Still giving back

Dr. Kay Miller Temple, a physician-journalist, uses her unique background to reach a national audience through UND’s Center for Rural Health

If you’ve seen one rural community …

… you’ve seen one rural community, said Dr. David Schmitz, professor of Family and Community Medicine at the UND School of Medicine & Health Sciences. Small towns vary tremendously in terms of not only culture, but also health care. Economically similar communities likely have very different rates of opioid use disorder, teen pregnancies, cancer diagnoses and other health challenges.

In response, Schmitz’s idea was to have UND medical students – many of whom spend weeks or months on rotation in small-town hospitals and clinics – write for the local newspaper about that town’s particular health care needs. But who would help the physicians-in-training with what is essentially a journalism job?

“That’s when Kay Miller Temple came along,” Schmitz said. “And it was just kind of incredible.”

Doctor and writer

Dr. Kay Miller Temple is UND’s own physician-journalist, one of the rare practitioners who has degrees in both fields: an M.D. from the University of South Dakota’s Sanford School of Medicine, plus a master’s degree from the Walter Cronkite School of Journalism and Mass Communication at Arizona State.

Triple-boarded in internal medicine, pediatrics, and hospice and palliative care, she also has extensive experience in not only direct patient care but also health care writing for lay publications.

For nearly 30 years, Miller Temple worked in a variety of clinical settings as a primary care physician, including the last 15 years as a hospitalist at the Arizona campus of the Mayo Clinic. Today, she’s a writer for the Rural Health Information Hub, the national clearinghouse on rural health issues that’s located at the Center for Rural Health at UND.

And as such, she was just the right person to help Schmitz’s Targeted Rural Health Education program succeed. “She takes the time to work with the students and helps them learn how to write about health issues in layman’s terms,” Schmitz said. She also uses her medical background to help make sure the health information that the students offer is accurate and up-to-date.

Her work as a writing mentor helped the program take off, Schmitz said. Today, the program is a formal part of UND’s medical school curriculum, “and it’s much bigger and more robust than it would have been had the students not been able to work with Kay.”

All in a day’s work, said Miller Temple. “I always loved the service aspect of medicine, and now, I’m finding I love the service aspect of writing about health care and teaching health care students, too,” she said.

“It’s just been so much fun. And I feel like I’m still giving back.”

Small-town roots

Besides her health care and journalism experience, Miller Temple brings a third valuable trait to her Rural Health Information Hub work: a small-town perspective. “My great-great grandparents homesteaded in Dakota Territory, and I grew up on the family farm,” she said, also sharing that she still spends a lot of time with family members who farm and ranch in South Dakota.

But after several decades as a clinician, Miller Temple found herself concerned that the long days and roller-coaster emotions of hospital internal medicine work were not sustainable into the later stages of her clinical career. Those thoughts prompted her to consider transitioning to a non-clinical career that would allow her to still be a good steward of her medical education and clinical experience.

Journalism fit that bill. “I’d kind of always been a writer, but I’d just never thought of doing it for a career,” she said.

She enrolled in the Cronkite School’s graduate program. “And for the 18 months that I was in that program, there was not one day when I thought, ‘Why am I doing this?’

“Instead, it was always, ‘This is right. This is it.’”

Strengthening rural communities

Then one day, as Miller Temple perused the website of the Association of Health Care Journalists, she spotted a “Writer wanted” ad for the Rural Health Information Hub. “I saw it and thought, ‘Oh my gosh, this is perfect,’” she said.

And so it was, said Kristine Sande, associate director of the Center for Rural Health and program director of RHIhub.

The Center, a department within the School of Medicine & Health Sciences at UND, is home to seven national programs, with the RHIhub being one. That means the RHIhub needs national talent, because its rural health information gets read by doctors, nurses, clinic administrators and others not only throughout rural America but also in Washington, D.C.

“So, having somebody with Kay’s specific knowledge and background has been really helpful,” Sande said.

“She has many years of working in health care, so she brings a unique perspective to the work that we do. She thinks outside of our typical box, which is great.

“And she really understands what the people we’re trying to help are experiencing.” Add to that Miller Temple’s passion for rural health journalism, and you’ll see why “we’re just thrilled that she decided to come work for us,” Sande said.

A physician’s perspective

If you visit the RHIhub’s website, you’ll find Miller Temple’s work in two key e-publications. The first is Rural Health Models and Innovations. These are in-depth descriptions of rural health programs that studies have found to be effective, Miller Temple said: “What we do is we take those programs, those success stories, and we drill down. What was the need? What was the intervention? What were the results, and can the program be replicated?”

Then the RHIhub ranks the programs by the strength of the evidence, Miller Temple said. The result is a user-friendly, jargon-free guide to the most promising solutions to the problems of rural health.

The second e-pub, The Rural Monitor, is an online magazine that carries in-depth feature stories about health care and public health in rural communities. The stories are written in an accessible and journalistic style; but Miller Temple’s medical background brings special insight to them, as two examples will show.

The first is “The Death Certificate: A document to be honored and accurate,” one of the Rural Monitor’s most popular stories of 2018, and a story that Miller Temple pitched, reported and then wrote.

“I had always wanted to tell a story about death certificates, because as a physician, I learned that there is no substitute document,” Miller Temple said.

“They’re the core of so much public health information, and they’re vital for business and legal transactions such as death benefits. But few practitioners are trained in completing them, which raises accuracy issues.

“And in rural areas, researchers can find the public data gleaned from those certificates to be a challenge.” That’s because confidentiality issues loom large when you’re looking at large geographic areas with only a few residents, she said, noting that the aggregate data is often less helpful.

Making data memorable

The second example is “What’s MAT Got to Do with It? Medication-Assisted Treatment for Opioid Use Disorder in Rural America.” In this 2018 story about MAT – an effective evidence-based treatment for opioid use disorder – Miller Temple’s fluency with the challenging topics of pain, opioids’ effects, and anti-opioid-use-disorder medications such as methadone is obvious, so much so that Miller Temple was informed by a federal agency’s regional medical director that the story’s information was valuable enough to forward to the other regional directors.

“I really enjoy that process of taking data and evidence, and using it to bring the ‘aha’ moment to the rural health issue being featured,” Miller Temple said. “One researcher said something complimentary. He said, ‘My data makes your story credible. But your story makes my data memorable.’”

To sum up, programs such as RHIhub and the Targeted Rural Health Education program are a big reason why UND stands out in rural health – and Miller Temple’s work is a big reason why those programs succeed, Dr. David Schmitz said.

“The resources at this institution are unique, and I know our students and the public benefit from them, particularly in the area of rural health,” he said.

“And some of that, we couldn’t do without Kay. She’s absolutely integral, and I’m very, very thankful for her applying her unique skills.”