Well Aware Fall 06
MID-COLUMBIA MEDICAL CENTER
Survivor Jenn Lyon Comes Home for Cancer Care
New Directions MCMC Meets Industry Challenges Head On
Fa l l 2 0 0 6 w w w. m c m c . n e t
Well Aware Fall 06
Dear Neighbor I
have been in healthcare my entire professional life, and I have seen in this industry my share of passing trends and fundamental shifts in the way hospitals conduct their business. And I know the difference between the two. For several months our hospital, our community, and you, the people we serve at Mid-Columbia Medical Center, have been experiencing the symptoms of the latter phenomenon. The healthcare model we have grown used to over the last several decades is changing rapidly and forever. Time was, when you brought a new primary care doctor to town, you could count on him or her settling in and helping manage the healthcare needs of area families for a long time, often through more than one generation of a family. That’s not the case any more. I am not suggesting we will never again see a new doctor come to town and complete an entire career here; however, I am saying that will likely be the exception,not the norm. This is not a trend that will soon pass. Young doctors entering the medical profession generally don’t have the same goals as previous generations of physicians. They look at the long hours primary care physicians put in and the other lifestyle sacrifices required, and they often decide to pursue other specialties. That’s not a judgment; it’s their personal choice. But it has created a shortage of primary care physicians that is dramatically changing the healthcare landscape nationwide. You will read in this issue of Well Aware the extent to which this is now happening and how it is reshaping the way healthcare is delivered in communities across America. Or at least it is in progressive communities, whose hospitals and healthcare providers recognize the difference between a trend and an unalterable reality. I hope that as you read the following articles pertaining to MCMC’s “New Directions for Changing Times” you will come to understand that the healthcare providers who serve your community have recognized this fundamental change in our industry. I also hope you feel reassured knowing we are addressing these issues with innovative solutions that will ensure you continue to have access to the high-quality primary care to which you have grown accustomed. At MCMC we are very excited about our New Directions; once you read about them yourself, I believe you will share our enthusiasm. Sincerely,
Duane Francis President/CEO
On the Cover: Jenn Lyon Photo by Jim Semlor
Well Aware Fall 06
Inside Scoop It is Our Mission. . .
(ON THE COVER)
To lead and act as a catalyst in promoting health for all people. To recognize the individual as a whole human being with different needs that must be enthusiastically met. To communicate a vision of health, art, education, technology and create a center for healing which will continually upgrade the quality of life in the community and environment in which we live.
Robert L.R. Bailey Jorge Barragán Pamela Clausen Duane Francis Gretchen Kimsey Robert A. Staver, M.D. Wallace Wolf, Jr., D.V.M. Well Aware is published by Mid-Columbia Medical Center 1700 East 19th Street The Dalles, OR 97058
Innovative measures are helping MCMC assure access to high-quality care in a dramatically changing medical environment.
Care When You Need It
13 14 15 16
The Doc Finder
Just For Women
Fall 2006 Lecture Series
To empower people to become partners in their health care. Mid-Columbia Medical Center is a not-for-profit healthcare organization offering comprehensive services to the Mid-Columbia Region, and is governed by a volunteer Board of Trustees:
Jenn Lyon thought competing on Survivor was tough until a cancer diagnosis drove home the difference between reality TV and reality.
All rights reserved. No information may be reprinted without the written consent of MCMC.
Medical records go high tech.
Direct Hit Repeat MCMC patient, and former footballer, John "David" Johnson gives hospitalist team credit for getting him back in the game.
If your doctor can’t see you today, the Convenience Care Clinic staff can.
Turning up the heat on physician recruitment.
LifeWorks’ New Medical Director MCHF ‘Chips In’ For Comfort Mind Matters The Center for Mind & Body Medicine celebrates a decade of helping people care for themselves.
Columbia River Women’s Clinic welcomes new doctor.
Photo Credits: Cover, pages 4, 6, 8, 10, 14, 16 & 17 photos by Jim Semlor Pages 2 & 18 photos by Susan Crowley
Well Aware Fall 06
Sur Jenn Lyon thought competing on Survivor was tough until a cancer diagnosis reminded her of the difference between reality TV and reality.
Well Aware Fall 06
tranded on a remote island in the Pacific for 37 days, Jennifer Lyon endured all manner of abuse to her system, her senses and her sensibilities. She lived on rice and whatever could be coaxed from the sea with crude fishing gear. At night she slept on a makeshift bed, soft as a picnic table, under a primitive lean-to. She fought through a series of challenges that tested her physical abilities and mental will, and she lived in constant fear of being stabbed in the back by a fellow castaway. Had someone told “Jenn” that, even after surviving all of that and more, an even bigger challenge soon awaited her, she would have bet an Immunity Idol that someone was off their rocker. And then there she was last October, back home in The Dalles, starting chemotherapy at Celilo Cancer Center. Just one year earlier Jenn had been deposited on the island of Palau for the filming of CBS TV’s reality show phenomenon, Survivor. By the end of her stay, after she had outwitted, outplayed
In high school, she had spent a year in Spain as a foreign exchange student, and she jumped at the opportunity to return to Europe. Two years later she was back in the states, settling in the Los Angeles area. “After growing up in a small town, I decided to go to the big city,” Jenn says. “So I was living in Venice Beach and doing some nutrition counseling. My cousin is a wedding photographer, and I love photography, so I assisted her for a while.” She also got some work as an extra on film sets, and was even cast in a music video. But Jenn still aspired to a career in the nutrition industry. In fact, she had returned to school and was working on her master’s degree when the talent scout walked up to her during a workout in a local gym. “He was actually casting for The Amazing Race (another CBS reality show), but they already had their blonde,” Jenn says smiling. “He suggested I try out for Survivor instead.”
rvivor by Dick Baltus
and outlasted all but three of her island mates, Jenn found it impossible to imagine going through anything more difficult. Now she could.
