Nate Defrees, MD: A Quintessential Small-Town Family Doctor
Nate, a family doctor in Baker City, serves his community with unparalleled dedication. He is passionate about being able to treat the whole family, adapting his care to fit each unique need. “It's not unusual that I'll see three generations of a family, maybe in the same day, which is a pretty special thing to be able to do,” Nate shared. Between delivering babies, tending to patients of all ages, performing endoscopies, volunteering as an EMT, serving as a medical examiner, directing a small clinic in Heppner, involvement with the Oregon Medical Association (OMA) and Oregon Academy of Family Physicians (OAFP), and working on the family ranch one day a week, Dr. Defrees does it all.
Being a fifth-generation cattle rancher from Sumpter, Nate always felt a pull to stay in rural Oregon. "I'm happy in Eastern Oregon. I don't need to go on vacations to other places—I stay pretty happy within a 150-mile radius from where I'm at," he described. His love for the outdoors and his commitment to his community made family medicine a natural fit. After completing his medical training at Oregon Health & Science University (OHSU) and Family Medicine Residency of Idaho, he returned to Baker City where he and his wife, a former health sciences teacher and current Talented and Gifted Program Director, now raise their three children.
Now eight years into his career, there has been a wrench thrown in the community—the maternity ward has closed. Just like many, Nate is worried about the health of women and babies. “Certainly, a really, really low point in my career here thus far,” he reflected. “It's really important that women have a safe way to deliver babies. And we're isolated enough out here that traveling when you're pregnant and delivering is hard.” With a mountain pass between Baker City and the nearest maternity ward in La Grande, there are significant concerns surrounding travel to give birth, particularly in the winter. Nate is still able to provide pre- and post-natal care, but can no longer deliver babies.
The only births that will be happen in Baker City will be in the emergency room, and Nate hopes that NEOAHEC’s acquisition of maternal and neonatal simulation equipment can help to prepare them. “A lot of those physicians maybe haven't delivered a baby since once in residency,” he explained. “So, I think the nurses and physicians in the emergency room…and some of our first responders would benefit from having those trainings with the manikins.” Nate can see the manikins saving lives through specialized training, “One thing you always do in maternity is drill for worst-case scenarios. It's important having a realistic manikin that can kinda help run nurses, physicians, personnel, respiratory therapists, everyone, through those drills.” These manikins can also help prepare the workforce in La Grande to be more adequate healthcare providers to compensate for the increase in births at the Grande Ronde Hospital.
In addition to his clinical work, Nate is passionate about teaching. As a preceptor, he views mentoring students as a way of honoring the “tradition of medicine,” a practice he learned from his own mentors. “I can point to probably a dozen different preceptors that really impacted me and my style and taught me a lot along the way,” he reflected. “Those of us that take learners really, really get a lot of out of it, too. It's nice to have a fresh eye on what you're doing…It's really a beneficial thing to have just for my continued growth as a physician and teacher.” He shares with his students not only his medical knowledge but also the community aspect of rural healthcare. His patients are always trying to convince them to move out to Baker City, and so is he. “And it's fun having learners around to kind of bring some liveliness to what I do…and my patients really love it too.” Nate and his community work together to welcome these students, inviting them to local events and even on weekly runs with his colleagues. “I try to make sure our students get a really meaningful rotation and understand the kind of relationship that you form with patients and the impact you can have on not only your patients but your community over the long term,” he reflected. It’s a supportive environment that shows students the rewards of a rural life.
For Nate, one of the best aspects of his practice is the deep relationships he builds with his patients. He believes that, rather than staying detached, he can provide the best care by knowing his patients well. Treating entire families over many years helps him understand his patients’ lives and needs on a personal level, allowing him to offer more tailored, effective care. “It’s meaningful for me in a lot of ways to help the people that I care for and love,” he shared. This doesn’t help him to leave his work in the clinic as easily as he could if he didn’t know his patients personally, but to him, the benefit of better care is worth the added worry. And this is the true benefit of living in a rural area—the relationships developed within the community. Nearly all of Nate’s colleagues come from rural backgrounds, many from Baker City itself, continuing a long-standing tradition of local providers serving their community. Nate sees this as proof that the best candidates for rural healthcare are those who already feel a connection to the area. “I think it's going to be hard to have physicians in rural Oregon unless they're coming from rural Oregon.” He explained that growing our own providers “is probably a necessity for continuing to have physicians in rural Oregon,” he explained. They’re the ones most likely to stay.
Beyond his daily practice, Nate is committed to making healthcare better in Oregon by being an active member of multiple healthcare societies. “The OMA and the OAFP both have really good advocacy kind of arms and policymaking departments that really drive healthcare decisions in our state,” he remarked. Nate brings a rural perspective, helping ensure that healthcare providers—not just large corporations—have a voice in decision-making. While he couldn’t prevent the closure of the maternity ward, he’s doing his part to influence a healthier future for Oregon. Though he doesn’t hold any current positions for these organizations, at various times he has served on the board of directors as a board member, member at large, and a student representative.
What’s next for Nate? There isn’t exactly a ladder to climb, but he’s committed for the long haul and hopes one day to serve as an “elder statesman” of rural medicine. You can’t do it all, but Dr. Nate Defrees is certainly trying. His secret? Ensuring that his whole family buys into the rural lifestyle and finds a way to call their small town home. “My wife’s from the Bay Area, California, so it was a pretty big culture shock for her,” he said with a smile, “But, you know what, she's really likes it and has settled in."