  SAN LUIS VALLEY REGIONAL MEDICAL CENTER For Janice Slade, having a good doctor is a life and death matter. Twelve years ago, Slade, 70, had a liver transplant because her own liver was failing. Then, the medication she had to take after the transplant caused her to get a rare cancer called Burkitt's Lymphoma. Slade lives in the small town of Del Norte in Colorado's remote San Luis Valley. Here, recruiting and retaining doctors poses great challenges to the community - including Slade's own daughter, Gwen Heller, who manages the physicians at San Luis Valley Regional Medical Center in Alamosa. Slade is typical of patients in rural areas who struggle to get adequate health care - even if they have insurance - because it's so hard to find and keep good doctors. "She represents a lot of our patients who have chronic medical needs. She can't ever be in the position where she's without a doctor," Heller said of her mother. Even with Heller helping her navigate the thicket of medical quandaries, Slade has had nine primary care doctors since 2000. Each time new doctors arrive, she must get them up to speed on her complicated condition. "You get a little tired of repeating your history over and over," said Slade. "When I get sick, I need to see someone fairly soon. I need a good working relationship with my doctor." Slade's daughter works constantly to recruit and retain more doctors to this area. Heller is hopeful that a new integrated medical model - where hospitals and doctors all work together under the same roof - will bring more doctors to the community to stay. The San Luis Valley Regional Medical Center is a participant in The Colorado Trust's Health Professions Workforce Policy Collaborative, which is working to establish a public policy framework to strengthen the state's health professions workforce. About four years ago, the medical group Heller manages gave up their private practice and became employees of the hospital in an integrated delivery environment. The cost savings and better insurance reimbursements have allowed Heller to offer potential new doctors much more competitive salaries and better tuition reimbursement programs. Retention is already improving. When the doctors were in private practice, the group had just 10 physicians and two physician assistants or nurse practitioners. Now they have 22 doctors and 12 mid-level practitioners. "Small, private practice groups, especially in primary care, are starting to disappear. People can't make enough money to provide for their family,'' Heller said. "Without the integrated delivery system, this area would have lost most of its specialists." Along with the new system, the medical center's "hospitalist" program is also easing the burden for primary care health workers throughout the valley. The program - unusual for such a small, rural hospital - brings in doctors who work solely in the hospital. This helps medical practitioners throughout the valley who no longer have to leave their communities and drive miles to check on hospitalized patients. Heller says she's hopeful that she can keep attracting great doctors for her mom and patients like her. For more information about The Trust's work to expand Colorado's health care workforce, contact Laurel Petralia, Program Officer, 303-837-1200, laurel@coloradotrust.org. |