All Buena Vsta wanted was a doctor …

Article by Martha Quillen

Rural medicine – July 1994 – Colorado Central Magazine

Buena Vista just wanted another doctor. But when the town started searching for a new physician, it got more than it bargained for.

Until last year, the Buena Vista Medical Clinic had boasted more doctors than the town could reliably support. Then Dr. McGowan retired. Dr. McCallon took a full-time position at the prison. Dr. Cline returned to Salida. Dr. Serafini went to Colorado Springs.

After that, Dr. Robert T. Vaughan was the only family physician left in town.

Because the clinic building where Vaughan rents office space actually belongs to the community, Buena Vista town trustees turned to the Heart of the Rockies Regional Medical Center in Salida for help.

A selection committee was formed, and numerous physicians applied, but the right “match” wasn’t found. HRRMC thought it was important to find someone who would work well with Dr. Vaughan, and approached the search accordingly. The selection committee wasn’t looking for just any doctor, it was looking for the right doctor.

But when no one was chosen after several months, Buena Vistans began to feel that HRRMC wasn’t trying hard enough.

That’s when St. Vincent General Hospital in Leadville came forward with an offer. St. Vincent wanted to rent part of the Buena Vista clinic for its own candidate, Dr. Tom Wenger from Los Alamos, N.M.

THE LEADVILLE HOSPITAL would not only guarantee Dr. Wenger’s salary, it would pay $25,000 a year for space in the clinic, or if that wasn’t feasible, it would consider putting in a modular medical unit.

But Wenger didn’t want to take out staff privileges at HRRMC, or at St. Vincent either, for that matter. Wenger wanted to refer patients needing hospitalization to other doctors.

Dr. Vaughan therefore objected to Wenger’s candidacy — because Vaughan wanted a full partner, which in this case, meant someone who could see Vaughan’s patients at HRRMC when Vaughan was unavailable.

“Their doctor would be what we in the business call ‘a doc in the box,'” said Mike Murphy, the administrator of HRRMC. “He would take patients, but if you had to go to the hospital, you’d be on your own.”

At first, Buena Vistans were divided. They wanted a doctor, but they didn’t want to risk losing Dr. Vaughan. But perhaps more to the point, HRRMC is partially supported by Buena Vista taxes, and most of the trustees couldn’t believe St. Vincent’s offer was purely altruistic.

Glade Hamilton, administrator at St. Vincent, contends that his hospital offered an advantageous arrangement for both sides — since Buena Vista needed a doctor and St. Vincent could provide one.

“We aren’t going into Buena Vista to steal patients from Salida, as some people have claimed,” Hamilton said. “Our intent is to provide a doctor, and if we get some patients to come our way because of the doctor provided, sure we would like that. I think any hospital would like that.

“But we are not going to make patients come here. If a patient wants to go to Salida, our doctor’s not going to say ‘no.’ Our doctor’s going to send that patient to Salida. We just want to give people a choice.”

MIKE MURPHY at HRRMC says that if Buena Vista patients decided to go to Leadville instead of Salida, “they’d be going up the mountain instead of down the mountain, on a little farther drive, to a less well equipped hospital where the charges are higher.”

Hamilton agrees that his facility may not have as large a staff as HRRMC, but he believes it can serve patient needs well with its system of rotating doctors. According to Hamilton, St. Vincent is already committed to serving Buena Vista, but he maintains that Leadville’s hospital is not trying to edge into Chaffee County.

“We’ve already got a doctor committed,” Hamilton said. “So we are going to have a doctor in Buena Vista. But our intent is to have him see his patients in Buena Vista — not to have the patients drive to Leadville or Salida. We’re going to provide Dr. Wenger, and we’ll guarantee his salary, but eventually, once he gets established, we can pull out.”

Because national averages indicate Buena Vista can only support two and one-half doctors, the town trustees are concerned about whether they’ll have even more trouble finding a doctor for their clinic if Leadville moves its candidate in first.

But in this case, the rapid growth in Chaffee County will probably serve the community well. At the rate things are growing near Buena Vista, the town may need three doctors before a second one can unpack his black bag.

If, as some people fear, St. Vincent does carve a substantial piece out of Chaffee County’s hospital business, Murphy says it could lead to choosing between higher charges, a reduction in services, or higher taxes to support HRRMC. But Murphy considers that possibility extremely unlikely, and doesn’t really feel that it’s something people in Chaffee County should worry about right now.

Asked whether competition over patients was common, Murphy replied, “Well, in urban markets it’s very common. I came from Houston, where you did everything you could to recruit physicians away and steal market share.

“But in rural areas it’s not so common. There are a whole lot of reasons why people in Buena Vista would prefer to come to Salida. First, they’re in our tax district, and our county, and they pay taxes here. Also, we have a better equipped hospital, we’re closer, we’re easier to get to, and we’re cheaper.”

IN THE END, Buena Vista’s town trustees apparently agreed. At a meeting on June 6, HRRMC signed an agreement to lease the town’s medical clinic for $30,000 yearly. Because there had obviously been communication problems between HRRMC and the trustees, a Buena Vista trustee was added to the recruiting committee, and Dr. McGowan has agreed to help in the selection process.

Mike Lockett, Buena Vista’s mayor, said, “We came to a good agreement. It’s like we’re all on the same wave length for a change, which is really nice.”

Murphy acknowledged that the process of finding a doctor might still require some patience on the part of Buena Vistans, but he feels that “finding the right doctor is more important than just finding a doctor.”

Murphy especially wants to find a doctor who will stay in the community.

And at this point, Buena Vistans undoubtedly agree.