, who grew up in Coeur d’Alene, is the first in his family to go to college. He went into medicine and graduated from Idaho State University’s PA School because he wanted to be able to answer health question from his friends and family. Ryan credits the NHSC with allowing him to do what he does. “I wouldn’t be able to support myself without NHSC Loan Repayment, but more than me, the NHSC allows community health centers all over the country to do what they do – which is to try to make a difference.”

When asked what his work means to him, Ryan responds with humble gratitude. “Most PAs don’t get the sort of opportunities I’ve had. You usually see the MDs running these sorts of programs. It feels really great to make a difference. We practice hope and reassurance first and medicine second. It’s the hope and reassurance that allows our patients to get through the day and come back to see us the next day. This program means so much to the people it serves, and I am just thankful to be part of it.”