The Rippel Foundation
NACHC Story: Primary Health Network
Dr. Garrow (third from the left) meets with health center partners at PHN’s offices. Their core values are displayed in the background (photo: PHN)
When you listen to Primary Health Network (PHN) CEO Dr. George Garrow describe belonging in his rural western Pennsylvania community, you can visualize a place where everyone knows each other by name. Dr. Garrow describes neighbors welcoming newcomers with freshly baked pies, Friday night football rallies, and community anchors like faith groups and 4-H clubs.
He believes that PHN can be an equally powerful anchor by investing in the vital conditions for health and well-being to address challenges in his rural community and serve as a model for health centers nationwide.
“When I talk to residents about the vital conditions, people say to me, ‘This is the first time I have felt hope for the well-being of our community,’” Dr. Garrow says.
That hope resonates deeply with Dr. Garrow, who grew up in rural poverty. For him, the vital conditions create a path toward thriving, by building on local assets rather than relying on systems that don’t always recognize rural communities’ unique barriers.
“Our communities are along the Appalachia stretch of Pennsylvania and don’t have public transportation,” he says. “Or, if they do, it’s a two-to-three-hour drive to a metropolitan center for care. Many are laborers, working in farming, agriculture, and other rural industries where they can’t get away during the day to visit a doctor. And poverty is a concern.”
These are all barriers that are linked to poor health outcomes.
Dr. Garrow travels to every one of PHN’s counties—16 in western Pennsylvania and one in Ohio—inviting residents, providers, service agencies, school systems, and others to roundtables. He opens the conversation by sharing their community’s health data and challenges them to shift the conversation toward shared stewardship: “I’m tired of talking about our outcomes and admiring our problems. Are you?”
“What I’ve learned from The Rippel Foundation and the vital conditions framework is to move away from reactive sick care,” he says. “Let’s talk about ways that we can invest in sustainability and well-being for communities over the long term. There are wonderful people in our communities doing wonderful things who sometimes feel that they’re working in siloes . No one hears them, no one sees them.”
Dr. Garrow works to hear them, see them, and help them see themselves as stewards creating conditions for everyone to thrive.
Responding to Crisis by Leaning in to Stewardship
PHN’s investment in the vital conditions, shared stewardship, and trust-building came to the forefront following a local crisis that gained national attention. In 2023, a train derailment and chemical spill in East Palestine, Ohio—just half a mile from Pennsylvania’s border—created serious ongoing health concerns for residents, many of whom were PHN patients and employees.
When the Pennsylvania Department of Health asked if PHN could set up a health resources center, Dr. Garrow said, “We’ll be right there.”
He was quickly on the scene with PHN’s mobile unit, providing care to first responders and residents who were consumed with fear about the spill’s short and long-term effects on their families, livestock, and crops.
“Every single one of them was scared,” Dr. Garrow says. “They wanted to know, what does this mean for me today? What does it mean for me next year or five years from now? We leaned into the human-centered part of our care. We listened to and documented residents’ concerns and created a registry so that, if a health issue emerges at higher rates in the future, there is a way to contact them. We reassured them that we were there for them at that moment, and in the future.”
After the crisis, new opportunities for shared stewardship emerged. Together with the Penn State University Commonwealth Campuses and community stakeholders, PHN created a Community of Practice meeting monthly to connect, learn, and teach clinicians about non-healthcare issues impacting health. “It’s an example of collaboration between an academic institution, a health center, and our communities to focus on the vital condition of a thriving natural world,” Dr. Garrow says.
PHN’s Buddy Bench Program places benches next to Little Free Libraries throughout their communities (photo: PHN)
Believing in Stewards
Believing in others is at the heart of Dr. Garrow’s stewardship. “If you see something in an individual, if you encourage them, who knows what great things will transpire?”
He believes residents have the answers—and his employees do, too.
“When I was asked to serve as CEO, I made a commitment on that very first day that I would visit all of our sites, shake every employee’s hand, thank them for their work, and listen. I wanted to know how can I help you to be a better servant to our patients and our community.”
Dr. Garrow offers the same encouragement and support to junior high and high school students pursuing healthcare careers. For cultivating a new generation of healthcare stewards, Dr. Garrow recently won the Wilford Payne Health Center Mentor Apex Award, an annual recognition of health care professionals who go above and beyond their call of duty..
“I wouldn’t be here doing what I’m doing if people didn’t believe in me when I was a young man in my community,” he says.
That early belief shaped everything. Now he works to create the same belonging and connection for others through gestures both big and small.