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NW HEALTHCARE TODAY Take a closer look at: • What Inland Northwest health providers are doing well • Anticipating future challenges

Plus -- 19 local

providers doing their part

all should do some sort of activity that gets our body moving. The recommended amount of exercise for an adult is 2 ½ hours a week or 30 minutes per day, five days a week.

Not realistic with your schedule or current physical condition? Ward says do whatever you can.

“When talking to my patients I say, ‘Five minutes is better than zero minutes.”

Even moderate low-impact exercise can help prevent diabetes, heart disease, stroke, even depression.

“Pick an activity you love and start incorporating it into your schedule, such as dancing or bowling, and if you can work up to that recommended amount of exercise,” he said.

Don’t worry about buying an expensive gym membership or fancy workout equipment.

Practice preventative maintenance for body and mind Even low-impact activity better than zero activity

By Tracy Damon Marketing Correspondent

A

s much as many of us don’t want to acknowledge it, nobody is getting out of this life alive. We’re all going to die at some point, but it is possible to get a few extra quality years in if you take basic pro-active measures.

Dr. David Ward, primary care provider from the Kendall Yards

Kaiser Permanente Medical Office, recently shared his thoughts on ways to live longer with a better quality of life.

Exercise on a regular basis We’re not all Olympic athletes. In fact, some of us aren’t athletes at all. What is important is that we

“I tell my senior patients, even if you take a can of food and lift it repeatedly, you’re doing something to strengthen your muscles and bones,” he said.

Protect your skin Skin cancer is the most common type of cancer in the United States. Help prevent it by limiting time in the sun, wearing protective clothing and hats, and using sunscreen year-round on all exposed skin, including the backs of hands, neck, and ears.

Don’t smoke, use tobacco, or vape Smoking and tobacco can cause heart disease, emphysema, and chronic obstructive pulmonary disease (COPD). Initially it was thought that vaping was less harmful than tobacco but now we know it has its own negative effects. Ward says

vaping can lead to tobacco addiction, just like with traditional cigarettes, but also impacts brain development, especially in young people, and can cause cancer.

“The liquid flavors in vaping devices can contain cancer-causing chemicals. We’ve seen lung failure as well,” he said.

Limit alcohol intake Not to harsh your buzz, but Ward says past studies that say a glass of wine every night is good for you no longer apply.

“The latest conglomeration of every study done in the world says that the only amount of alcohol that is safe for you is zero,” he said.

He acknowledges that enjoying a moderate amount of alcohol isn’t going to kill you: the Centers for Disease Control and Prevention still recommends no more than two drinks a day for men and no more than one drink a day for women.

Plus, alcohol use is intertwined in our culture and in places where drinking is more common, such as Italy, some study groups have shown little to no negative impacts from alcohol consumption.

But the potential for problems is there. Alcohol consumption can cause liver damage and cancers to the throat, liver, or pancreas. It can also contribute to domestic violence, drunk driving, and other social issues.

See your doctor Don’t ignore annual checkups, and don’t forget the dentist and eye doctor. Preventive care can detect disease and prevent illness before it starts. For women, this means getting regular mammograms (breast

cancer is a leading cause of death for women) and pap smears, and colonoscopies for both women and men over the age of 45.

• Take daily supplements if needed but make an effort to get vitamins naturally.

“You should try to get as many good “For men it’s almost a similar essential vitamins in healthy foods story: prostate cancer is most as possible,” said Ward. If you’re common for men,” said Ward. having vegetables, beans, nuts, green leafy vegetables, that’s best “If men are having changes in how by far…. Doing it naturally, adding they urinate or how many times in exercising, getting outside, eating they get up at night to urinate, they healthy, is best.” should talk to their doctor.”

• Drink water (the “official” Other fairly easy steps you can take recommendation is still 6-8 glasses to maintain your health include: per day as a baseline and more if • Getting enough sleep. you work out, live in a hot or dry “We all have access to this climate, or work outside). unbelievable super-power that is • Get vaccinations. Flu and COVID sleep,” Ward said. “We all should vaccines are Ward’s top vaccine invest in a great bed and a great place recommendations, but he says to sleep. Most people do best on 7 to specialized shots for tetanus and 8 hours of sleep.” whooping cough/pertussis are important.

Ward’s No. 1 recommendation to live longer, healthier, and happier? Build and maintain healthy relationships, as they are a key staple of strong mental and emotional health.

“We’re learning with our latest understanding of longevity and health that only 25 to 30 percent is genetic.

The top contributor is the quality of long-term relationships you have.

