The Stanley Clinic is the only medical facility in Stanley, Idaho. When nurse practitioner Marie Osborne founded the clinic in 1972, she became the only medical provider across 6,000 square miles—a fact that sounds like something straight out of the days of prospecting and mail by Pony Express. It was, and is, a daunting responsibility. When Osborne retired in 1999, that responsibility eventually fell to physician assistant Amy Klingler, who after decades on the job has proven to be a perfect fit for the role.
As a physician assistant (PA), Klingler practices under the supervision of a physician, in this case Dr. Richard Paris of Hailey. Klingler began her practice in rural Stanley in June 2006, becoming an integral part of the community. Growing up in Virginia, Klingler and her family would take ski vacations every year, instilling in her a desire to not just visit the mountains but to make her life in them.
After graduating college and moving out West, Klingler learned about Stanley and its small clinic. “I was inspired by the location and the impact you can have in a rural community—you can really make a difference in people’s lives,” she explained in a recent interview. That inspiration prompted Klingler to go to PA school in the hopes of getting the job she has today.
Practicing rural medicine is no easy feat, and not simply from a medical point of view. Earning the trust of the community is essential, and something that Klingler has succeeded in doing. After Osborne retired, the clinic went through a handful of PAs before finding Klingler.
“It took a while for the community to trust again in a new person and see I was committed to being here,” Klingler said. “I joke that once I’d been here about 10 years, people were like, ‘Oh, maybe she’s going to stick around, and we can use her for primary care.’”
As the only medical provider in town, Klingler practices both family medicine and urgent care and is the primary care physician for almost everyone in the area.
On a day-to-day basis, Klingler’s job may take many forms, from seeing patients for regular visits at her clinic, to making judgment calls on whether to send someone by ambulance to the emergency department in Ketchum, to calling a patient (and likely neighbor or friend) to check in. While working with your friends and neighbors can mean never really being off the clock—Klingler jokes that people hide their grocery carts from her at the local grocery store, lest she see them buying junk food—she recognizes that it allows her to practice more thorough, personalized medicine since she has extensive knowledge of that person’s health and family history. And knowing patients on such an intimate level makes her truly care about the outcome in every scenario.
“Prescribing blood pressure medicine isn’t the most exciting part of my day but connecting with a person . . . that is what motivates me and makes this job so special,” Klingler offered. She admits that she doesn’t have the greatest work-life balance, as might be expected in such a small community. “The trade-offs are, I love my life,” she said. “I love being a part of this community. I do sometimes wish I had stronger boundaries, but if I see a patient during the day, and I’m worried about them at night, I’d rather call them and see how they are than worry about it.”
One of Klingler’s greatest strengths is her diagnostic skill—as well as a certain tolerance for risk. Owing to the clinic’s size and remote location, there are no X-rays or diagnostic imaging or any kind of immediate test results available. Nor does she have colleagues down the hall to run something by. Given that an ambulance or helicopter ride to the emergency department in the Wood River Valley is not only pricey but time consuming, Klingler is extremely wary of sending anyone out of town for medical reasons unless it is absolutely necessary.
Dr. Deborah Robertson, an attending emergency physician and Vice Chief of Staff at the St. Luke’s Wood River Medical Center, has known Klingler for 17 years. Robertson admires Klingler’s ability to practice medicine in this way—a way, she is quick to add, that most physicians would not be comfortable with. “She has to be comfortable with making decisions without knowing all the facts,” Robertson said. “It reflects a risk tolerance that is a strength of hers. To me, there’s a certain special quality to every person who lives in a remote rural area like Stanley.”
Indeed, Klingler has made it feel much safer to live in an area like Stanley, given her clinical intuition and the care and attention she provides her patients. When Robertson has seen patients from Stanley who have Klingler as their primary care physician, she often hears this from the patients: “We would not live in Stanley if it weren’t for Klingler.”
“She provides so much peace of mind and reassurance,” Robertson said. “Knowing Klingler is there gives them the confidence to live that remotely.”
Not only has Klingler found the community she was looking for, but her family has, too. Klingler’s husband, Chris, a native Idahoan, found his dream job in the area as a wildlife biologist doing work for the Sawtooth National Recreation Area. Their son, Grady, is now a freshman at the College of Idaho after having attended school in Stanley for K–8th grade and then completing high school online from home.
“My family’s really important,” Klingler said. “The quality of life we’re able to have in Stanley is incredible.”
While practicing rural medicine isn’t for everyone, for Klingler, it’s a passion that makes it possible to live in a beautiful place while connecting with her newfound hometown and its residents.
“One of my favorite things about it is just being part of a community. I’m really proud of the health care we provide, the kind of attention we give to people in our community. I just feel like I’ve been able to carve out a bit of connection with people through the work I do here. It’s what sustains me.”