SCHD welcomes internist Dr. Hastey

MARBLETON – Medicine involves a measure of detective work – unraveling the mystery of the complex human body to discover the root cause of a patient’s distress.

“People’s symptoms are not always what the textbook might say about a specific disease,” said Dr. Rafael Hastey, new doctor of internal medicine at the Sublette County Hospital District. “You have to find those clues. That is part of the excitement of medicine – to find those clues and answers.”

Practitioners of internal medicine focus on adult illnesses, particularly patients with multiple chronic medical conditions, Hastey said. Some internists specialize in specific areas, like cardiology. Dr. Hastey practices general internal medicine and can treat people suffering from a wide variety of ailments, from diabetes and high blood pressure to autoimmune diseases.

The diversity of Dr. Hastey’s patients highlighted the importance of good detecting skills. A key to detection is communicating with patients, building a sense of rapport and trust to get to the bottom of the problem.

“Most of what we do is based on questions – asking the right questions and asking questions in the right way, because people interpret questions differently,” Hastey said. “(Laboratory) tests can help confirm things, but a good chunk of what we’ll find in terms of answers is asking the right questions.”

Getting to know patients and interacting with them is an aspect of the job Hastey particularly enjoys.

“Once you learn more about people, you can help them better in terms of meeting them where they are and knowing what works for them as you help them through their medical problems,” he said.

Hastey’s primary practice principles are “to give practical and accurate medical advice” to improve a patient’s quality of life while “respecting patients’ personal autonomy.”

Hastey is eager to apply these principals to help people across Sublette County. So he dove dove right in. He is already seeing patients at both the Pinedale and Marbleton-Big Piney clinics.

“I look forward to having longer, steady relationships with patients in terms of following their health over time,” he said. “I’ve been very lucky to be around great coworkers and great people already in Sublette County. Everything has been really positive.”

A passion for science and people

Science fascinated Dr. Hastey for as long as he can remember. As an undergraduate at the University of Montana, he majored in physics and set his sights on pursuing a medical career.

“I initially thought about doing veterinary medicine, but I wasn’t very good with animals,” he said.

Animals cannot speak to their doctor, a factor that makes human medicine more attractive.

“You can talk to people, which is huge,” he added. “There are so many aspects of science that come together in human medicine. I like to have that pragmatic side of things, as far as being able to help people. I do have great respect for veterinarians, though.”

Hastey enrolled at the University of Virginia School of Medicine in Charlottesville where he spent the first two years in the classroom, learning the “textbook science” on how the body works.

The next two years of medical school consisted of rotations through different specialties, including work in hospitals and the emergency room.

From the beginning of medical school, Hastey knew he preferred adult primary care and focused on internal medicine. The rotations proved beneficial in helping Hastey pursue a path in general internal medicine, rather than focusing on a single organ as a cardiologist or gastroenterologist.

Upon graduation from medical school, Dr. Hastey began his residency at the University of Wisconsin. Residencies are renowned for brutal shifts and stress.

“People’s lives are on the line and you are tired,” Hastey said. “On top of that, you’re learning how to practice medicine.”

Seeing and helping actual patients in a primary care setting inspired Hastey to stick with the grueling pace.

Strong mentors, in residency, medical school and college, guided Hastey through the challenging process. Instructors that stood out to Hastey pushed a holistic approach to internal medicine – going beyond the medical angle to include a person’s social background, their day-to-day habits and their ability to pay for medication or travel to appointments.

“Practical things like that often times makes or breaks whether a treatment works,” Hastey said. “I had a few mentors that helped me see that and that was very useful.”

An ounce of prevention

Internists spend significant time treating chronic illnesses and responding to acute problems caused by different diseases. Part of the job involves preventing long-term health issues from happening in the first place.

“I love preventive medicine, because I feel like prevention is underplayed, or almost ignored sometimes, and we only tend to focus on acute issues,” Dr. Hastey said. “There are so many things we can do to prevent illness, especially in younger adults, so they don’t get to that chronic illness stage later on.”

Changing personal habits cannot prevent all disease, Hastey acknowledged, although making different life choices can avert certain chronic conditions.

Developing good practices, including maintaining a healthy diet, regular exercise, getting enough sleep, staying mentally and socially active and avoiding smoking and excess alcohol, all play a role in preventing some chronic illnesses, he added.

Hastey believes in modeling prevention in his own life.

“I try to do healthy things myself, in terms of diet, exercise and sleep,” he said. “If I don’t, I have less credibility as far as telling other people to do those things, plus I can actually speak from experience on things that might work for others.”

One healthy step is to hit the great outdoors. Hastey’s hobbies include bicycling, basketball, downhill skiing and hiking – a perfect fit in a place like Sublette County with endless recreational opportunities.

Hastey thanked his wife for being by his side as he pursued his dream to become a doctor.

“My wife has supported me a lot, especially through medical training, which is pretty stressful,” he said. “Having someone there who is supportive is huge.”

Dr. Hastey plans to make Sublette County home as he builds his practice.

“I really look forward to living here for a long time,” he said. “It’s a really nice community and a gorgeous place.”


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