Image provided by: University of Oregon Libraries; Eugene, OR
About East Oregonian : E.O. (Pendleton, OR) 1888-current | View Entire Issue (Aug. 19, 2017)
Page 12A OFF PAGE ONE East Oregonian DOCTORS: 10,247 of Oregon doctors practice in urban/non-rural areas and 2,362 work in rural areas Continued from 1A idence St. Mary Medical Center. “I love it,” Wick said. It’s a happy outcome in a time of doctor shortages in rural America. The shortage, espe- cially of primary care physicians, continues to worsen. That is partially due to an imbalance in pay between primary care doctors and specialists. According to Medscape’s 2017 Physician Compensation Report, ortho- pedists, cardiologists, plastic surgeons and urologists all earn $400,000 or more on average. But pediatricians, internists and family medicine doctors make $225,000 or less. Maggie Elehwany, the National Rural Health Associa- tion’s vice president of govern- ment affairs, said rural America needs more doctors. “Twenty percent of the popu- lation is scattered over 90 percent of the land mass,” she said. “This 20 percent of the population has nine percent of the physicians.” In addition, “there’s a higher percentage of chronic disease in rural America. They’re poorer and sicker.” Oregon isn’t quite that low. Based on Oregon Medical Board licensures and the OHSU Offi ce of Rural Health, 10,247 of Oregon doctors practice in urban/ non-rural areas and 2,362 work in rural areas (defi ned as 10 miles or more away from a population center of at least 40,000). The national shortage could grow to 45,000 by the year 2020, according to the NRHA. Since 2010, more than 80 rural hospi- tals have closed, including Walla Walla General Hospital. Internist Norman Sitz is a popular Pendleton physician who is pondering retirement in the next couple of years. He worries about his patients when that time comes. He doesn’t have hard numbers but he knows his town is short on docs. “People are always calling to get in,” Sitz said. “I don’t know what my patients are going to do.” Sitz grew up in Ontario, so as a young internist he felt no qualms about practicing in a rural area. Though Pendleton wasn’t his fi rst choice, he soon grew attached to this little place where “people get along with each other” and he has stayed for 40 years and counting. The locale was close to good hunting and fi shing and proved a great place to raise his and wife Michelle’s three children. He doesn’t mind seeing his patients around town and his home phone number is in the book. “People don’t abuse that,” he said. Sitz and his partner Daniel Marier sold their practice to the Praxis Medical Group three years ago as a way to rein in costs and get better bargaining power with insurance companies. The increasing regulation, complexity and requirements for such things as electronic health records have altered the landscape. “You can’t open a small clinic now,” Sitz said. “There’s no way to do it on your own. Fifteen years ago, someone could come to Pendleton and open a small practice.” Still, there are plenty of mid-level opportunities and not enough physicians to fi ll them. Money isn’t necessarily the reason for reluctance to leave urban centers. Wick said doctors who go to rural areas often get paid more by employers as an incentive. Doctors, dentists, optometrists, nurses, physician assistants, nurse practitioners and certain others also receive up to $5,000 in annual tax credits to entice them to practice in rural Oregon. The Oregon Legislature recently renewed the credit, originally enacted in 1989. A 2012 survey found that 45 percent of respondents felt the tax credit infl uenced their decision to practice in rural Oregon. More than 2,100 providers, including 60 in Pendleton and 76 in Hermiston, claimed the credit in 2015, the most recent data year available. Barriers to a rural practice include resistance from partners, pressure to pay off debt and worry about being too far away from academia, specialists and the amenities of city life. Some creative efforts aim to turn the tide. OHSU’s Area Health Education Centers, scat- tered around the state, introduce ALL NEW 2017 RAV4’S IN STOCK $ K-12 students to the notion of working in health care through career exploration activities. OHSU also requires medical students to experience small town medicine during rotations in rural parts of the state. Greggory Dallas, a second- year OHSU medical student from Pendleton, is one of several students with rural roots who helped organize rural medicine discovery trips to small towns this past year. The treks were designed to open urban medical students’ minds to rural medicine and remind rural students about reasons to return. Dallas’ own plans are evolving. She left Pendleton in 2002 to attend Columbia Univer- sity — in the center of New York City — not planning on returning home for a career. “I assumed I’d be in a city,” she said. “I never imagined I’d be back in Pendleton.” After a stint in Madagascar as a health care worker for the Peace Corps and before enrolling in medical school, she worked at the Pendleton Center for the Arts and her thinking changed. “I saw the impacts of what you can do in a small community,” she said. “That excited me.” Hoping to pass some of this excitement on to her fellow medical students, she helped with a pair of trips to rural Oregon, including a trek to Enterprise and La Grande. “Many of them said they’d never been to Eastern Oregon,” Dallas said. “A lot of them left feeling really inspired.” Many, however, fi nd it hard to imagine themselves working in a rural environment. Besides concerns about spouses getting jobs and the other reasons, she