There is amazing research being done around how quality relationships really do impact your well-being.”

Dr. David Ward Kaiser Permanente

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Morgan Thomas, Business Intelligence Manager, CHAS Health

Wilfred Alex “Wilkie” Madarang, MD, FAAFP, Chief Clinical Officer, CHAS Health

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ow long have you worked here?

This month marks my 12th year with CHAS Health. I started as a family practice provider and have added leadership roles.

What do you like about where you work?

The collaborative culture and working with individuals who value the same important things I went to medical school for. Caring for patients and other providers, leading and inspiring our staff while having fun, and having an entrepreneurial spirit.

How long have you worked in health care?

Over 20 years. I did my medical education in the Philippines, at Ateneo de Manila for my bachelor’s degree and St. Luke’s College of Medicine for my medical degree. A few years later, I came to the United States and did my residency for Family Practice at Penn State Medical Center.

What do you like most about what you do?

I get to care about patients and at the very core of my specialty, helping them become healthier. I also like teaching nurse practitioner residents. As Chief Clinical Officer, I now get to lead our clinical programs and make an impact on how we deliver health care.

What’s something you wish people could know more about your profession?

Most people who go through this profession are not in it for monetary reasons but to make a positive impact. There are a lot of clinicians who struggle in their own health: physically, emotionally, and mentally.

H

ow long have you worked here?

7 years

What do you like about where you work?

CHAS Health is a very collaborative place to work. Everyone I work with wants to help improve patient care and expand access to services in our region. When there are tough problems to solve, we come together to help each other and really elevate each other.

How long have you worked in health care?

10 years Where did you study?

University of Washington 2013, bachelor’s of Physiology 2017 Eastern Washington University master’s in Biology

What do you like most about what you do?

I enjoy using data to not only highlight health disparities but also to create tools to help address those disparities and improve patient outcomes.

Why did you want to work in health care?

I come from a long line of public servants. Both my grandmas worked in healthcare -- a pharmacist and a nurse -- and I feel good about the value CHAS Health adds to the community. It feels good to go to work everyday to serve that purpose.

What’s something you wish people could know more about your profession?

There are a lot of accessible tools available to learn how to handle and analyze data, people who have a logical mindset and like to solve problems can thrive in data professions.

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Kim Jorgensen, director of Women’s and Children’s Services at Kootenai Health, visits a patient during a training with her team of labor and delivery nurses.

Courtesy Kootenai Health

Politics, retirements, and staffing shortages create challenges Heath care outlook strong but current picture not so rosy

By Jean Arthur Marketing Correspondent

T

he Inland Northwest is not alone in facing challenges to medical treatment.

Nationwide struggles among health care facilities and medical professionals are well-documented, yet shining examples of resiliency blended by vivid challenges are emerging from regional medical centers such as Kootenai Health in Coeur d’Alene.

“We did expand, adding a new cardiovascular wing, part of a larger expansion project to meet the region’s growth and needs,” said cardiologist Eric Wallace.

The cardio unit expansion included procedural areas, like a cath lab and electrophysiology lab, in addition to additional patient recovery rooms and a new floor.

Wallace notes that the previous space

limited care. But thanks to local community members’ donations, and other fundraising, the expanded heart center opened in August.

“The one thing that the new Heart Center will do is add space in procedural areas that gives us more timely access, and allows us to handle multiple emergencies,” he said.

The 41,000-foot, three-story expansion anticipates future growth. Wallace says that one solution to maintaining current medical staffing is to remain current in both facilities and equipment.

“Challenges include maintaining facilities so they’re attractive to practitioners, that allow us to recruit and retain high-quality providers,” Wallace said. “Keeping up with North Idaho’s 10 years of growth and expecting continued growth, we have to make sure we have

facilities to meet growing demand. Nurses and physicians will want to practice here because they have contemporary facilities. And it’s a great place to live.”

This view is echoed by others, including Jeremy Evans, Chief Operations Officer of Kootenai Health.

“As community health care needs grow across the region, Kootenai Health needs to keep pace in our surgical and heart center capacity,” said Evans in a press release.

Of course, not all in health care is rosy right now, especially in Idaho.

According to the Boise-based Idaho Nursing Workforce Center at the Idaho Center for Nursing’s 2023 study, 29 percent of the state’s nurses are aged 55plus, and 3 percent are 65-plus, according to licensure data. With retirement age at 67 years, many plan to leave the industry soon.

On a national scale, 18 percent of new nurses quit not just their jobs, but the profession entirely during their first year.

