PA’s Relatability, Determination Help Expand Access to Care in Rural Tennessee

As a Clinic Owner, PA Greg Cain Strives to Make Patients Feel Comfortable

January 24, 2024

By Dave Andrews

As the saying goes, “it’s what’s on the inside that counts.” However, there are certainly times when what’s on the outside will also make an impact. Just ask PA Greg Cain, owner and medical director at United Primary Care based in Madisonville, Tennessee.

When he opened his clinic about 12 years ago, he initially wore dress slacks and a button-down shirt underneath his lab coat. But that just didn’t feel right. So it wasn’t long before his work attire had evolved to a more casual look: boots, jeans, and a comfortable shirt.

And he’s stuck with it ever since – not only for his own comfort, but also that of his patients.

“I’ve had countless patients who would tell me in one way or another that because I dress the same as many of them, it puts them at ease and makes me more relatable,” Cain said. “All it took was a few patients to tell me that early on, and I knew it was the right move.”

Cain acknowledges his casual dress code wouldn’t work in most other healthcare settings, but for him, the rest of the medical staff and their patients, it’s had a subtle-yet-positive effect.

“I tell [the other providers] they can wear whatever they’re comfortable with,” Cain said. “And for me, really the only time I’ll wear a white coat is for a ceremonial ribbon cutting or something like that. And when I do, I’m sure many of my patients don’t recognize me right away.”

Improving Rural Access to Care
Being relatable and establishing a rapport with patients comes naturally to Cain – and it involves much more than just his wardrobe. Having been born and raised in a small town in rural Tennessee, Cain has a unique perspective and endearing approach that resonates with each of his patients.

He’s also well aware of the challenges area residents previously faced regarding scarce access to care. Cain says he knew countless people who were so discouraged with the nearby healthcare options that they would feel obligated to drive more than an hour away to Knoxville to receive care. And for many others, the lack of options meant postponing much-needed treatments.

Since opening his doors for business, Cain has made significant strides in helping to address that gap. After setting up his first primary care clinic in Madisonville, he has since added two more in the nearby towns of Athens and Etowah, Tennessee. Together, they serve a patient population that has swelled to nearly 20,000.

Cain also relies on what some might consider a unique staffing model: He does not employ any physicians, rather his entire medical staff consists of seven PAs and one nurse practitioner. With a clinic that is PA-owned and run, Cain admits he feels added pressure because there are no other medical facilities like it in that region. However, the clinic’s success and continual growth over the years speaks for itself.

“Our top priority has always been to provide the highest quality of care possible, and then, let patients vote with their feet,” Cain said. “It’s clear that they feel they’re getting better care here, otherwise I’m pretty sure they’d go elsewhere.”

Inspiring the Next Generation of PAs
One of Cain’s former patients was so impressed with his passion and style of care that it motivated her to become a PA herself. PA Deletra Wilke was working as a certified nursing assistant when she first met Cain, but she was looking for a career change within healthcare.

“I’ve always loved medicine, and I wanted to find a career path that would still afford me the right balance between work and my family life,” Wilke said. “After seeing how Greg approached his practice and after talking to him about my goals, our conversations re-sparked my interest in becoming a PA.”

Wilke was offered the opportunity to shadow Cain and some of the other PAs on his staff, and soon after, she enrolled in PA school. She then did her family medicine rotation at United Primary Care and was ultimately hired by Cain full time after she graduated.

Nearly six years later, Wilke couldn’t be happier with her decision.

“The flexibility and freedom we enjoy as PAs is really unique,” Wilke said. “Plus, I truly love primary care because I get to care for people in my own community, many of whom I’ve known for most of my life.”

Challenges of Business Management
Compared to Wilke, Cain’s career path before becoming a PA was much longer and more diverse. After high school, he served in the Navy and the National Guard for several years, and then worked as a real estate developer and financial advisor. But healthcare was always in the back of his mind, and he eventually decided to become a PA.

Cain says his time serving in the military and working in the business world provided valuable experience that he could apply to running a successful clinic. However, he admits that owning a clinic isn’t for everyone.

“It’s tough. Running any business is hard, but owning a private medical clinic is far and away the toughest thing I’ve ever done in my life. Tougher than any of my military assignments. Tougher than any other business I’ve been involved with,” he said.

Despite the challenges of business management, Cain never shies away from new opportunities to expand care throughout the area. A prime example is in the field of occupational health: For several years, United Primary Care has partnered with a growing number of local manufacturing companies to provide a wide range of healthcare services such as managing work-related injuries, hearing exams, pre-employment physicals and drug screens.

Because occupational health services were not readily accessible in the region previously, Cain says the venture has been increasingly successful. Occupational health services now account for roughly half of the clinic’s revenue. And as a direct result, Cain’s primary care practice has seen significant growth in patient volume as well.

Although the recipe for success is different for everyone, Cain says, there are a few staple ingredients he encourages all of his fellow PAs to keep in mind:

“Always maintain a relentless determination to not give up when things get tough, a willingness to quickly adapt to shifting challenges, and the capacity to make hard decisions.”

Dave Andrews is a freelance writer and public relations professional based in Northern Virginia. Contact him at [email protected].

Editor’s Note: This article was originally published in October 2022.

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