Jenn wasn’t born in The Dalles — Larry and Jane Lyon moved Jenn and her brother Mark here from Nevada when she was 11 — but this was home from the time she entered fifth grade at Dry Hollow Elementary School to the day she left for Portland State University. Before graduating from The Dalles High School in 1990, Jenn made her mark as a three-sport athlete, playing basketball, track and soccer (continuing the latter in college). She went from PSU to Western Oregon, then on to Oregon State, where she earned her degree in food and nutrition. The plan was to start doing some nutritional counseling and eventually get to work on a master’s degree. But that got waylaid when Jenn was offered a job as a nanny for an American family living in London.
And so it was that, after putting off the second year of her graduate work; after sitting through several interviews and photo sessions; after making the final cut of 50 and being sequestered for a week in an L.A. hotel while the show’s producers watched and made notes of her actions and interactions with other candidates; after being told, “Sorry we’re going another direction,” then being told, “No wait, that’s a mistake, you made it;” after enduring all that, now Jenn was being told that a sweat suit wasn’t going to work for the boat ride. “They gave us a list of suggested clothing to pack for the show, but they told us how they wanted us to dress for the flight and the boat trip to the island,” Jenn says. “They told us to wear whatever we’d most likely have on at work or on a regular daily basis. They wanted viewers to get an idea who we were.” (For the uninitiated, the first episode of the season features cast members traveling by boat to their (Continued on page 6)
Well Aware Fall 06
“The acupuncturist helped me deal with hot flashes and other symptoms of radiation treatment. I got massages while I was waiting for my treatment. It all helped immensely. Considering how stressful a cancer diagnosis is, Celilo made the whole experience pretty relaxing.”
(Continued from page 5)
unknown destination, dressed in street attire. The competition begins with the cast diving off the boat and swimming to shore, fully clothed.) When Jenn told the producers she’d most likely be found in sweats, they decided the show didn’t need to be that realistic. “They said they’d rather I wear a mini-skirt,” Jenn says. Jenn, her wet mini-skirt and small bag of personal items landed on Palau on Oct. 27, 2004. Shortly before she left, Jenn had felt something strange in her right breast. It didn’t feel normal, but neither did it feel like the small pea she had heard could be the early sign of cancer. It felt more like “several small rocks strung together.” After doing an Internet search Jenn convinced herself it was scar tissue that had developed after she got saline implants several years earlier. Uninsured at the time, Jenn elected not to follow up immediately with a physician. Feeling healthy as ever, Jenn landed on Palau eager to enjoy what, in many ways, would be one of the worst experiences of her life — one she says she would repeat in a heartbeat. “I would absolutely do it again,” she says. “It was really hard, but it was the best, most exciting adventure I have ever had. Not knowing what was going to happen from one minute to the next; getting to know people and trying to figure out the best strategies to stay alive; testing your limits physically and mentally…it was very tough to get through, but I loved living life that way.” Jenn’s game plan was to lie low and not draw too much attention to herself in the early going, befriending as many people as possible and trying not to alienate anyone. It was a sound strategy that kept her on the island all the way to the final four, but kept her off
the TV screen for much of the early part of the show. But as one after another cast member met their fate at Tribal Council, Jenn, who performed well at the physical challenges and managed not to make an enemy, emerged as a threat to go all the way. Her demise finally came two days from the end of filming, when she lost a tiebreaking fire-starting contest. The show was filmed between October and December 2004, and Jenn couldn’t tell a soul what she had been up to until “Survivor Palau” began airing in February 2005. When the final episode aired in May, with Tom, the firefighter from New York, claiming the $1 million first prize, Jenn and her fellow cast members performed a tribal tradition that dates back to the start of the series. “Once the finale happens, everyone runs out and gets an agent,” she says. “Because you’re only going to be hot for a short period of time.” Jenn accepted a few small offers — like a special for the E network — and turned down a major one — an invitation from Playboy magazine — before getting ready to settle back into her former life. That’s about the time she felt another lump in her breast, a year after she had discovered the first. “This time I felt one lump right in the center of my breast, and another in my right armpit,” she remembers. Jenn visited an L.A. surgeon who rather unceremoniously announced she was almost certain the lumps were breast cancer. A mammogram, ultrasound and biopsy confirmed Jenn’s worst fears — stage III breast cancer. She had a modified, radical bilateral mastectomy on Aug. 29 at Cedars-Sinai Medical Center in L.A. But, for her follow-up chemotherapy and radiation therapy, Jenn was coming home.