Randall Hudspeth, Ph.D., MBA, APRN, the retiring executive director of ICN, is hopeful but still sees flaws in being able to adequately educate enough new nurses to meet Idaho’s future care needs. According to the U.S. Bureau of Labor Statistics, “Employment of registered nurses is projected to grow 6 percent from 2022 to 2032, faster than the average for all occupations.”

“The good news is that we have many young high school graduates interested in becoming nurses,” said Hudspeth. “We see 3 to 5 qualified applicants for every classroom seat, but still have more young people interested in becoming nurses than capacity to educate.”

He said the limiting factor in why Idaho cannot produce more nursing graduates is because there are not sufficient numbers of faculty employed to meet the nursing educational standards for student and faculty ratios.

“Legislators need to fund our state schools to have more faculty, and faculty salaries need to be competitive with what nurses make in hospitals,” Hudspeth said.

Idaho’s 10 colleges and universities that offer nursing programs are constrained by costs to place students in clinical settings.

ICN estimates that annually, the state

will need to add more than 500 nurses annually to meet job demands resulting from nurse retirements and a migration of older adults moving to Idaho.

A salaried position including benefits nears $100,000 for each nurse-educator who works as a nursing professional and a teacher. Idaho’s Legislature would need “several million a year to each program” within the state’s public schools of nursing, including three baccalaureate programs at Lewis and Clark, Boise State and Idaho State, and five community college associate degree programs such as North Idaho College in Coeur d’Alene.

Private programs at BYUI and Northwest Nazarene University do not receive state funding.

“What needs to happen in schools that are state funded, the legislators need to appropriate funds for faculty salaries so capacity of nursing undergrads could be increased,” Hudspeth says. “Nursing clinical education requirements demand 1 faculty for every 10 students. So, we see the need to increase clinicians to hire to be able to increase the number of students.”

He explains that in Boise, eastern Idaho, and Kootenai County, the region’s hospitals support adjacent nursing schools, either by maintaining nurseeducators as employees or funding through grants “But it’s not a sustainable plan, just a Band-Aid,” Hudspeth said.

He’s concerned that this support may be quick to be pulled back if a hospital encounters financial constraints due to cutbacks in Medicare/Medicaid.

He blames the state’s legislature for not addressing funding needs that have now resulted in a major nursing workforce shortage statewide that will not be easily resolved.

“The only real sustainable program to increase the number of nurses is through legislative approval for increased funding to the Board of Education so student capacity for clinical positions can happen,” Hudspeth said. “We seriously attempted that in the last few years, but our legislators have failed.

It’s a backlash in some respect because that very conservative legislature acted somewhat punitively toward universities because those legislators had an idea that

universities were teaching critical race theory—which has nothing to do with clinical education. That’s a radical rightwing talking point that a few have driven to the front of conversation.”

Hudspeth does point out that there are efforts to keep nurses happy. St. Adolphus Regional Medical Center in Boise recently instituted a Calling Care Team that checks in on nurses regularly to try to counter declines in mental and physical health.

Idaho contrasts with Washington in terms of legislative support for nursing programs. In April 2023, Gov. Jay Inslee signed bills approving safe staffing and reducing barriers to nurse education.

These were created by the state Senate to address statewide nursing shortages, alleviating workloads and providing more nurse autonomy in treating patients.

Idaho and Washington are part of the WWAMI training program which is designed to encourage homegrown physicians who want to study at schools in the region by offering reduced tuition costs and opportunities to practice in

rural communities.

But political challenges have been diminishing some of the numbers of practicing professionals thanks to the Supreme Court’s 2022 decision eliminating the Roe v Wade decision.

In Idaho, an abortion ban went into immediate effect.

This led to Bonner General Heath in Sandpoint shuttering its OBGYN clinic, saying that any doctors in this program feared fines and jail time if they performed medically necessary abortions.

Bonner General Health’s maternity ward annually delivered 300 babies. But now, pregnant parents must travel more than 50 minutes to Coeur d’Alene or into Eastern Washington—sometimes on icy roads—for general pregnancy care.

Anyone seeking or requiring an abortion must travel out of state.

Legal complaints have already been filed against Idaho, including by The Center for Reproductive Rights and The Idaho Academy of Family Physicians, on behalf of women who had to travel out of state for abortions after discovering their

fetuses had non-survivable conditions or life-threatening situations for the mothers.

The Center for Reproductive Rights noted that, “Clarifying the laws’ exceptions would allow physicians to provide life-saving care without waiting for patients to be near death. The lawsuit also seeks to clarify and expand the exceptions under the two bans to ensure physicians can provide abortion care to preserve a pregnant person’s health and for cases of fatal fetal diagnoses.”

