One of the trends in modern health care is a return to going where patients are.
I wrote about this in a recent blog that focused on our Community Paramedic Program, and I alluded to the olden days of doctors arriving in a horse-drawn carriage at your front porch and climbing down, black medical bag in hand, to enter your home and care for your loved ones.
For much of the last half of the 1900s, this definitely wasn’t the case. A patient was expected to travel to physicians, no matter how far or how inconvenient it was for the sick person.
Thankfully, that model of care has moved off into the horizon, far, far away, and hopefully it’ll never wander back our way.
The Greeley Tribune recently published an excellent feature article about the frequent travels of two oncology physicians who have journeyed eastward for decades to treat patients in rural communities.
The two featured physicians were Dr. Douglas Kemme, a physician with the Medical Clinic at Centerra, Loveland, who once a month motors to Yuma, on the eastern plains of Colorado, and Grant, Neb., and Dr. Thomas Lininger, a Greeley Medical Clinic physician who has traveled to Sterling on a weekly basis for 35 years. As the Tribune pointed out, “That’s the equivalent of around the globe at least once.”
Now, that’s commitment to patients!
I’d like to offer some excerpts from the Tribune story as a way to tell you about the motivation. The staff reporter, Dan England, wrote:
“It doesn’t make much business sense to continue to travel to Yuma, he (Dr. Kemme) said. But there is something about those small towns. He sees the names of players on the basketball teams in store windows. Everybody is just so nice. They seem to appreciate him even more than the grateful patients in Greeley.”
“…he wants his patients to be treated in their towns because that goes along with everything else he believes about how medicine works.
“…he said, ‘I see less patients, and I spend more time with them. A family physician might see three times the patients I do in one day. You have to have that personal contact. I want to know the names of their spouses and dogs.’”
PVHS does not have a policy requiring specialty physicians to go to rural areas to treat patients. That decision is left to individual doctors and their clinics.
Let me offer you an example of how dedicated city-based physicians are in traveling to rural areas to offer patient care. One of the pioneers in Fort Collins was Dr. Gary Luckasen, a founder of the Heart Center of the Rockies. The journeying to rural areas began in 1980 and now HCOR physicians routinely travel to small communities on the prairies and in the mountains.
“There was a huge gap that we saw and decided to fill,” Dr. Luckasen recalls. “Going to the areas where patients live has worked out well for the patients and their families. Our coming to them causes considerably less physical, emotional and medical stress on the patient.”
I asked our physician outreach department to gather some facts to give a perspective on how extensively the specialty physicians on our medical staff travel to rural areas to hold clinics. “Clinics,” by the way, is what we call these visits; physicians will see patients in previously arranged clinic locations like local physician offices or community hospitals in the rural towns.
Here’s the info for 2011:
• Our physicians received a total of 12,229 patient visits in rural areas.
• The Colorado communities included Brush, Craig, Estes Park, Fort Morgan, Grandby, Holyoke, Kremmling, Steamboat Springs, Sterling, Walden, Wray, and Yuma. The Nebraska communities were Alliance, Grant and Sidney.
• The medical specialties taken to patients were cardiology, cardiovascular surgery, general surgery, nephrology, neurology, oncology, and pulmonology. All of these are specialties generally not found in small communities, where, typically, family medicine is the primary avenue for medical care.
Our director of physician outreach services, Erica DeMint, offers this perspective on why local physicians hold rural clinics:
“The shortage of medical services is a big issue in rural communities. Local hospitals and clinics are often staffed by family physicians who are stretched to provide care across a wide spectrum of conditions. The on-site specialty clinics that our physicians hold augment services already available to patients and families where they need it the most—close to home.
“Working closely with the existing local physicians and other healthcare providers in the rural communities to build relationships enhances patient care and provides access to additional valuable patient resources that may be unavailable locally, such as diabetes education, information about bariatric services and cardiac device monitoring,” Erica concludes.
I’d like to say thank you to all of the physicians who go the extra mile (literally!) to offer care to rural residents. In conjunction with local physicians in these communities, they provide services that will help to keep the people in our region healthy.
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