WISE — Raised on Lick Creek and Sandy Ridge in Dickenson County, Starla Kiser would eventually add worldly education and work experiences to her resume.
From the Silicon Valley in California to Harvard Medical School in Boston, Mass., to Iora Health in Chicago, Ill., Kiser also has made stops along the way studying in Holland, Moscow, India, Kenya, Tanzania and South Sudan.
Part of what she learned is why her new address is Wise County and the latest addition to her resume as founder of and medical doctor at Healios Health Center.
"The people in South Sudan know the solutions to their issues more than I do," she said. It's the same here, and is the "road that led me back home."
Opened Dec. 11, Kiser's new practice follows the direct primary care model, an alternative to the fee-for-service approach. She doesn't accept insurance. Patients are charged a monthly fee instead.
This is not a new model of care, Kiser notes. Since Virginia did not expand Medicaid, she had a feeling there would be people caught in the gap without insurance. She has been open a month, business has been steady and she is hearing positive feedback from people.
"I think this will really benefit the community," she said, adding that she is passionate about the approach. "I believe in what I am doing or I wouldn't have done it."
Before returning to Wise County, she had spent two years as a clinical innovator working for a company pioneering new approaches to health care delivery. It wound up losing millions, she acknowledged, and closed. She lost her job and had a choice to make about her future. She decided the time had come to return home.
One of the big benefits of travel, seeing other parts of the world and meeting different people, Kiser said, was building an appreciation of where she was from, its distinctive culture, music and food.
"We are all people," she said, born in different places under different circumstances. "You don't look down on other parts of the world."
After graduating from Ervinton High School, she went to East Tennessee State University. All during college, she worked with NASA Develop, which introduced her to other NASA programs. She wound up at the Astro Biology Academy in California, living on the Stanford University campus. That opened a lot of doors, she said, and was an eye-opening experience.
A country girl from Dickenson County, Kiser said she was kind of scared to move and questioned whether she was going to be on par with others. She was.
When she got back to ETSU, she realized there was a whole different way of the world. She hadn't attended an elite private school, she said, she learned along the way, grabbing bits and pieces. She studied the humanities in Holland for six months and learned some Dutch. She did a space medicine program at Moscow University.
She did different things while in school, was thinking about medicine and wondering how she would combine her experiences. As she grew to appreciate her own home community more and more, she decided she wanted to be in some kind of service. "If you've been given a lot, I felt like I should give back," she said.
She was accepted into Harvard Medical School in 2006. "I would never have conceived it is possible," Kiser said. "I didn't even dream it." She believes her background here in the Appalachia mountains contributed to her acceptance. "It's more than numbers," she said. At Harvard, "everybody's smart." She admits wondering if she would be able to thrive in a place filled with "just a bunch of geniuses."
She had a great time at Harvard, found not all were geniuses and again was introduced to different types of people and experiences. "People who I went to high school with are just as smart as people in medical schools," she said.
Kiser had developed an interest in public policy and public health. She attended graduate school at Harvard’s Kennedy School on a fellowship.
That proved another eye-opening experience, she said. She started studying international development, diplomacy and foreign affairs. She did work in Kenya, Tanzania and South Sudan. She studied in India.
She finished her residency in 2015, concluded primary care was her calling but also knew a traditional clinic would not be a fit. "I just knew I would get burned out," she said.
That's when she joined Iora Health, as a clinical innovator.
Now back home, Kiser sees herself almost like a country doctor, where the practice is built upon the physician and the patient, with no one in the middle. "I want to keep my promises," she said.
Her aim is to keep a small patient load and her operation lean. Without insurance, she doesn't need someone to do billing and coding, she noted.
She feels confident about her practice and her choice.
"I don't think you need millions of dollars to do something worthwhile," she said. The answers are here, Kiser said. Young people deciding to stay here is important, she said. The key is them creating small businesses and success for themselves, she said, not waiting for it to happen.
Kiser's office is located in the Wise County Industrial Park in Esserville, in the old Buster Brown building.