Eren Tataragasi

Richmond County Daily Journal

The world of medicine is always evolving, and in order to stay up to date with the latest practices and research, area hospitals are hiring younger professionals to join their medical teams.

In the last two years, both First Health Richmond Memorial and Sandhills Regional Medical Center have added younger doctor’s resh out of medical school to their staff, bringing with them new knowledge, experience and one main goal of practicing preventative medicine.

Physician’s Assistant Julie Fetterman, 24, who works at the FirstHealth Family Medical Center in Ellerbe, didn’t start out wanting to go into family practice. But after doing her internship rotations during PA school, she realized family practice was exactly where she wanted to be.

When she was 17 and just starting out in college, Fetterman originally wanted to become a dentist, but once she decided on going to school to become a PA she’d originally wanted to work in the fields of surgery or dermatology, but she said she’s happy with her decision to go into family practice.

Fetterman received her undergraduate degree in biology from a university in Pennsylvania and she graduated from Methodist College in Fayetteville in December 2008 with her PA degree.

“I love my job,” she said. “I love being here and I plan on staying until they make me leave.

“I like the health maintenance aspect because when in a specialty, you only see a patient until they’re fixed. Family practice is continuous care and you learn a lot more about the person and are able to make positive changes. You also see all age ranges here, except for infants.”

Fetterman, who lives in Pinehurst with her fiancé, who is also PA in Troy, said the Ellerbe office has been a good fit because she feels she’s providing the female patients another option.

Also new to the area is Dr. Dierdre Young-Cadore, who came to Richmond County when she was recruited by the Sandhills Medical Group in 2007. She was doing her residency in New York at the time, but had been wanting to move closer to home — Effingham, S.C.

Young-Cadore received her undergraduate degree at Frances Marion University, attended an international medical school in Mexico then went to New York for her residency.

“One thing about practicing medicine in a big city is you get more exposure and more experience so when you move elsewhere, you’re prepared for almost anything,” she said.

Young-Cadore practices internal medicine and focuses on preventative care.

“My main goal is preventative medicine, to catch something before it gets worse,” she said.

Her experiences in Mexico, a country where there is no easy access to MRIs and CAT scans, not only made her fluent in Spanish but it made her rely more on the physical examination of patients and asking the right questions.

“It’s helped me in Richmond County because I know what’s going on with a patient before the test results come back,” she said.

Young-Cadore also said her previous experiences help her to enjoy working in Richmond County even more.

“I’m used to a fast pace so when you come here, you enjoy it more and don’t take it for granted because you’ve been through worse,” she said. “It’s a good speed.”

When Young-Cadore first came to Richmond County she was working with Dr. Fred McQueen who she said had a lot of old-school medical knowledge, so the two learned a lot from each other. She branched off, though, and now has her own practice within the Sandhills Medical Group.

Richmond County is a different working environment from New York and Mexico, but Young-Cadore said it’s a much better place to build relationships with patients.

“You develop a closer relationship with patients here,” she said. “In New York, the closeness isn’t there because there are so many patients and so many doctors.”

Young-Cadore, who is also the medical director for the Richmond County Hospice and a volunteer at the Compassionate Care Clinic, said she, too, practices evidence-based medicine, which is medicine supported by medical trials and research.

“Being younger you stay on top of new things and do a lot more research about new techniques and medicines,” she said. “When you’re younger you research more because that was your training — you were told not to take anything at face value but to find the evidence to support it.”

And because Young-Cadore works in internal medicine she said some of her cases are more complicated because she’s got to get to the root of the problem, but she says even the most bizarre cases are not seen as a complication, but as a challenge.

“We’ll find out what it is,” she said.

Dr. Kimberley Sierra and Dr. Steven Alexander also recently joined the FirstHealth team at the Rockingham Family Medical Center and are equally dedicated to the field of preventative care and evidence-based medicine.

Sierra grew up in New Jersey and attended medical school at Temple University, completing her residency at West Penn Hospital in Pennsylvania. She moved to Rockingham in June.

Alexander, who also moved to the area this summer, also grew up in New Jersey but attended New York University for his undergrad degree, attended medical school in India and did his residency at the University of Houston.

Sierra came to Richmond County because she was looking for a warmer climate that was still relatively close to home. Alexander followed his parents who moved to North Carolina for their retirement. Both feel the job and community is exactly what they were looking for.

Both Sierra and Alexander specialize in family medicine, but Sierra also has a special interest in children’s and women’s heath and sports medicine. Alexander’s passion is prevention and maintenance of diabetes, hypertension, and other common diseases.

Sierra and Alexander said one great part about being fresh out of school and in this community is the opportunity they have to teach the doctors and the patients they work with.

“The three mid-level (doctors) here have about 30 years of experience between them but they still come to us with questions, and one nice thing is the fact that I have the opportunity to teach them,” Sierra said.

They said the patient’s they’ve seen in the last couple months have been “cautiously excited” about having new doctors, since their previous doctor had been practicing medicine for about 50 years.

“Medicine is always evolving,” Alexander said. “There’s always new guidelines, new ways to manage conditions and you have to keep up to date. We always have to look at evidence-based medicine and that helps. Sometimes you have to adjust how a patient’s care is done because of new information and that makes a difference for the patients in the community.”

Sierra said the biggest things she and Alexander are able to bring back into the clinic is minor office procedures. The two of them have been meeting with their fellow doctors to discuss doing skin biopsies, joint injections, toenail removals and other basic office procedures.

“We’ve had discussions on techniques for treating and monitoring depression, pulmonary lung diseases, managing Coumedin, etc.,” Sierra said. “Next week we’re having a sutures exercise in the office.”

Sierra said another great thing about working with the doctors at the Rockingham clinic is that they all share the same philosophy when it comes to patient care.

“We all work well together with similar views and different fortes, which is a nice combination to have under one roof,” Sierra said. “If one doctor has to cover for the other, the patient still gets the same spirit of care because we all share the same medical philosophies.”

Both say it’s been a transition from medical school and their residencies to being a full-time physician, but it’s been one they’ve been ready for and have enjoyed.

“We’ve had a panel of patients for years now because residency is a lot like this,” Sierra said. “For me it’s been exciting and the transition has worked out even better than I hoped.”

Some patients may get nervous when they walk into an exam room to see the doctor is years younger than them, but Alexander said it hasn’t been a problem.

“When it comes to the patients we see, it’s not really our age that matters, but the relationship we can build with them,” he said. “We help them understand their problems, build that bond and figure out the right care.”

Alexander said the best thing about practicing family medicine was that idea of “continuous care,” as Fetterman previously described.

“Just being able to take care of the entire family ... you build more of a special bond as a family physician than a specialty doctor,” Alexander said. “You interact with the family and become part of the family. You know what they’re going through, you’re there for their physical and mental well-being, and the entire spectrum of things you see is also appealing.”

For Sierra, it’s that bond, but also the education she enjoys.

“I enjoy treating people I get to know,” Sierra said. “But I picked family practice because I like to teach, not in a formal classroom, but in family medicine when you get a patient in the exam room you teach people what’s going on with them and how to care for themselves and it’s personalized. It makes my job fun.”

Both see this as a long-term career because private-practice doesn’t seem as viable an option anymore.

And with the current health care debate in Washington, both said they’re just going to keep practicing medicine and hope for the best.

“No matter what happens with the government, patients still need health care so we’ll just keep seeing patients,” Sierra said.

Alexander said during his residency he saw a lot of patients without health insurance.

“Something needs to be done,” he said. “I don’t know what, but too many people are not covered for various reasons. But no matter the outcome, it won’t affect my choice of profession because I love what I do.”