Well Aware Fall 06
“Around this same time, my brother Mark’s wife Jamie was being treated at Celilo for brain cancer,” Jenn says. “I’d visited her there and knew what a wonderful place it was. I thought it was amazing to have all those resources in a single place, and in my small hometown. It was so progressive. There are certainly lots of cancer resources in the L.A. area, but they’re spread out all over the place.” Jenn started chemotherapy in October 2005; Coby Archa, the Texas hairdresser who was part of her Survivor tribe, accompanied her to Celilo the day of her first treatment. Chemo treatment ended last January; radiation therapy followed from February to April. During her repeated visits to Celilo Jenn availed herself of the center’s complete array of complementary therapies, which include massage therapy, acupuncture, yoga, stress management classes and t’ai chi. “I think I used everything,” she says. “The acupuncturist helped me deal with hot flashes and other symptoms of radiation treatment. I got massages while I was waiting for my treatment. It all helped immensely. Considering how stressful a cancer diagnosis is, Celilo made the whole experience pretty relaxing.” Prior to coming back to The Dalles, Jenn had talked by phone with Keith Stelzer, M.D., Ph.D., Celilo’s
medical director of radiation oncology. “He wanted to know everything that I was concerned about, and by the time I got up there he had pulled together a whole packet of information for me to read. I was really impressed by how knowledgeable and thoughtful the physicians are.” Jenn says she still has name and face recognition from Survivor and she has been hard at work using that as a platform to spread a message about cancer awareness. “I’m taking advantage of every opportunity I get to speak to women about this disease,” she says. There were times during treatment when Jenn wondered if she would ever return to her old self again. But, she says, she’s back now. All the way. “I feel like I’m ready to go back on Survivor again. In a weird way I feel sort of lucky to have gotten cancer at such a young age. It’s hard to explain, and I certainly wouldn’t wish it on anyone. But in many ways it has been an amazing experience. It makes you value every day, and it sure makes you appreciate the people in your life and the things you’ve always taken for granted. You emerge at the end feeling truly changed, but changed for the better, and that’s a gift.”
October is Breast Cancer Awareness Month are you due for a mammogram? Though one in seven women will develop breast cancer, survival rates increase dramatically when the disease is detected in its earliest stages. That alone should provide enough incentive to encourage you to make sure you have regular mammograms, but if you need a little extra motivation, here it is. Every woman who has a mammogram at MCMC through November 24 will be eligible to win a free KitchenAide® mixer. It's just our way of rewarding you for taking the time to do something really important for yourself. The National Cancer Institute, the American Cancer Society and the American College of Radiology all recommend annual mammograms for women over 40.
Schedule your mammogram today by calling Mammography Services: 541.298.4000
Well Aware Fall 06
Gretchen Blair, M.D., (left) is one of MCMC’s new hospital-based physicians.
by Stu Watson
Innovative measures are helping MCMC assure access to highquality care in a dramatically changing medical environment.
s in communities all over the United States, the Mid-Columbia region is struggling to attract and keep enough doctors to provide the first line of care to a growing population of patients. “The United States is in the midst of a healthcare crisis that is expected to worsen over the next several years,” according to a report this spring by the American College of Physicians.
The facts are startling: • 21 percent of doctors who were certified to practice internal medicine in the early 1990s have left the practice. • Only 20 percent of physicians in the last year of medical residency programs say they plan to practice internal medicine, a decline of 63 percent in the last seven years. • The Council on Graduate Medical Education forecasts a shortage of at least 65,000 physicians — and possibly as many as 150,000 — by the year 2020. • By 2020, internal medicine doctors will spend 25 percent more time — about 40 percent of total time — with patients age 65 and above. People in The Dalles aren’t immune to the effects of these changes.
“We’ve lost five internists in the last eight months,” says Tom Nichol, M.D. “People moved on for various reasons.” Lifestyle choices drove several of those departures. In particular, physicians want predictable, regular hours. Many are even choosing to work part time, so they can have more time for other personal interests. Under the traditional model of care, a physician would see patients in the office, and also when they went into the hospital. Typically, a doctor would respond to urgent needs of their hospitalized patients during the day. After hours, however, they would share that duty with other doctors. The greater the pool of doctors, the less frequent any individual doctor would have to wear a beeper that might yank them out of bed at 3 a.m. to attend to a patient in the hospital. All that is changing. A dwindling pool of internists has increased the frequency of “call” duty for those who remain, and that has boosted disruptions to office hours and personal time. More disruptions equals higher stress equals greater pressure to consider professional change. “No way they’re taking call every other night,” is how local internist Gretchen Blair, M.D., summed up the attitude of an increasing number of physicians. In response to this situation, Mid-Columbia Medical Center
Well Aware Fall 06
and its affiliated physician practices have adopted several innovations intended to ensure that everyone gets the care they need (see pages 9-13 for more information): • Creation of hospitalist teams to provide all hospital care to patients admitted by internal medicine doctors. This frees internal medicine doctors from working on call, and lets them focus on patients in the office setting. • Creation of a “Convenience Care Clinic” to serve pressing care needs of patients who have no regular doctor, or who can’t find time on their doctor’s schedule. • Hiring of a full-time physician recruiter to focus on hiring physicians both for the hospitalist teams, and to assume care of patients in the office setting. • Adoption of an advanced electronic medical records system that, when fully implemented, will link everyone providing care — in the doctor’s office or in the hospital — to full and current information about each patient. “This is an effort to minimize turnover,” says Tom Hodge, M.D., medical director of the MidColumbia Medical Group, which provides business services to the majority of internal medicine and family practice physicians in The Dalles. “We’re being responsive to a changing healthcare model.” NEW FOR CHANGI NG
Getting Connected MCMC’s new electronic medical records system provides an important and efficient link between providers and the patients in their care.
