Quiet Charm of Chambersburg, Pennsylvania, Entices City Doctor to Set Down Roots

When David Hoffmann set his sights on medicine during his senior year of college at the University of Denver, he wasn't planning to practice someday in a rural farming community. Born and raised in Philadelphia, Hoffmann had always embraced city life, even in his move out West, for his undergraduate degree.

But after finishing his training in osteopathic medicine and his residency in family practice, Hoffmann's future was overshadowed by mortgage-size school loans. That's when a fellow student told him about the NHSC.

"The truth is that I really didn't know much about working with underserved communities," he recalls. "I grew up with a middle-class background, and was just looking for somewhere to get loan repayment. I didn't have any great calling." What he didn't realize then was how much personal and professional satisfaction life could offer in a small town. And he certainly didn't count on wanting to stay after his loans were repaid.

Clinical Frontier

Because they preferred to remain within driving distance of their Pennsylvania in-laws, Hoffmann and his wife Angie began their search for jobs by spreading out a map of the state. They examined the area between Philadelphia and Angie's hometown of State College. The historic town of Chambersburg, population 17,000, fell almost directly in the middle. Hoffmann called the local NHSC clinic, Keystone Health Center, and set up a meeting.

Keystone Health Center was founded in Chambersburg in 1986 as a migrant health clinic, providing treatment and preventive health care to the mostly Hispanic workers and their families who migrated north from Florida each autumn to pick peaches, apples, and cherries. When Dr. Hoffmann arrived in 1994, he was only the second physician to join Keystone's staff. "It was a tiny little place, and I was on call every other night and every other weekend," he remembers. "They'd give you your check on Friday and say, 'Listen, don't cash it until next Wednesday.'"

Still, the enthusiasm and focused drive of Keystone's small staff captured Hoffmann's interest. "I interviewed with this great group of people…they were really struggling, but I bought into their mission." Eventually, it was the vision of Keystone's founder and CEO Joanne Cochran, and the mentoring of the then director of Keystone's family practice clinic that inspired him to move to Chambersburg and call this small town's residents his patients.

Frontlines Training

It turns out that the long hours and responsibility that daunted him in the beginning were among the same reasons Hoffmann has remained at Keystone. "What's great about this area is that family doctors can practice the full scope of medicine," he explains. "We have family doctors that do obstetrics, that do colposcopies and vasectomies and flex-sigs," he adds, noting that these are procedures he would never be able to do if he were practicing in an urban area with plenty of specialists.

Hoffmann uses this aspect of his job as a selling point when he recruits other NHSC members to join Keystone's staff. "If a doctor comes here for 3 years and gets their loans paid off, when they leave, they can go into any kind of private practice situation and do well."

Nine years after his arrival, Hoffmann has also made tremendous advances in his career. He is now medical director of Keystone's Family Practice Clinic, overseeing the clinic's quality control measures and accreditation, and providing specialized care for Franklin County's 75 HIV patients. He has even learned to speak Spanish, a skill that helps him communicate with patients who are sometimes among the neediest in the community.

More Than Just Money

Although NHSC's support of his work in a rural community has provided financial freedom and the opportunity for extraordinary professional growth, Hoffmann admits that he misses going to Phillies or Eagles games that were close by in his old Philadelphia neighborhood. But that's okay, he explains, because he lives by the "95:5 rule."

"When you're married and have kids, 95 percent of your time is spent going to the supermarket or taking your kids to soccer practice, and 5 percent of your time is going out to dinners or going to see a play. Here, the 95 percent is really great, and for the other 5 percent of the time, we'll go down to Washington, D.C. or Baltimore."

He also appreciates the quality of schools in Chambersburg, the safety of the community, the fact that traffic is virtually nonexistant (allowing him to go home during the week for lunch with his wife and three kids), and adds, "Even though I'm not paid as much as doctors in private practice or in the city, I could never live in the same size house or do the things there that I do here, where my dollar goes really far."

When Hoffmann first approached the NHSC, his concern was focused on the bottom line. But the charm of this small town and the mission-driven work of everyone at Keystone convinced him that he could gain far more, in terms of his overall quality of life, by staying in Chambersburg well beyond his NHSC commitment period.

"My plan was to come, get my loans paid off, and get back to Philly," he admits. "But I've gotten to see some of the struggles that people go through, and it's made me feel more fortunate. Really, the health center's given me, professionally, much more than I've given to it."

Now, when he recruits other NHSC clinicians to join his staff, he applies the same measured practicality to his candidates. "There are a lot of issues associated with taking care of the underserved; it can be difficult. But what I've found is you get a core of people that buy into the philosophy and buy into our mission." Of course, once he's selected a candidate for hire, Hoffmann doesn't have to put too much effort into convincing them to stay. The warm community atmosphere in Chambersburg and the rapport that Keystone clinicians share with their patients usually take care of that issue for him.

Learn about other NHSC success stories.