There are three not-so-new medical providers seeing patients at Petersburg Medical Center. Dr. Alice Hulebak is back, and her husband Erik Hulebak is now a Physician's Assistant (PA). Also, Angela Menish has completed her education and is now working as a nurse practitioner.

Dr. Alice Hulebak has worked at Petersburg Medical Center before, from 2010-2013, but moved back to Albequerque, New Mexico for her husband to attend PA school. Most recently they worked in Kalispell, Montana but had been waiting for a chance to come back to Petersburg.

She thought she wanted to be a veterinarian and completed some training towards that end through her high school's continuing education program. Soon though, she realized that she wanted to talk to people more and switched to human medicine. At first, she says she, "wanted to work for Indian health service but realized that it was just kind of rural medicine that I liked. I knew I wanted to be in a smaller place, and family medicine allows you to do that, where a lot of these subspecialties, a lot of surgical subspecialties you have to be in a large metropolitan area in order to have a job."

She grew up in Albuquerque, and thought she would stay in New Mexico, but the residency program in Anchorage stood out with a focus on rural family medicine and Native health services. While in Anchorage, she remembers, "Of all things while I was there a nurse asked me about our last name Hulebak, which is Norwegian, and they asked, 'Oh, have you been to Little Norway in Alaska? There's this town called Petersburg.' . . . Because of this, learning that it was the Little Norway, I looked into coming down here for rotation, and we came here for a month. We also spent a month in Juneau and decided that we like Petersburg much more than Juneau...then they were hiring here when I finished."

About returning after nine years away, Dr. Hulebak says, "I don't find it dramatically different, yes there's a new electronic health record, and there's different people working, but it doesn't seem as different as I thought it would...You can't move back to a place and expect it to be the same, so I had in my mind almost zero expectations of it being the same, so when things are similar it's nice."

"It's nice not working for a large healthcare corporation . . . You get to see more of the medical process, but also when you're not being told how long you have with a patient, or what boxes to check, you can focus on taking care of the patient and not having to worry about all of those things."

"It is a different way of practicing medicine when you don't have immediate access to specialty care, or certain technologies, an MRI for example, or a special heart test called an echocardiogram. You have to step back and think does the person really need this? Instead of being like just go across the street . . . It can certainly be done, it's just when it will be done, and travel is a big deal. For some people it doesn't seem like a big deal, but for others of course, it is."

Dr. Hulebak is looking forward to getting back into the swing of things here, and she says her reintroduction has been smooth. "It's been kind of nice to have him (Dr. Tuccillo) around for the last month, learning the electronic record and learning the workflow and not seeing too many people instantly."

It's a good hospital to work for, a community to live in . . . the fact that we are able to stay fully staffed-not every place has that reputation."

Erik Hulebak, who's married to Dr. Alice Hulebak, is also no stranger to town but is new to Petersburg Medical Center in his role as a PA.

He started on the medical path long ago though, he explains, "I was a Navy United States Fleet Marine Force Corpsman...a medic, but I was stationed with the Marines the whole time...A lot of times, we just had makeshift rooms from the barracks that we converted into offices to see patients...The advantage is they're generally 18 to 30-year-old healthy men. If they find something significantly wrong, they end up getting discharged, so it weeds out chronic disease. It's truncated medicine, but I still got some skills."

After completing his time in the navy Erik quickly got his bachelor's degree in biology and worked as a herpetologist, studying Anolis lizards in South America. Soon he felt pulled back to human biology, though.

Erik had planned to go to med school himself when Alice began her residency, but when she took a residency in Anchorage, he thought that sounded cool enough to put his education on hold. He taught biology and did fisheries biology, running a salmon wheel on the Matanuska River before they decided to start a family. After being a stay-at-home dad for nearly 5 years, Erik decided that after two years with their youngest he wanted to go back to school. "At this point, I'm 32...If I do med school, I'll be gone and my kids'll be teenagers. I'll wake up one day and have missed their lives. So, I should do PA school. Two years, and then get to do family medicine, which I wanted to do anyway...Our goal was to come back here when I finished school, but the jobs weren't here."

When the openings did pop up, it was a no-brainer. Erik Hulebak is thrilled about his new role at the medical center, seeing patients on his own for wellness visits and exams, but not having to be on call. One parent on call during the week is enough.

He adds, "Did I spend six hours standing out in that crazy rain yesterday duck hunting? Yep."

Angela Menish is a long-time local and a familiar face at Petersburg Medical Center, but she's recently completed her education and is now playing a bigger role as a nurse practitioner.

"I first became an ETT, then an EMT 1, just any way I could get my foot in the door to get some training, and then took the CNA class and kind of kept going from there. It took a while to get the pre-nursing stuff done and get into the nursing program." Getting her pre-nursing credits online through Weber State in Ogden, Utah, she worked as a registered nurse at PMC for 17 years, advancing from staff nurse to director of patient care service, and director of nursing for acute care and ER. After raising her kids, she went back to school in 2017 to be a nurse practitioner, and being a student again felt natural thanks to her time teaching at PMC.

"Family nurse practitioners take care of patients across their lifespans. We're trained to take care of people from infancy to elderly." Finishing her bachelor's through Western Governors University, then getting into George Mason University, she was lucky to be part of the first cohort of their online program, fully formed before COVID. And she was lucky to be in Petersburg.

"They said if you can get into a family practice that sees patients across the lifespan, get in there and stay in there, because that is where you're going to learn best. What better place than Petersburg? Because our providers see everyone in the community. So I did all 600-plus hours of my clinical time at our clinic. Dr. Hess and Dr. Hyer won an award for their outstanding faculty through the University of Washington, because they're amazing preceptors. I feel like I was luckier than any student in my program, because especially with COVID...they were struggling to find preceptors to take them...I only had to leave town to take my boards (final exams)."

The CNA and RN certification program in Petersburg is still going strong, with new cohorts accepted every other year. RN students' studies take them out of town for a month or more, but the CNA program is fully "Grow your own," Menish says, proud of her many years teaching CNA students in town.

To move up to nurse practitioner, what Menish didn't learn in-person at PMC, she did virtually. "There were some telehealth-style visits that we had to do. We had to use a lot of different technologies to be interactive because they wanted us to simulate being with a patient. At first, you think this is odd, but it really worked." And she excelled at virtual learning. "I won the Daisy award for student excellence from George Mason. I'm one of those people that likes to reach out if I don't know something...because that's what I expected of my students. I formed a really good relationship with all the faculty I worked with. It was pretty cool, because it's a big school. To be an online student, in Alaska, and to still be able to stand out was a big honor."

"Training to be a nurse practitioner there's a huge focus on partnering with patients...and coming up with an individualized plan to promote their wellbeing...I watched a lecture that was all about a patient that said, 'I'm healthy, I haven't been to the doctor in 20 years.' But then they come in and they're hypertensive, and they have other conditions that could have been managed years ago...With the Affordable Care Act, a lot of those preventative services are covered without any additional cost to the patient. A yearly physical, lab work, most insurance companies, unless they're grandfathered in, have to cover that."

Starting as an emergency trauma technician, Angela Menish has come full circle to now see patients while they're still healthy, and she aims to keep them that way.