In this episode of Stories from the Field, Wilderness Medical Staffing founder Mary Ellen Doty, NP, sits down with Zach G., PA, to discuss how his path from paramedic to physician assistant and mission work shaped his approach to rural healthcare.

Drawing on years of experience in remote Alaska, Zach shares how working outside traditional urban systems requires flexibility — both in medical ethics and in mindset. He talks about adapting to limited resources, staying grounded under pressure, and the importance of realistic expectations and mental agility in rural medicine.

Through his perspective, Zach reveals what it truly means to practice medicine in places where creativity, compassion, and problem-solving often matter just as much as clinical skill.

Continue reading below for a clip from Zach’s interview, where he expands on the adaptability and balance required to thrive in rural locum tenens work. Or, watch the full length video for more great insights!

Mary Ellen Doty: “How does that feel, working where you are now? Does that fit for you?

Zach G.: There’s a sort of philosophical mindset that transfers really well between environments. Practicing medicine in austere or remote settings isn’t about having every answer — it’s about having the mental agility to adapt, triage your options, and make your next best call.

Sometimes your first, second, or even third option just isn’t available. So you learn to think creatively and operate in a constantly changing environment. That kind of flexibility is something you have to practice — and honestly, I’m still learning, too.

You don’t have to be a walking encyclopedia to do this work. That’s not a realistic expectation anyway.”

Watch this clip, and more, on our YouTube.