For example, a historically successful, multi-practice group had run into this "wall" characteristic of rural medicine. They had done everything right: hired strong leadership, started a surgery center, opened radiology suites, expanded their laboratory, added specialists, and relocated in a modern and attractive office building. They were "it" for doctors in the San Luis Valley. But in September 2006, they closed their independent practice as it was impossible to competitively operate a multi-specialty group while serving three times the number of uninsured and Medicaid patients compared to providers in other areas. As physician incomes decline, recruiting physicians to rural areas is increasingly difficult and the capital needed to invest in electronic medical records and state-of-the art surgical equipment simply isn't available. As it turns out, the closing of the multi-specialty practice was a wakeup call for the San Luis Valley Regional Medical Center and it helped us to redefine who we are. The hospital is no longer a cloistered organization that, although ready to take care of whoever walked in the door, was otherwise disengaged from the community. The multi-specialty group determined it was no longer a separate, independent (and often adversarial) colleague to the hospital. We discovered that what we thought of as separate and distinct purposes were actually very much aligned: to serve the community and to enjoy life. We also learned that there were many opportunities to support one another in pursuit of our shared goals. And we began to think of ourselves as one, and to work in ways that helped each other and our community. First, we fully embraced the physician group, which became a new division of the hospital. We shared best practices and economies of scale that reduced hospital operating costs and improved services. We also shared technology and joined together to plan and prioritize our future needs, including:
We found that our scope of work and thinking expanded into areas beyond health care. For example, hearing that the quality of our schools was affecting the ability to recruit physicians with young families, hospital leaders got involved in a campaign to build two new grade schools and hire a new superintendent. Active grassroots involvement led to the successful passage of a $25-million bond issue in a slow economy of our rural community to fund the new school construction. Further, the hospital is developing videos that will be used for introducing the community to our health care workforce, for new employee orientation, and in new physician and provider recruitment efforts. Workforce is perhaps our greatest health care challenge in the next decade. Although capital for technology will be scarce, health care is, first and foremost, a people business. With all the macro-level indicators heading in the wrong direction for there to be an adequate health professions workforce, we cannot overstate this challenge; I see it as our number one priority. We must do all we can to attract and retain skilled professionals in our industry. And we must never forget that these individuals and their families can choose to live anywhere they wish. By partnering with our providers and creating an organization of which they are proud to be a part, we'll serve our community better, improve our health care quality and attract the physicians, nurses and other professionals we will need in the decade ahead. It is an exciting challenge and a great opportunity to become a better rural hospital and contribute to a thriving community in ways never before imagined. The San Luis Valley Regional Medical Center is a full-service facility that serves a rural, southern Colorado alpine valley of 47,000 people in 8,000 square miles. |