April 19, 2021
My Why: Dr. Cindy Firkins Smith
I don’t come from a world of medicine. My dad was a truck driver. He’s deceased now. My mom got a two-year degree in elementary education and actually worked in our trucking business. She ended up transitioning and is still working. I was the first one in my immediate family to get a college degree. So honestly, thinking about going into medicine—thinking about being a doctor—wasn’t something that anybody ever thought about. You know, it was like going to the moon in my family. But to me, it looked like a career where I could make a difference.
—I’m a rural girl. I was born rural, raised rural, and I’ll die rural. Country is in my bones.
I had been very interested in a variety of English classes and all kinds of different things in high school but took a science class from one of the best teachers ever, who was a physiology instructor. He got me very intrigued with science and the human body, and the opportunity to put that together to make a difference in people’s lives. That’s what drove me into medicine.
And of course, rural medicine because I grew up in a small town. I’m a rural girl. I was born rural, raised rural, and I’ll die rural. Country is in my bones. So they can’t take that out of me.
My Why
My Why in this role as Vice President of Rural Health is kind of a combination of accident and intent.
Being a physician wasn’t accidental, but being a dermatologist was kind of accidental. When I went into medical school, I intended to be an OB GYN. But that didn’t quite fit. After the babies were born, I was more inclined to mess with the babies and not so much with the moms. So then I kind of fell then into family medicine and thought that would be a good fit for me, but I realized pretty quickly that I wasn’t smart enough to handle the breadth of information needed. I needed to focus a little and dermatology found me. I’m a visual learner and it was just a really good fit for me. I have what I do. It’s been a great career.
I wanted to be a rural dermatologist. There was a great need for that. But my professors in my residency weren’t very supportive of that idea. They were good people but had some biases about rural. One of the most memorable quotes I heard was, “You don’t want to be a rural dermatologist. All you’ll ever see are warts and acne. You belong in academics.” I doubted that was true, and I wanted to live in a rural area and serve people.
So when I was a senior resident, I came out to Willmar. (My husband was from Renville.) They needed a dermatologist and I worked on weekends for a full year while I was still a resident. I wanted to see what the scope of practice was and what my future partners might be like. It was an incredible practice. The physicians and the staff were bright and committed. The patients were incredible and the scope of practice was broad. And you got to do all kinds of things because people weren’t going to drive a hundred miles to the Twin Cities. When my residency was done, my husband and I moved the family out here, and we’ve been here for 30 years.
It’s a tough time for rural medicine. There are hospitals and clinics in rural America that are closing and patients losing access to healthcare close to home.
Throughout that time, I have been advocating in academics, with the Minnesota Medical Association, and at the legislature for rural medicine and rural patients. Then five years ago, I became CEO of ACMC when we were trying to decide what our future should look like because rural medicine across the country is challenged. It’s a tough time for rural medicine. There are hospitals and clinics in rural America that are closing and patients losing access to healthcare close to home. That’s what led us to CentraCare as the right partner. They were committed to rural health and they were right down the road. We shared patients for years. So we came together and created Carris Health.
There is still work to be done. We have created a division of Rural Health. No one else in the country has done that. And now we will dive into that with No Fear. We will elevate rural health and optimize it. We will re-envision and innovate in ways we’ve never thought of before. And we will do it fearlessly.
Cindy Firkins-Smith, MD
Vice President, Rural Health