said lack of diversity is another apprehension. “Some of my classmates from minority or LGBT back- grounds wonder if they would be welcome,” Dallas said. “That’s something that’s come up a lot this year.” Lending credence to that fear, an OHSU emergency room doctor tweeted this week about racism she occasionally expe- riences from ER patients. Dr. Esther Choo authored the series 4 , 000 OFF MSRP 196 0 DOWN Continued from 1A chairs near the railings ready for customers. The DJ booth sits at the opposite end. Some tables and chairs make up the rest of the spartan accommodations. Evans was at the club Thursday night and in charge of most operations. Another man worked as security while the “house mom” took the cash to get in and helped Evans with the four dancers. He said since the “grand opening” around a couple of weeks ago, Zen-Den had maybe 20 customers. The pace picks up around 1 a.m., he said, when folks leave the Riverside Sports Bar and Lounge, one of the other adult entertain- ment venues in Umatilla. The city’s mayor, Daren Dufl oth, owns the Riverside. And Steve Bunn owns Honeybunnz Hideout, the other strip club in the city. Like Zen-Den, Honeybunnz serves no alcohol. Bunn and Evans have a history of confl ict that in early 2015 resulted in a felony assault conviction for Evans. That history led Milton-Freewater months later to reject Evans’ application to open a strip club there. Zi Chen of Hermiston is buying the prop- erty where Zen-Den is located. He owns the Fortune Garden restaurant on Hermiston’s north end. He said he heard a couple weeks ago about the adult entertainment club but was not aware it lacked a business license. He said he pays Preferred Property Management Inc., Hermiston, to oversee the site. Randy Randall is the principal broker of Preferred Property and is chair of the Umatilla County Planning Commission. He said he has yet to see evidence Zen-Den has been a problem or is violating any rules or laws. “Without a citation, I can’t take action,” he said. The people working in the two secondhand and gift shops next to Zen-Den said they have seen no problems with their newest neighbor and didn’t even know who worked there. Evans said the business is open to the public 9 p.m. to 3 a.m. Thursdays through Sundays. “By the time we open there’s not a single other business in Power City that is open,” he said. “We are completely out of sight, out of mind as far as the mainstream community is concerned. ... I don’t know why anybody would have a problem or a complaint with the facility or the location of it.” The sheriff’s offi ce last Saturday responded to the club after an anonymous caller report of a fi ght. But there was no fi ght. “What we believe is going on is the compet- itor in Umatilla is falsely reporting,” Rowan said. Rowan didn’t specify which competitor that might be. Evans said he had no doubt that was the case and illustrates the unfair treatment Zen-Den is receiving. 4 , 000 OFF MSRP DOUBLE CAB 4X4 ONLY 299 NEW 2017 TACOMA SR5 $ MO $ ZEN-DEN: Abutting businesses have not seen any problems ALL NEW 2017 $ CAMRYS IN STOCK ALL NEW 2017 YARIS IA $ of tweets in response to the white supremacists and Neo-Nazis who marched in Charlottesville, Virginia, last weekend. The Asian-American physician, educated at Yale University and Boston Medical Center, said patients occasionally refuse treatment because of her race in favor of a white, less-experienced intern. “Sometimes I just look at them, my kin in 99.9 percent of our genetic code, and fail to believe they don’t see our shared humanity,” Choo tweeted. As a way to move past the worries and get actual experience in a non-urban place, OHSU’s Oregon Rural Scholars Program places students in rural Oregon for three-month stints. Dr. Paul Gorman, assistant dean for rural medical education, spends every day focusing on exposing medical students to rural areas. He made the jump himself in the 1980s as a young doctor who grew up in Chicago. He and his wife — also a doctor — took jobs at a clinic in Astoria. “We wanted to be small town docs,” he said. “We thought it would be a really great place to start a family.” Gorman said OHSU requires every student to complete a rural clinic experience. Students are free to sample specialties during their rural rotations. Elehwany, of the NRHA, said OHSU is on the right track. Her organization, with their eye on the entire nation, encourages both rural rotations and grow- your-own efforts. The latter has proved successful in the wilds of Alaska. “They’ve been able to attract kids, get them interested in attending medical school and get them back,” Elehwany said. “Growing your own is a big part of the solution.” Sitz, the doctor preparing to retire in Pendleton, gave his own off-the-cuff solution with a grin. “We’ll probably just have to throw money at them to get them to come,” he said. “Once they’re here, they won’t want to leave.” ——— Contact Kathy Aney at kaney@eastoregonian.com or call 541-966-0810. Saturday, August 19, 2017 DOWN! 299 $ PER MONTH ON APPROVED CREDIT ON APPROVED CREDIT stk# 17th728. 2017 Yaris IA. Sale $17,935. Net Cap Cost $17,750. GFU $10,044. 36mo/12k miles per year lease. $1,000 down = $196mo. On approved credit. Plus tax, title and $75 doc fee. Offer expires 8/31/17. Stk# 17TH723. New 2017 Toyota Tacoma 4x4 SR5 Double Cab. MSRP $36,082. Net Cap $34,550. GFU $27,456. 12,000 mile/36 month lease. $299/month with $299 down payment. Exclusive of other special finance offers. On approved credit. No security deposit required. See dealer for details. Does not include military or college rebates. Plus tax, title and $75 dealer doc fee. Offer expires 8/31/17.