edical records are like a road map to a foreign country. Without them, doctors wouldn’t know where the patient had been, where their health currently stood, and where they might go next to reach a healthy destination. Providing quick and universal access to the most current information about a patient is a key component to Mid-Columbia Medical Center’s continuing efforts to improve efficiency — and patient care. Electronic records are the solution, and MCMC is on track to link all its caregivers — inside and outside the hospital — to the same electronic files. The offices of internal medicine doctors are the first to get the new NextGen electronic medical records system. Kathy Johnson, director of business services for MCMC, says the system will be installed and introduced to the offices of family practice physicians this fall. “Once all the doctors are on it, we’ll be implementing it in the hospital,” Johnson says. “We want to give physicians electronic records that can be accessed from the hospital. That way, if one of their patients shows up in the Emergency Room, for example, the physician would have their medications list, and would know what took place at their last office visit.” The goal is to eliminate paper charts, and speed communication. When a doctor orders lab tests, to offer another illustration, the order will be communicated electronically, and the results will come back the same way. Doctors who now have the system in their offices can enter or access information at desktop personal computers, or by using a portable wireless tablet. The tablet now is the only way for a physician making hospital rounds to access records electronically. “The tablet is about the same dimensions as a sheet of paper,” Johnson says. “The doctors can enter material in writing, type it in or use templates.” Hospital officials expect the system, once fully installed, to reduce errors, improve physician efficiency and ensure that a patient’s treatment continues on course from the off-site office through the hospital stay.
Well Aware Fall 06
Direct Hit Repeat MCMC patient, and former footballer, John "David" Johnson gives hospitalist team credit for getting him back in the game. by Stu Watson
attling offensive linemen for legendary University of Alabama football coach Bear Bryant was nothing compared to John “David” Johnson’s 21-year battle against a host of serious medical issues. Given his druthers, Johnson would prefer to trade helmet shots for the days and weeks he has spent in hospital care for a ruptured appendix, Crohn’s disease, pancreatitis, gall bladder surgery, kidney stones, colon cancer and six bowel resections. Johnson, 47, of The Dalles, sees huge parallels between playing on two national championship football teams in the 1970s, and working with the team at Mid-Columbia Medical Center. “Thank God for the doctors and medical professionals,” he says. “They keep me in the game.” These days, the “game” includes coaching junior and senior high school football and basketball, plus the American Legion Hustlers. For the game of life, Johnson credits the medical team with pulling his bacon out of the fire on numerous occasions, particularly last March after a Crohn’s episode forced admission to the hospital. “I honestly think Dr. (Tom) Nichol saved my life,” Johnson says. Johnson knows something about healthcare, from both sides of the bed. A late uncle was chief of staff at the University of Utah hospital, and Johnson’s stepfather is a pediatrician. Johnson trained as a medic in the Army, and worked as a certified nurse’s aide after the service. “It gave me a lot more empathy,” he says. “If you’ve been in a hospital bed for two or three months, it’s easier to relate.” After his appendix blew during his junior year at Alabama, he spent six months in the hospital. Years later, after a move to Phoenix, a trip to the emergency room led to the diagnosis of his Crohn’s disease, a chronic condition that leads to inflammation of the digestive tract and other complications.
Well Aware Fall 06
He says his physical conditioning and medical knowledge helped him defy predictions that he wouldn’t live beyond five years. It also helped him find good physicians in Phoenix and in The Dalles after moving north with his wife, Kami, and six children in 1995. Johnson’s experience mirrors that of many internal medicine patients in the Mid-Columbia community. He has seen doctors come and doctors go. The recent departure of several internal medicine doctors has put the squeeze on those who remain. After his last physician left, Johnson found himself without a doctor — for about five months. A trip to the hospital introduced him to his current internist, Kimya Nguyen, M.D., who helped provide treatment as part of the hospital’s trial during the last year of the hospitalist staffing model. Hospitalists are internal medicine doctors who provide care to patients in the hospital. During the trial, local internal medicine doctors would spend a week at a time working primarily with hospital patients. “The first time I met Dr. Nguyen, I was in the hospital for an infection in my face,” Johnson recalls. “She was very friendly, very knowledgeable, and I felt good about that fact that she was the doctor caring for me.”
