“We are your old-time country doctors,” Michele Sadler ’91, D.O., says of herself and her three colleagues in Guttenberg, Iowa. Along with a nurse practitioner and a physician assistant, the four doctors serve the town of 1,900 and its surrounding communities, covering the hospital, emergency room, nursing home, regular doctor’s visits and delivery room all by themselves.
As you can imagine, it’s a lot of work. But Sadler loves the diversity of the job. A trained family practice physician, she treats the entire body. “One of the jokes we have in family practice is that it’s actually a specialty, where cardiologists and others are more minimalists,” says Sadler. “They know a lot about that little part of the world, but we have to know a lot about every part of the medical world.”
On a typical day, Sadler might deliver a baby, see a teenager for a routine check-up, help a middle-aged man through a heart attack and make an elderly woman more comfortable as she dies. “We like to say we do everything for our patients—from being born to being buried,” says Sadler. “There are some very rewarding parts of helping a family go through the dying process—because it should be dignified.”
Sadler works four days a week and is on call at the hospital one day a week and one weekend every month. Committed to her community, she often heads to another meeting after her 11-hour day. She is on the library board and the county board of health and sings in the church choir. She also helps organize the annual bluegrass festival in a nearby town.
Although she has lived and worked in Guttenberg for 15 years, Sadler is still a newbie compared to the other doctors, who have a combined 85 years between them. The stability of a small town is a perk of rural medicine. She knows the personalities and medical backgrounds of every patient intimately. “When a patient comes in, I already know the family dynamic because I’ve seen them before. In some cases, I’ve been involved in their lives since before they were born,” she says. “That is so beneficial as a doctor, when you know the nuances of their care.”
Although Sadler didn’t grow up in Guttenberg, she was raised in the small town of Strawberry Point 45 minutes away. She always wanted to work as a rural doctor in northeast Iowa. After her residency in Des Moines, opportunity knocked; Guttenberg was looking for another physician, and Sadler was a perfect fit.
Over the past 15 years, Sadler has become a staple of the community, both as a doctor and a friend. That can make losing a patient extra difficult, but Sadler isn’t weighed down by the emotional struggles and doubts that come with the territory in rural medicine. She lives and works by the words of a mentor doctor she once knew: “As doctors, we are given tools to use. Sometimes we can do everything right and things go wrong. Or we do everything wrong and things go right. We just have to use the tools we’ve been given.”
Sadler believes these are words of wisdom for all of us. “It’s true not just in medicine but in life. Use what you’re given and things will be all right.”
Q&A with Michele Sadler ’91, D.O.
Q: Are you ever frustrated by aspects of the health care system?
A: The answer is yes, but it’s hard to say which parts. The system is changing all the time, and things
are not always consistent from one provider to another. When patients ask me what their insurance will cover, I tell them that I don’t worry about insurance, I worry about what I need to do to take care of them.
The reality is that insurance companies make you do so many things before you can take care of your patient. They are trying to manage health care dollars, but you end up spending more on health care because of it. That’s the most frustrating part, as an administrator. There are so many people trying to tell me how to do my job instead of just letting me do it.
I think the government is trying to come up with a solution. I don’t worry about politics; I worry about my end of the job.
Q: What do you do when you’re not working?
A: You always have to find free time because you have to feed both sides of your brain for balance. I go camping when I can. I’m pretty involved with the bluegrass world, and I play standup bass. The free time gets you away from the other part of your world, and yet ties it all together in some way.
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