District recruits medical providers

The Upper San Juan Health Service District is now hiring ... physicians and midlevel providers, that is.

During its regular monthly meeting last week, the district board of directors approved Pagosa Mountain Hospital (PMH) CEO Brad Cochennet’s request to commence an active recruitment program intended to increase the number of medical services providers within district boundaries. Cochennet’s request came in view of a provider shortage that has plagued Pagosa Springs and the surrounding community for years.

In fact, according to the Health Resources and Services Administration (of the U.S. Department of Health and Human Services), Archuleta County is a “Primary Care Health Professional Shortage Area (HPSA)” and a “Medically Underserved Area.”

Based on Cochennet’s analyses of the immediate and upcoming needs of PMH, two private provider clinics and a planned rural health clinic, he believes the district is now short six full-time providers.

In a Provider Recruiting Business Plan Cochennet submitted as part of his request, he emphasized the fact that, “Hospitals don’t have patients, providers do and only through providers and their referrals is a hospital viable.” He added that PMH must have a strong provider network in its primary service area in order to survive and prosper.

While describing existing medical services and providers, and the fact that just one privately owned clinic is actively recruiting additional staff, Cochennet recommended that the district (and PMH) take on the majority of responsibility in recruiting new providers to the community. He offered several suggestions that should lead to success, not the least of which includes:

• Being market competitive in the recruitment of providers, while offering a community package broader than just wages and benefits.

• Establishing a system that strengthens provider relationships and alliances within the community, while making it possible for providers to own and control their own facilities.

• Developing a primary service area health record system with established payment terms and pre-qualified service levels, while maximizing payment programs and services from outside the community.

• Improving technology, training and education to keep providers up to date.

• Developing physician billing capabilities and back office functions to allow doctors to focus on being doctors, while minimizing their energy drain and duplication of services.

Cochennet’s plan continued, by explaining the difficulty local providers had in recruiting new individuals last year, while, at the same time, struggling to meet contractual obligations at PMH. While covering shifts in the ER, caring for inpatients and maintaining private clinic responsibilities, providers were logging 80-hour weeks.

Waning provider morale and growing exhaustion ultimately led to PMH contracting with Southwest Emergency Physicians for additional ER coverage. Meanwhile, a new midlevel provider (Martin Neubert, PA) has joined PMH, and a Docs Who Care physician has come on, at least temporarily.

Nevertheless, Southwest Emergency Physicians can only offer limited resources, while Dr. Robert “Buz” Bricca will soon leave Pagosa Family Medicine (and the community). Too, the recruitment of surgeons and specialists to perform procedures at PMH has, to date, been disappointing.

Therefore, the district and PMH are now stepping up efforts to attract new providers.

“We are developing a data base of physician contacts and will be including the many retired/semi-retired providers who frequent Pagosa Springs throughout the year in a contact sourcing group,” Cochennet’s plan reads. “With the growing list of physicians who had shown interest in our hospital/community, along with the large number of retired physicians already located here, we believe we will be able to source candidates through good old fashioned hard work and avoid the expensive recruiting services.”

During a recent phone interview, Cochennet emphasized the need for business interests and the entire community to assist in recruiting new providers.

“It takes a community to hire a physician,” he said. “It’s more than just offering a salary, we need community leadership to help. They can meet with candidates and tell them what’s going on in the community. They can explain the benefits of being here, what local conditions would support their particular interests and lifestyle, and show how the hospital is supported (by the community).”

Cochennet also mentioned that two positions are now “very close to getting recruited.” He explained that one candidate is working in the hospital ER, while the other is working with Dr. Pruitt at Pagosa Family Medicine.

“We’re not starting this thing flat-footed,” Cochennet said. “We’ve been working on this for awhile, using existing contacts.”

He hopes to hire a couple of hospital ER providers soon, with an eye on two to four more as the proposed rural health clinic becomes a reality. They could be any combination of physicians or midlevels, with midlevels being licensed clinical professionals who examine patients, diagnose injuries or illness, and prescribe treatment under the direct supervision of a physician. They include physician assistants, nurse practitioners and certified registered nurse anesthetists.

Cochennet said recruiting will continue, as needs dictate. To avoid tipping the hand of potential candidates, he chose not to discuss likely salaries or other forms of compensation, but assured The SUN that the district will be “market competitive.”

chuck@pagosasun.com