Dr. Todd Hoopman, Kootenai Health Courtesy Kootenai Health

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Sharon Walden, MA, Certified Medical Assistant, Lidgerwood Medical Center, Kaiser Permanente Washington

H

ow long have you worked here?

I’ve been in the same position for 30 years. I’m proud of that.

What do you like about where you work?

I’ve worked with great health care workers, from the front office to patient care, nurses, providers.

What I love most is when we’re working together as a team for the good of the patient. It’s a real privilege for patients to have that cohesive team. They like the familiarity.

I have a motto in my daily work that I stole from a coworker when I worked as a dyad. “There is something we can do for everyone.”

It might not be exactly what they wanted, but when they leave, they felt like they got what they needed.

I love seeing patients leave feeling they’ve been helped. I love helping them navigate the health care system.

How long have you worked in health care?

My first medical assisting job was in 1983. I’ve been mostly in family

practice. I taught medical assisting for about 8 years.

Where did you study?

Kinman Business University, a small but reputable school that used to be in Spokane.

Why did you want to work in health care?

The primary reason was job security because I always knew I would have work. As far as medical assisting, it was family security: I wanted to be a mom and be home with kids at night, weekends and holidays.

What do you wish people could know more about your profession?

Medical Assistants play a vital role for the provider and the patient.

We are tasked with keeping the provider’s workflow balanced and acting as patient advocates.

I’ve always said a good medical assistant is the key to a successful practice.

Sony Tuggle, RN, Kendall Yards Medical Center, Kaiser Permanente

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ow long have you worked here?

Since 2019

What do you like about where you work?

My favorite part, I would jokingly tell you, is the fish tank. I feed them every day. But it would actually be the people I work with. We have the most wonderful group. It’s easy to do a good job when everyone alongside you does a good job. The PAs, the MAs, the lab techs, the radiologist.

I like the relationships, especially in outpatient medicine. When I worked in the hospital, I’d wonder how my patients were doing once they were discharged. My favorite thing about working outpatient is I have an opportunity to get to know the patients and their families. I can really build that rapport.

How long have you worked in health care?

A long time. Longer than I can remember. I’ve had so many different roles.

Where did you study?

Pacific Lutheran University Why did you want to work in health care?

I worked as a vet assistant for a long time, and I loved the health care aspect, but I didn’t find a lot of job security. I didn’t think working with people would be that different (which I was wrong about), but I still love it! I knew nursing would be a career that allowed me to support my family.

What’s something you wish people could know more about your profession?

It’s hard. It’s a hard job. I have a little plaque that one of my bosses gave me that says, “Nursing is the hardest job you’ll ever love.” It’s a hard job but also rewarding.

Kelsey Pfurisich, RN Riverfront Medical Center, Kaiser Permanente Washington

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ow long have you worked here?

I’ve been with Kaiser Permanente Washington for about 10 years. I came from Kaiser Permanente Northwest.

What do you like about where you work?

I like KP’s model of care, the whole integrated model. We have access to specialties, lab, radiology, mental health, all in the building. It is great for patients. I’ve also felt really supported in my career goals. I started out in ICU at a hospital and then worked labor and delivery, and now outpatient in a clinic. There’s a lot of variation, and I don’t get bored.

I love working with people. I love that I get to have a small impact on somebody’s day and life. I feel like many of my patients are going through a challenging season (labor

and delivery, post-partum) and if I can ease their day in some small way, that’s really rewarding.

How long have you worked in health care?

About 12 ½ years.

Where did you study?

I did my nurse and undergrad at Whitworth University and nursing at Washington State University

There’s so many opportunities and challenges. I appreciate that I’m not stuck in one area. I’m actually going back to school for my Nurse Practitioner degree. Compared to some of my medical doctor friends, who get stuck in their specialty, I have opportunity and variety. I don’t think people understand all the variety of roles nurses can have.

Anything else you want readers to know?

Why did you want to work in health I developed a program for Kaiser care?

Permanente Washington in Spokane I love science and medicine and anat- called Early Beginning, supporting omy and physiology. I have always post-partum families. It includes a been interested in medicine, nursing one-hour nursing visit for a 3- to especially. I love being able to care 5-day old infant. The family can ask for people, the hands-on work, and the questions, get help with breast feedvariety you can do. ing, talk through anything else. It’s a cool opportunity for families to get What do you wish people could more support. know more about your profession?

Within nursing, you really get to have a great impact on people’s lives.

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A

s with other categories under the health care umbrella, elder care has a major shortage of workers.