MCMC has hired three hospitalists to join the team. Two other physicians have both expressed strong interest in the last hospitalist position. By staffing MCMC 24/7 with hospitalists, Dr. Nichol says, outpatient internal medicine doctors will no longer have to share on-call duties. That should aid recruiting efforts. After the change, those doctors can focus on office patients, without interruptions. “To provide good care, we need office-based doctors to be in the office every day and not be overburdened,” Dr. Nichol says. “I’m convinced that this is going to lead to better care.” Dr. Nguyen has seen the benefit of the hospitalist model to her outpatient practice. “When I have a sick patient in the (critical care) unit, I can spend hours in the hospital,” she says. “Having hospitalists is very helpful; I don’t have to leave my practice to take care of patients in the hospital, because the hospitalists can do that.” For patients, going from their own doctor into the care of a hospitalist can be a little disconcerting. Johnson recalls wishing his internist had been able to continue his care in the hospital. “If you feel good about the doctor, and they know you, you don’t question the care,” he says.
“I would tell anyone that being in the care of a hospitalist is a good experience.” Johnson understands why, effective Sept. 1, Mid-Columbia Medical Center will shift all care of internal medicine admissions to a team of six hospitalists. Longtime local internists Tom Nichol, M.D., and Gretchen Blair, M.D., will head the team. According to the American College of Physicians, the number of new physicians choosing to specialize in internal medicine has declined by 67 percent over the last seven years. At the same time, the number of new physicians choosing to work as hospitalists has increased by 200 percent. “The hospitalist is doing shift work,” says Tom Hodge, M.D., Mid-Columbia Medical Group medical director. “We’re better able to recruit to that.” Translation: Hospitalists work fixed hours, and do not have to wear a beeper or serve on-call one or more days (and nights) a week. So far, MCMC has found it easier to recruit hospitalists than internal medicine physicians for its outpatient clinics.
But Dr. Nguyen and others serving as hospitalists put his concerns to rest. “As a patient, I felt all my needs were met,” Johnson says. “At no time did I have to wait for things to happen. Everything was done in a timely and professional manner.” Johnson appreciated the speed with which an on-site physician could respond to his needs, adjust medication, communicate with staff. “I had a good sense that things were moving smoothly from one doctor to another,” he says. Dr. Nguyen, who had been hired as a hospitalist, chose late last year to set up her own practice. Based on what Johnson had seen of her care, he was eager to have Nguyen take him on as a patient. “I would tell anyone that being in the care of a hospitalist is a good experience,” Johnson says. “If not for the hospitalist NEW program, I would never FOR CHANGI NG have met Dr. Nguyen.”
Well Aware Fall 06
Care When You Need It If your doctor can’t see you today, the Convenience Care Clinic staff can.
NEW FOR CHANGI NG
hen you need a physician — whether you’ve got a doctor, or not — we’ve got you covered. As Mid-Columbia Medical Center and its affiliated clinics respond to changing times, the organization remains committed to providing quality care, when you need it. If you or a family member is feeling sick or needs help with a chronic condition, you’ve got a couple options. First, if you have a regular doctor, call their office. If you don’t have a regular doctor, call us at 541-296-9151 and we’ll find someone who can see you. If your own doctor can’t see you, we’ll try to get you in to see another doctor in the same practice. If that’s not possible, we’ll refer you to the Convenience Care Clinic at 1815 E. 19th St. in The Dalles. MCMC set up the clinic in February to handle pressing needs that don’t require a visit to the Emergency Room at MCMC. Two physicians and a nurse practitioner share the care of patients at the Convenience Care Clinic. Sonia Schuemann, M.D. trained in family practice, sees patients two days a week. Stephanie O’Connor, a nurse practitioner, also works two days. Stephen McLennon, M.D., a family practice physician, staffs the clinic on Fridays. If you are referred to the clinic, you will be advised to show up between 10 a.m. and 2 p.m., or 3 and 6 p.m. “The important thing to remember is that you’ll need to call one of our offices first,” says Kim Boothe, director of family practice for the Mid-Columbia Medical Group. “You can’t just walk in to the clinic; you need to be referred, so they know you’re coming.” But Boothe says the clinic ensures that if you need to see a doctor that day, you’ll see a doctor … that day. “It’s been working awesome,” she says. “Concerns about access to care have definitely declined.”
Well Aware Fall 06
The Doc Finder
New physician recruiter tackles the increasingly tough job of finding internists wanting to practice in small communities like The Dalles. by Stu Watson
verybody thinks their job is tough, but Mary Weerts may have one of the toughest in medicine these days. Since joining Mid-Columbia Medical Center in February, she has lived front and center in the middle of the intense national battle to find and hire internal medicine physicians. “It’s getting very difficult to find internal medicine doctors and family practitioners, all over the country” says Weerts. The American College of Physicians, which represents 119,000 internists, annually surveys third-year medical school residents about their career plans. Since 1998, responses have shown a 63 percent decline in the number of physicians who plan to practice internal medicine. At the same time, the U.S. Census predicts an increase in the number of people over age 65 from 38 million today to 55 million in the year 2020. Do the math: 17 million more patients, fewer physicians. The ACP calls it a “crisis.” In the old days, a physician would set up a practice, then share responsibility with other internists for care of patients who had been admitted to the hospital. The stress of trying to manage care for patients in an office, and in a hospital, has taken its toll. More than one-fifth of board-certified internal medicine physicians have left the field since the early 1990s. At the same time, new physicians are choosing other specialties.
