Dr. Karen Perser, the only female orthopedic surgeon in the Flathead Valley, surprises some patients when she enters examination rooms at Northwest Orthopedics and Sports Medicine or the emergency room.

“Some patients are shocked. They say, ‘Oh, I wasn’t expecting to have a female doctor,’” she said. “By the time I finish talking to them, they’re fine.”

Perser said it’s a positive surprise for most people.

Tall, athletic and energetic, the young surgeon joins a vanguard of women entering orthopedics, a male-dominated medical specialty. Unlike the first women breaking into medicine, Perser said she encountered little hostility during her many years of preparation to become an orthopedic surgeon.

“I can honestly say that I never got the feeling through any of my training that I wasn’t welcome or that there was a ‘What are you doing here?’ kind of mentality,” she said.

At 34 and single, Perser has created a life for herself that many would envy. Since moving to the valley two years ago she has embraced nearly every aspect of outdoor activity, including downhill and cross-country skiing, snowshoeing, kayaking, biking, hiking and backpacking through Glacier National Park with friends.

“I did that for the first time last year,” she said. “I just loved going out there carrying everything you need on your back.”

According to Perser, mountains, snow and many outdoor options played a role in bringing her to the Flathead Valley. Although she grew up mainly in the Dallas area, she spent some years in Alaska at an early age.

“My dad worked for an oil company so we went to Anchorage for several years and that’s where I went to elementary school,” she said. “I loved it and liked being outdoors and I liked the mountains.”

The daughter of an engineer and a math teacher, Perser said she first thought about a career in medicine when she was in middle school in Rockwall, a suburb of Dallas, where she had a neighbor who was a pediatrician. She enjoyed hearing his stories, so she took part in a program where she was able to job-shadow medical specialists and then volunteer at Parkland Hospital.

In the summer after high school, she participated in an internship program there.

“That’s where I was introduced to orthopedics,” she said.

Like most college-bound high school graduates, Perser said she dreamed of attending a school far, far away from her parents, but ended up with a full academic scholarship in her backyard at Southern Methodist University in Dallas. Medical school provided just a little more distance, taking her to the University of Texas in Houston.

During medical school, she said she was determined to keep an open mind as she rotated through various areas of medicine.

“I kind of systematically went through each one,” she said.

Perser said she was leaning toward surgery when she had her last rotation in obstetrics and gynecology.

She expected that birth would be a beautiful thing. Perser laughed as she recalled her father describing her own birth as more “gross” than beautiful.

“I said, ‘Come on Dad, you’re pulling my leg.’”

It turns out she was her father’s daughter in that regard. Working with the tired, unsung medical heroes serving women in the throes of hard labor, she quickly crossed off that area.

“After the first day, it was no, not so much,” she said.

Her rotation in orthopedics was a different story. Perser said she enjoyed the people and the environment.

“They were having fun. They were treating all different ages — the weekend warrior to the elderly — that was one aspect I liked,” she said. “The surgeries are fun. You’re putting people back together. You’re getting people back to doing the things they like to do.”

During her orthopedic surgery residency at the University of Washington Medical Center, Perser was one of three women in a class of eight residents. She said a group of almost 50 percent women was unusual but not unexpected for the progressive West Coast.

“The first female that went through that program is still on staff there and she is probably in her 60s. It was really neat,” she said. “She had some interesting stories about that.”

Perser thinks the field has been male-dominated for a number of reasons.

She said the physicality of the pushing and pulling plays into its macho appeal as well as the carpentry component with its saws and drills. Perser said an orthopedic surgeon does need some physical strength.

“But most of the time, it’s technique,” she said. “I’m not a 300-pound person but I can do the same things that someone twice my size can do. You just do it a little differently or use tools to help you.”

She didn’t have carpentry experience, but she learned to work with her hands and tools by watching and helping her father tinker with cars. Perser said she grew up next to boys so she was always doing other boy-type activities.

Playing volleyball, basketball and softball in her younger years fueled her desire to study sports medicine. A fellowship at the State University of New York provided the opportunity just as she completed her orthopedic surgery residency in 2009.

“It was primarily an arthroscopic (minimally invasive) fellowship doing knees, shoulders and hips and taking care of some sports teams at the college level and then the professional level,” she said.

At first, Perser was less than excited about the prospect of taking care of a professional team because she had no aspiration to do that with her career. But she found she really enjoyed working with both the Buffalo state college teams and the Buffalo Sabres hockey team that ended up in the playoffs that year.

She said it was a completely new and different exposure.

“There’s a lot of urgency to it. You have to get these people back right away,” she said. “They’re losing money and they’re needing to know what their future is going to hold.”

Her experience was put to good use taking care of high school athletes and the Glacier Nationals hockey team after she finished her fellowship in 2010 and joined Northwest Orthopedics and Sports Medicine.

Her decision to start her career in the Flathead Valley was based on several factors .

She said she became familiar with Montana and its beauty while driving back and forth between Washington and Texas. Also during her residency, Perser developed a lot of respect for the emergency room care of Kalispell Regional Medical Center.

“Anytime I heard something was coming from Kalispell, it was usually something serious — it wasn’t something someone didn’t want to take care of. It was a big injury,” she said. “And it was always well-stabilized before it came over. So I knew they had a good medical center here.”

Perser was impressed by the high level of technology at the hospital and the quality of the support staff. She also determined that her partners were supportive.

Even after two years, she said one of her partners calls most of the time that she is on call and offers to pitch in if she needs any help on a big case.

“That’s kind of a rarity,” she said. “We don’t compete — we support each other.”

Her practice covers a wide spectrum with about 50 percent sports medicine, 30 percent trauma and 20 percent joints. Perser specializes in rotator cuff repairs using the arthroscopic skills she developed during her fellowship.

Although hunting season slows down elective surgeries, Perser said her patient load keeps expanding.

“It’s really ramped up this year,” she said.

According to Perser, demand for orthopedic surgeons in the future remains huge with the aging population. She looks forward to exciting advances in the field, such as cell-based cures for early arthritis.

By staying active and eating a healthy diet, Perser looks forward to keeping on top of those new developments while providing a role model of healthy living for her patients with her energy and zest for orthopedic surgery.

“I’m very happy,” she said. “I couldn’t imagine doing something different.”

Reporter Candace Chase may be reached at 758-4436 or by email at cchase@dailyinterlake.com.