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Hettinger is heart of rural medicine

Related story: Bowman supports healthcare expansion

by Luann Dart


Photo by John Kary

Tucked along the maze of clinic and hospital hallways of West River Health Services in Hettinger, the conspicuous stars vie for attention – the imposing 64-slice CT scanner, a bustling modern addition, or the lab’s enormously expensive chemistry analyzer.

But it’s the not-so-obvious clues that truly define West River Health Services (WRHS). There are the posters announcing the retirement of Dr. Thomas Jacobsen after 44 years of practice. Some say he delivered an estimated 6,000 babies during his career – nearly five times the entire population of Hettinger. There’s the unobtrusive wall of honors listing all the awards bestowed to the staff or the facility over the years. Then there’s the student from Norway peering into a microscope in the lab.

It’s all part of a visionary plan to provide topnotch medical services in rural North Dakota.

“It’s sort of a mission-driven practice. We believe very strongly that the people in rural areas deserve high-quality medical care,” explains Dr. Catherine Houle, a native of Beach who now practices family medicine at WRHS.

To meet its mission, WRHS has been a pioneer in rural  medicine. It was one of the first in the state to open satellite clinics, and to merge hospital and clinic services. Now, it’s the leader in a rural family medicine program which will introduce students to rural medicine in Hettinger.

“Our mission is to provide comprehensive health and wellness services for the residents of this region. That’s what we need to do,” says Jim Long, CEO and administrator of WRHS.

Planting a tree
“There’s a proverb that states the best time to plant a tree is 20 years ago,” says Dr. Houle. “That model is what keeps us alive. If we didn’t have our satellite clinic network, we couldn’t possibly support what we have here.”

It’s a vision Dr. Gerald Sailer and Dr. Paul Retzer planted in the 1960s when they started a practice focusing on technology, then casting a wide net for patients, which allowed for doctor recruitment. Today, WRHS has lifelines reaching into six outlying communities.

West River Health Services Foundation is the parent corporation of WRHS and Western Horizons Living Centers. United Clinic Physicians Group is another affiliated corporation providing the services of 14 doctors to WRHS. The entire network employs more than 400 people.

WRHS consists of a 25-bed critical access hospital, eight clinics, a wellness center and a home medical store. Two clinics – a medical clinic and optometrist – are based in Hettinger. Satellite clinics are based in New England, Mott, Scranton, Bowman and Lemmon, S.D., along with a foot and ankle center in Dickinson. The living centers include a skilled and basic care facility and 16 assisted living apartments.

The $9 million Centennial Addition, completed in 2009, houses the surgery center and clinics, along with state-of-the-art equipment.

“I know of no other rural hospital in a community of 1,300 that would have a 64-slice CT scanner, fixed MRI, have the nuclear medicine and diagnostic ultrasound,” Long says. “I don’t think another sister facility exists.”

The facility utilizes telemedicine, along with e-Emergency to assist in documentation and transport arrangements with its average of 1,800 emergency room visits each year. It also operates an ambulance service and an evening-hour convenience clinic.

WRHS was recently recognized by the National Organization of State Offices of Rural Health as a HealthStrong™ Award winner for Excellence in Outcomes and Efficiency, reflecting top quartile performance among all rural critical access hospitals in the nation. Outcomes measure factors such as patient safety and readmission rates, while efficiencies measure costs and charges.

“Being able to achieve the level of service and technology that it has is the number one thing,” Long says.

Growing doctors
While providers like Dr. Houle are the true heart of WRHS, recruiting physicians to a rural medical center is challenging.
“The biggest challenge is getting them here to start with,” Long says, so WRHS welcomes students to the facility - from across the state and even as far away as Norway.

“The whole idea is for them to come out, spend some time and learn, so the perception they might have is addressed,” Long explains.

Having the greatest impact is the Rural Opportunities in Medical Education (ROME) Program, which brings two, third-year medical students to spend six months in Hettinger each year.

“They deliver babies, they see patients, they go to surgery, so they get a real nice broad experience. They get a lot of one-on-one teaching with the physicians and they see that you can do good medicine in a rural area,” Dr. Houle says.

“Our docs love to teach. They let them do it hands-on,” Long adds.

This year, the University of North Dakota School of Medicine and Health Services will partner with WRHS and Mercy Medical Center in Williston to train physicians to practice rural family medicine in a new program.

After completing four years of medical school, physicians must then complete a three-year residency program. Under the new program, students will complete their first year of residency at the UND Centers for Family Medicine in Bismarck or Minot, then spend two years in Hettinger or Williston. The rural training track program is supported by an appropriation from the 2011 Legislature.

“We’re real excited about it,” Dr. Houle says.

“Eighty percent end up 50 to 100 miles of where they do their residency,” Long says, so the program will benefit all of western North Dakota.

Operating a rural medical center where charity care and bad debt are four times the bottom line creates other challenges, Long points out, so funding for these innovative programs is vital.

“Trying to keep ourselves at the forefront of technology and services and doing that in a rural environment is a challenge. Finances is always the struggle,” he says.

But then he points to the mission created by the founders.
“They said rural people deserve the same level of medicine as urban,” he says. “Everybody is working together as a team for the benefit of the patient.”

“Early on, there was a lot of innovative thinking,” Houle adds. “People in rural areas deserve high-quality care.”

Luann Dart is a freelance writer and editor who lives near Elgin.

 


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