Individuals enter the field of health care for a variety of reasons but mainly to help. Once in the field, the place in which they choose to practice can mold and shape their ideas about healthcare and about the communities that they serve. As they spend time in the field, their motivations and perspectives change and, in turn, alter their approach to the communities they serve. Rural Appalachian communities which often are home to people of poverty and isolation can present unique challenges to the skills of healthcare providers. Such challenges may cause fatigue and stress in helpers who may counter with protective strategies such as withdrawal from the community and the creation of psychological separation between themselves and their communities. The present study seeks to examine the beliefs and attitudes that early, mid, and late career healthcare providers in rural Appalachia express about the services they provide and the challenges they encounter in the communities they serve. A qualitative methodology is used to allow providers to talk, in their own words, about their motivations for their work and the manner in which their experiences have provided both impetus and impediment to their ability to deliver services in their communities.