Money is one reason; the average student debt for new physicians exceeds $100,000. Lifestyle choices also drive decisions. New physicians want to work flexible schedules, or part-time. New physicians want fixed hours and normal family lives, minus the disruption and stress of “call” rotations. New physicians willingly relocate to pursue new career opportunities. After the departures of several internists in the last couple of years, MCMC knew it needed to put a fullcourt press on the physician-hiring front. Enter Mary Weerts. Weerts is cheerfully optimistic about the community’s ability to lure new internists. “MCMC and Celilo have special and unique niches,” she says. “It’s a beautiful area, with a great lifestyle. We have progressive technology. “Once recruits get to visit the hospital and meet the physicians, they want to work here.” Finding interested prospects is the challenge. “It’s like finding a needle in a haystack,” she says. “They’re in such demand throughout the country.” Weerts says physicians often fall into two major groups: Big-city docs, and small-town docs. The physician may be interested, but also has to convince their spouse that a move to The Dalles will fit their needs — personally and professionally.
“As far as incentives and pay, we’re on target and higher in some cases, and living is very affordable here. They can afford a home for their family, and still have money to pay back their student loans.” Weerts has helped hire three new internists to work in MCMC’s hospitalist program. “They could have gone anywhere in the country, and they chose to come here,” she says. And she has two key candidates who could join the community by the end of the year, or early 2007. In the mean time, the hospital is employing what are called “locum tenens” — temporary doctors — to help see patients in the offices managed by the Mid-Columbia Medical Group.
Well Aware Fall 06
LifeWorks Comfort Care Team Welcomes
New Medical Director by Karen Knoll
illiam Hamilton, M.D., has assumed the role of medical director of LifeWorks Comfort Care, a palliative care program at MidColumbia Medical Center. Dr. Hamilton opened his practice, Mid-Columbia Surgical Specialists, in The Dalles in 1987. “Dr. Hamilton has played an integral role in The Dalles medical community for many years. The respect and compassion he brings to this position will truly elevate this program to the next level,” says Annie Soper, R.N., LifeWorks director. LifeWorks is a palliative care program designed to support anyone with a non-curative condition as they strive to live the best quality of life through all their remaining days. Palliative care is defined as “relieving or soothing the symptoms of a disease or disorder without effecting a cure.” “LifeWorks is such an important program for this community,” says Dr. Hamilton.“It is vital that we have systems in place to care for our families and loved ones when someone is diagnosed with a condition that is not curable.” LifeWorks is a team approach to working with patients and their families, under the direction of their primary care physician, to personalize, humanize and demystify the processes involved in symptom management and complex end-of-life issues. The LifeWorks team considers the whole person and addresses their emotional, psychological, spiritual and social needs in addition to their physical needs when mutually determining a care plan.
“We need to be able to educate our patients and their families to all the resources and services that are available to them and provide them straightforward access to these resources.” adds Dr. Hamilton. “I want patients and their families to feel empowered to make their own choices regarding how they choose to live and remain comfortable throughout all their days.”
“It is vital that we have systems in place to care for our families and loved ones when someone is diagnosed with a condition that is not curable.” For more information about the LifeWorks Comfort Care program at Mid-Columbia Medical Center, please call 541-298-7925 or visit www.mcmc.net.
Well Aware Fall 06
Mid-Columbia Health Foundation
‘Chips In’ For Comfort T
he sun was just peeking over the horizon as the first wave of golfers arrived at The Dalles Country Club on the morning of Tuesday, June 13 for the 21st Annual Mid-Columbia Health Foundation Golf Benefit. “Mother Nature had comfort in mind when she blessed us with this glorious day,” said Anne Copper, project coordinator for the Foundation. “We are so pleased to be able to support the LifeWorks Comfort Care program, once again, through this fun event.” Throughout the day, 36 teams, 144 golfers, over 40 businesses from throughout Oregon and SW Washington and more than 40 volunteers all pitched, putted and drove toward the same goal, to raise funds for the LifeWorks Comfort Care program at Mid-Columbia Medical Center. LifeWorks began as a vision in 2004, came to fruition in April 2005 and continues today to provide comfort for so many throughout the Mid-Columbia region. LifeWorks is a palliative care program designed to support anyone with a non-curative condition as they strive to live the best quality of life through all their
remaining days. The LifeWorks program was developed by Mid-Columbia Medical Center as the next logical step in the healing process beyond the services that have previously been available in this region. “Through the generosity of everyone here today,” said Celeste Hill-Thomas, executive director, “The MidColumbia Health Foundation will be able to give more than $27,000 to help the LifeWorks team continue to do the amazing things they do for so many members of our community who need their services.” Although the first place award went to the Oil Can Henry’s team, the real winners of this tournament are the patients of LifeWorks. Thank you to all who made this tournament a success! For more information on how you can partner with the Mid-Columbia Health Foundation to “make a healthy difference” in our community, please call 541-296-7275 or visit us at www.mcmc.net.
Well Aware Fall 06
by Stu Watson
The Center for Mind & Body Medicine celebrates a decade of helping people care for themselves.
ike ripe fruit hanging from a tree, the treasure of good health draws nutrients from deep and diverse roots, broad and soaring branches. As The Center for Mind & Body Medicine turns the corner into its second decade, its directors hope to expand public awareness of the many paths that lead to the singular destination of optimal health. In a nutshell, the center brings an array of complementary disciplines to the treatment and prevention of health problems. Those therapies include nutrition and fitness education, acupuncture, breath work, massage,
meditation, aromatherapy, support groups, t'ai chi and yoga. Founded 10 years ago, the center reflected a vision to offer “integrative type therapies to take care of the whole person,” says Barbara Robison, director of the center. Since then, the center has become a valued partner to the community’s traditional and integrative medical care. “When people finally get to us, they’re sick and tired of being sick and tired,” Robison says. “They’ve had some big wakeup call, and they want to change things.”
