Putting Patients First: Dr. Cindy Firkins Smith on the Importance of Rural Health Care

From the editor of her school newspaper, to physician, to health system CEO, Dr. Cindy Firkins Smith never imagined she would have the career she does today. Growing up, she didn’t dream of becoming a doctor as many physicians do. Instead, with a passion for literature and languages, Dr. Smith had ambitions to pursue a career in broadcast journalism.

But that all changed her junior year of high school after her first physiology class. “The teacher was great and the subject matter was compelling,” Dr. Smith recalled. “So that’s when I decided I wanted to study medicine.”

After high school graduation, Dr. Smith moved from her hometown in Emmetsburg, Iowa to Mankato, Minnesota where she began her college career. It was there that Dr. Smith met her now husband and earned degrees in biology and psychology.

After finishing her undergraduate studies, Dr. Smith began working on her master’s degree and welcomed her first child into the world. She was then accepted into medical school at the University of Minnesota. “I started medical school with a nine-month old baby at home so it was a little crazy,” Dr. Smith joked. “It wasn’t the best way and it was very challenging at times, but it forced me to set priorities.”

When she began medical school, Dr. Smith thought she wanted to specialize in Obstetrics/Gynecology but she never felt it was the right fit for her. “I liked the specialty but it wasn’t something I wanted to do every day,” Dr. Smith explained. “So, I just sort of fell into Dermatology. It’s an artistic specialty and I was an artist at heart.”

When the time came for Dr. Smith to begin her residency, there were only three clinics in the nation where she could match dermatology straight out of medical school: Cleveland Clinic, Arkansas, and the University of Minnesota. “I interviewed at all three clinics but, fortunately, was matched at the University of Minnesota,” she said. “It was my first choice and it allowed my husband to continue working in the Twin Cities.

During her residency, Dr. Smith had her third child and knew she and her husband would need to decide where they would call home. “It was a really tough decision because I was encouraged to stay in academics. However, my husband and I both grew up in small towns and we wanted to raise our children in that environment,” Dr. Smith said.

Dr. Smith enjoyed working at the university because it allowed her to be involved with academics which were very important to her. “My dad never graduated high school and my mother received her teaching degree from a community college but then gave up her career to help with my dad’s trucking company,” Dr. Smith explained. “My dad always regretted quitting school and my mother always knew how important education was, so they really emphasized this to me growing up.”

This is also the reason that Dr. Smith chose to later become a Clinical Professor of Dermatology at the University of Minnesota. “When I finished school, I immediately asked if I could apply for a faculty position,” she explained. “It gave me an opportunity to feed my academic appetite and I was still able to live my rural experience, so it’s truly been the best of both worlds.”

Because her husband was originally from Renville, Minnesota, Dr. Smith began her job search in West Central Minnesota. As luck would have it, Dr. Smith stumbled upon a job opening in Willmar.

“I was a first-year dermatology resident at the time,” Dr. Smith recalled. “So, even though I had two years of residency left I wanted to show that I was interested in their position.” Fortunately for Dr. Smith, the Dermatologist at that time, Dr. Milton Sadd, agreed to interview her right away.

Dr. Smith visited the community and completed her interview but still wasn’t sure rural medicine was right for her. “I had been in academics for so long that going into rural medicine was very unknown to me,” she explained.

After speaking with ACMC’s recruiter, Dr. Smith brought her family to Willmar for a week and they vacationed while she worked in the clinic. This gave her an opportunity to meet patients and fellow physicians to truly get a feel for what the ACMC clinic and the Willmar community were all about. “I was so impressed,” Dr. Smith remembered. “The doctors were incredibly committed to their patients and the people in the community. Plus, the people of Willmar and the surrounding area were kind and welcoming. It just felt like a great fit.”

After her initial visit, Dr. Smith continued working one weekend a month at the ACMC-Willmar clinic and, after a few months, she fully committed to the position in Willmar. “It was the only place I ever interviewed and I’ve never regretted it.”

Now, 27 years later, Dr. Smith still loves West Central Minnesota living. “It’s just such a wonderful place to raise a family,” she said. “It’s my nirvana.”

She even joked that there aren’t many places that you can go to the grocery store and make a dermatological diagnosis while in the produce department. “Everywhere you go in our community, people know who you are and what you do,” she explained. “I get medical questions when I least expect it which can become a problem when people start taking their clothes off. Trust me, it happens!

During her 27 years with ACMC, Dr. Smith has built more than just a successful dermatology practice, she has also taken on leadership roles in her industry and in the clinic system. Dr. Smith previously served as the President of the Minnesota Dermatological Society, President of the Minnesota Medical Association and is a delegate to the American Medical Association. “It was all serendipitous,” Dr. Smith explained. “It was never my intent to do these things or build a resume. Everything I have done is simply because a need was present, I could fill the need, and I felt driven to help.”

These positions helped prepare Dr. Smith for her prior role as CEO and president of ACMC Health and, then, co-CEO of the newly formed Carris Health, a partnership between ACMC Health, Rice Memorial Hospital, and CentraCare in 2018. “I was very happy in my job as a dermatologist and never aspired to an administrative career. But given the changes in the world of health care delivery, the challenges rural medicine faces and my experience in the MMA and AMA, when Dr. Holmgren retired I was asked to consider the job. Once again, I thought perhaps I could serve a need.”

During her time as ACMC’s president and CEO, Dr. Smith recognized a shift in health care and saw a need to create a sustainable system for our patients. “We have four areas of focus for our new partnership,” Dr. Smith said. “We wanted our patients to receive the right care, in the right place, at the right time, at the right cost.”

In order to do that, ACMC Health and Rice Memorial Hospital with CentraCare decided to collaborate to form a new, innovative health care organization known as Carris Health.

“Our goal is to work together to strengthen rural health care,” Dr. Smith explained. “We want to do what is best for every single community and make sure everyone has the health care services they need to take care of the people within that community.”

In 2022, Carris Health renamed to CentraCare, and the system continues it’s rural focus on healthcare.

As Dr. Smith begins her next adventure in health care, she is excited for the opportunities that Carris Health will provide for rural Minnesota and the patients in our communities.