Transforming health care in rural Oregon
New medical facility in Klamath Falls trains doctors, other health care professionals
The grand opening of the $50 million Sky Lakes Collaborative Health Center in Klamath Falls celebrated much more than the completion of a successful building project. The December event marked the launch of a new way to educate medical professionals that community leaders hope will transform the face of rural health care.
The health challenges faced by rural Oregon are well known: Although more than one-third of residents live in rural communities, only about 10% of physicians practice there, leaving many areas without any primary care providers. Transportation and geography create barriers to existing care. Significant health disparities are well documented in rural Oregon, where adults are 36% more likely to report their health status as fair or poor than are adults in urban areas.
The Sky Lakes Collaborative Health Center, a partnership of Sky Lakes Medical Center and Oregon Health & Science University, is tackling that complex problem head on, by training doctors and other health care professionals in the areas that need them most — rural Oregon.
The health center, besides bringing all Sky Lakes primary care under one roof, offers expanded training opportunities for medical providers interested in rural health, with the ultimate goal of boosting the number of health care workers who stay in rural Oregon to practice. “The intent when this is all done is to have essentially all students in all colleges do a rural rotation,” says Paul Stewart, president and chief executive of Sky Lakes Medical Center.
The center will serve as a hub for health professionals in many different disciplines
The advantages of such a model have far-reaching implications. “Any experience in working in an underserved area changes the individual in such a way that they care more for the underserved in whatever setting they are working in,” says Joe Robertson, the retired OHSU president whose leadership was critical in planning the project. “They will likely be in positions of leadership as it relates to healthcare and now they are people who understand rural areas.”
The center will serve as a hub for health professionals in many different disciplines, who will do their rotations in Klamath Falls and in many “spoke” communities throughout rural Oregon. “The idea is if you are training people to practice in a rural community, you should be teaching them in a rural community,” says Rod Wendt, the Klamath Falls businessman and Sky Lakes board member who was a pivotal early supporter of the project. “The hub-and-spoke model is a fabulous improvement and benefit over how we have been previously training our health professionals.”
It’s a concept with a stellar track record. Completion of the center coincides with the 25th anniversary of Cascades East Family Medicine Residency program in Klamath Falls — the first rural family medicine residency in Oregon. There, OHSU medical students spend their residencies in Klamath Falls, with stints in communities such as Medford, Bend, Burns, Lake-view, Enterprise and John Day.
“Even if you are interested in rural health, if you spend your residency in Portland, lots of things will pull you away from that vision,” says Dr. Joyce Hollander-Rodriguez, the residency director at OHSU Cascades East Family Medicine Center; she is also regional associate dean at OHSU Campus for Rural Health.
Growing up in Pleasant Hill, Hollander-Rodriguez knows that first hand. “I was so eager to get out of a small town and out of Oregon,” she says. “But after I went off to college, I missed Oregon, came back to OHSU, and came here to Klamath Falls because I wanted to help meet the needs of rural communities.”
The success of the strategy is in the numbers. After 25 years, an impressive 80% of graduates have entered practice in rural areas. “Students and residents come through, and see communities that are so grateful to see them,” says Hollander-Rodriguez. “The communities are one of our most effect recruiting tools.”
The center has expanded the program from medical residents to include health professions such as pharmacy, dietetics, dentistry and public health. When at goal, the center hopes to see 600 students working in rural Oregon; its roster now numbers about 45.
Power of partnership
Stewart describes the community response to the project as “ecstatic.” The new four-story building, the single largest construction project ever to take place in the area, was one of the smoothest projects he says he’s ever seen.
The project’s economic spinoffs of the Collaborative Health Center are already apparent, triggering housing revitalization and beatification efforts.
“The feedback I am hearing is that it’s really working,” Wendt says. “Students really like it here. Other communities like Coos Bay and La Grande, are benefiting, and it’s been beneficial for both medical professionals and the community.”
Robertson agrees: “This entire project is a demonstration of community-building, with parties coming together with a shared purpose, shared vision, an open mind and a boundless energy. That’s the power of partnership, where partners benefit to a much greater degree than if they acted independently. It’s a wonderful example and should be a model for all of rural Oregon, and not just in healthcare.”