Well Aware Fall 06
The center’s staff works to treat more than just the immediate physical problem. It works to lift the emotional, spiritual, intellectual and attitudinal barriers that can impede someone from taking a more active role in their own recovery and wellness. Jeanette Paysse, M.D., an internal medicine physician and medical director at the center, brings a personal passion and sweeping view of health care to her work. She loves to ski and bike. She studies yoga. She has modified her own diet to eliminate meat, refined sugar and processed food. “When I take care of myself, I’m healthier all around, emotionally and physically,” Dr. Paysse says. “So when I tell patients, ‘Watch what you eat; take care of your anxiety without medications,’ I’m speaking from experience.” During a previous solo practice in Steamboat Springs, Colo., she made friends with a naturopathic physician. The two often shared patients, and privately Dr. Paysse learned a lot about nutrition, and natural supplements that help tackle the underlying causes of chronic diseases. “It had an amazing and profound effect on the way I looked at medicine,” she says. The experience energized her passion for healing in the broadest sense of the word. Trained in traditional
She understands, however, that many physicians have less time to provide such counsel than they might like. It’s why she appreciates the complementary value of The Center for Mind & Body Medicine. “The center is a resource, absolutely,” she says. “I refer patients over here for so many things.” A patient’s success with a first toe-dip into a center program, such as cardio-pulmonary rehabilitation, often stimulates a desire to learn more, and engage other disciplines. "When people contact us they often say they are fatigued, have challenges with daily activities and motivation and they find it difficult to change their lifestyle," says Robison. "It's exciting to see people get involved in our programs, take control of their health and feel better. That is a testament to health and we feel privileged to be a part of that." That patient satisfaction, Dr. Paysse says, is the center’s greatest accomplishment. “What we do here is astounding work,” Paysse says. “The staff has a lot of compassion and empathy, and patients come out saying they want more.” In the near future, Dr. Paysse and Robison both say they would like to expand awareness and use of
western medicine — what is also called allopathic medicine — Dr. Paysse brought to her medical practice and work with the center a desire to help people “make better choices to make themselves healthier.” She says allopathic medicine focuses on diagnosis and medications. “Allopathic medicine doesn’t always emphasize the importance of taking personal responsibility for ones own health,” she says. That’s why she finds time with each of her patients to educate them a bit about nutrition, stress reduction and exercise.
the center, among the physicians in the community, and among the broader public. “The mind’s ability to heal is just as important as any pills,” Dr. Paysse says. “If the physician doesn’t address the mind’s role in healing, it will be a major component of healing that will be lost.” “Bringing people to optimal health is our goal,” Robison says. “It takes work. At the center, we’re focused on helping people make healthy changes that are enjoyable, obtainable and lifelong.”
Well Aware Fall 06
think that the relationship “ Ibetween doctor and patient should be a collaborative one where both are working together for the best interest of the patient.
— Analene Pentopoulos, M.D.
Well Aware Fall 06
Women’s Clinic Welcomes Doctor by Stu Watson
he opportunity to develop long-term relationships with women and their children has led Analene Pentopoulos, M.D., to join the Columbia River Women’s Clinic in The Dalles. Dr. Pentopoulos, an obstetrics and gynecology specialist, joins the practice of Drs. David Mack and James Faherty. “Dr. Pentopoulos is brilliant,” said Dr. Faherty. “We’re very much looking forward to her joining our practice.” Dr. Pentopoulos will fill a position left vacant for the last 16 months after the departure of Dr. Diane Ellis, who followed her husband to England so he could pursue a fellowship. Dr. Faherty said recruiting someone of Dr. Pentopoulos’ caliber takes awhile, for a variety of reasons. For one thing, many new physicians prefer part-time work, he said. For another, few new physicians want to work on-call as part of a small practice. In the case of the Women’s Clinic, that means responding to urgent patient needs once every third night. In a larger practice, the frequency of working call can be as little as once every 10 days. “One thing that attracted her to us and us to her is that we do a full range of obstetrics — incontinence work, cancer surgery, gynecologic urology, obstetric and gynecologic ultrasound,” Dr. Faherty said. “In a bigger city, a patient usually goes to someone who does only one thing. Dr. Pentopoulos has told me she wanted to practice where she saw a lot of diversity of cases, more complexity, than a general ob/gyn would see in a city.” Dr. Pentopoulos followed a path to The Dalles somewhat similar to the path that led Dr. Faherty to town 10 years ago — through New Zealand. Dr. Faherty had spent a year of his residency at the University of Otago in Dunedin, New Zealand. Dr. Pentopoulos wanted to spend a year in New Zealand as well, learned of Dr. Faherty, and contacted him. He put her in touch with the manager
of the residency program at the New Zealand school. When she returned, Dr. Pentopoulos began discussions about a possible practice with the Women’s Clinic. She signed a contract in the fall of 2005, midway through her final year of residency. After graduating Magna Cum Laude with a bachelor of science degree in microbiology from the University of California at San Diego, Dr. Pentopoulos completed medical studies in 2002 at Yale University Medical School. This summer she finished four years of internship and residency in obstetrics and gynecology at Oregon Health & Sciences University in Portland. During her years at OHSU, Dr. Pentopoulos attended to the delivery of more than 500 babies. By its nature, her medical training required her to work different shifts and focus on different aspects of medicine. It didn’t foster many close relationships with patients. Dr. Pentopoulos said she is eager to practice in a clinical setting, and definitely looks forward to getting to know her patients in The Dalles and provide for their care as long as they need. “I think that the relationship between doctor and patient should be a collaborative one where both are working together for the best interest of the patient,” Dr. Pentopoulos said. Dr. Pentopoulos brings a world view to her profession. Born in the United States to parents who had grown up in Zimbabwe, she spent the first six years of her life in South Africa. She spent the balance of her formative years in Walnut Creek, Calif., then a much smaller town than it is now. She wants to return to the life of a smaller community. “Here's someone who basically came to me, and when talking about business stuff, she said ‘I'm not worried about that; I trust your reputation’,” Dr. Faherty recalls. “The only commitment she wanted from me was that I wouldn’t be leaving the community. She bought a house before signing her contract.” For more information, or to schedule an appointment with Dr. Pentopoulos, please call 541-296-5657.
Well Aware Fall 06
FALL 2006 Planetree Health Resource Center Health Lecture Series Informative Discussions on Your Good Health — All lectures are free and open to the public. Lectures are held in the Medical Center Office Plaza Conference Room at Mid-Columbia Medical Center, 1810 E. 19th St., The Dalles. All programs are from 7 to 8:30 p.m. Your on-time arrival is appreciated. Phone 541-296-8444 to pre-register. You may also register on our web site: www.mcmc.net (click on Planetree Resource Library, then Lecture Series). We look forward to seeing you. TUESDAY, SEPT. 19
Pressing for Pain Relief Acupuncture and acupressure are ancient therapies that offer new solutions to effective pain management. If you suffer from acute or chronic pain and are looking for relief, this program is for you. Carola Stepper, RN, LAc, explains the science behind acupuncture, when it is appropriate to use and the value of adding it to your care. Simple instructions on using Acupressure points to ease pain will also be shared.
ofreciendo consejos prácticos de cómo enfrentarse a la depresión, así como técnicas que los familiares y amigos pueden usar para apoyar a un querido que padece de depresión. Nota: Esta conferencia es gratis y abierta al público. Se celebrará de las 7:00 PM a las 8:30 PM el 26 de Septiembre en el salón de conferencias del edificio de consultorios (Medical Center Office Plaza Conference Room) del Mid-Columbia Medical Center, 1810 E. 19th St., The Dalles.
TUESDAY, SEPT. 26
Blues Clues: Living with Depression Depression changes how you view the world. It’s not just feeling sad or down, it is a serious illness of the mind. We all get the blues, so how do you recognize depression? Does social isolation contribute to depression? What works best in treating it? Joella Anglin, Clinical Social Worker with Lifeworks Comfort Care, Mid-Columbia Medical Center, sheds some light on depression. She’ll offer tips on how to cope as well as skills family or friends can use to support a loved one with depression.
Blues Clues (Pistas de Blue, título de popular programa televisivo para niños que tiene doble sentido de “indicios de la depresión):
Viviendo con la Depresión La depresión cambia la manera en que consideramos el mundo. No sólo se trata de sentirse triste o decaído, sino que es una enfermedad mental grave. Todos nos sentimos decaídos de vez en cuando, ¿pero cómo reconocer cuando se trata de la depresión? ¿Contribuye el aislamiento social a la depresión? ¿Qué funciona mejor en cuanto al tratamiento? Joella Anglin, Trabajadora Social del Lifeworks Comfort Care, MidColumbia Medical Center, arroja luz sobre la depresión,
TUESDAY, OCT. 3
Fire in the Hole: GERD Do you suffer from GERD, or gastroesophageal reflux? GERD is ‘heartburn’ that occurs two or more times per week. If so, join Jeanette Paysse, M.D. as she helps you put out the fire! Dr. Paysse will explain the causes of GERD and share information about natural and preventive approaches to minimizing it through nutrition and stress reduction. She will also explain the risks & benefits of medications from proton pump inhibitors to antacids used to treat GERD. TUESDAY, OCT. 10
The Startled Brain: Understanding Stroke “A chief event of life is the day in which we have encountered a mind that startled us.” Ralph Waldo Emerson Paul Cardosi, M.D., medical director of mPower, MCMC’s Acute Rehabilitation Program, talks about recognizing the signs of stroke, the different types of stroke and the degrees of disability that follow one depending upon which part of the brain is injured. Who’s at risk for stroke and important tips on how to prevent stroke will also be shared. Please join us for this important program.
NON-PROFIT CURRENT RESIDENT
1700 E. 19th St., The Dalles, OR 97058
PAID MID-COLUMBIA MEDICAL CENTER Permit #161