And in this field, this need is being felt even more dramatically because of the size of the demographic.

“This is called ‘the silver tsunami’ -- the Baby Boomer generation is large and the amount of care that they’re needing is growing and there just aren’t enough resources to meet all the needs,” said Kari Stevens, Community Living Connections Director at Aging and Long Term Care of Eastern Washington (ALTCEW).

Data from the 2020 census says that 1 in every 6 people in the United States is over the age of 65. The caregiver shortage has been an issue for years but, according to Stevens, things got worse as more people left the healthcare field during the COVID pandemic.

With fewer caregivers available and more senior citizens, some innovative technology and new approaches have been taken to mitigate the lack of resources while keeping older people physically and mentally healthy.

New approach to ongoing challenges

Care for today’s seniors calls for more innovation, workers

By Tracy Damon Marketing Correspondent

Repurposing technology While mobile apps might be used most commonly to listen to music, order rides or food, and adjust lighting, they are now also being used by healthcare professionals and their patients. Apps that tell people when to take their medications are particularly helpful to those on multiple prescriptions. They can help prevent confusion, send alerts when it’s time to take one, and even send reminders when it’s time to get prescriptions refilled.

Google Maps and other navigation apps can help people experiencing memory issues remember where they parked or how to get where they are going, and GPS tracking devices can be used to monitor the whereabouts of those with dementia who may wander.

“We do refer a lot of those assistive technology options to people. It really just depends on what insurance plan is covering them,” said Stevens. “That can be a barrier for folks trying to get devices.”

She says many insurance companies

are starting to realize the advantages of preventative maintenance and becoming more progressive about providing nonmedical related benefits to their coverage packages.

Some personal tech helpful for seniors can even be purchased over the counter.

For instance, Stevens cites a real-life case where her mother had a medical emergency, and as a result, the family is investing in an Apple watch for her.

Both Apple watches and FitBits can be repurposed to not only count daily steps and track how many hours you sleep but can sense sudden changes in speed and altitude, indicating a fall.

When this happens, the device contacts the wearer to see if they are OK and alerts a caregiver if there is no response.

These wearables also monitor vitals and can send an alert when they sense danger.

Other simple options that come with smartphones, such as flashlight or magnifying glass apps, help older people be able to better read menus and other small print. Audio books are also a great option for those with diminished eyesight or arthritis that can make holding a book difficult.

Stevens does say that the “digital divide” is a real thing for seniors though, and not all are comfortable or interested in learning how to use technology that may be new to them.

Virtual reality Just because someone is no longer physically fit to travel doesn’t mean they can’t still see the world.

Virtual reality is being used to keep seniors from being bored and reducing depression. While they may no longer be able to travel due to physical or financial limitations, “virtual tours” using virtual reality goggles can be tailored to almost any experience.

Conversely, virtual reality is also allowing able-bodied people to experience what it’s like to have Alzheimer’s, Parkinsons, macular degeneration or dementia. Caregivers and loved ones are using this tech to better understand the needs of their clients and loved ones.

Stevens says there is also a local movement to connect seniors with

others virtually for learning and social purposes. The Washington State Department of Social and Health Services purchased a statewide account to an online learning service called “Get Fed Up” that involves cooking interactively with the instructor and others online.

“So our seniors can access any Zoom meeting class online … some of the classes are taught by other seniors so it’s a peer-to-peer effort,” she said.

There are a variety of Get Fed Up topics; everything from making pasta to more complicated culinary options. She says the subscription to this service was a result of the isolation of the COVID-19 pandemic when people were isolated but still wanted to gather.

Improved living options Communities for people 55 and over are becoming more common and more creative.

Many seniors are choosing to give up their homes before they reach the point where they can’t maintain them any longer, or the house no longer meets their needs as it can’t accommodate walkers or wheelchairs.

Many new senior living communities put an emphasis on being active, offering amenities like on-site bowling alleys, pubs, and dog spas, but also companionship with other residents and medical professionals on staff so residents can remain in the community longer as they age.

“They’re trying to create more communal communities… that were borne out of lack of resources,” said Stevens.

They were also borne out of newer recognition that, with each move to a new residence an older person makes, the more cognitive loss they suffer. As they are moved from their home to an apartment and then to an assisted living center, every move may accelerate mental deterioration, particularly for people with existing medical conditions.

“When you’re dealing with dementia it’s literally brain death, so the more stress and anxiety you add to that, the faster it (the brain) deteriorates. And you are in a new space and don’t recognize your surroundings and that’s completely terrifying,” Stevens said.

As a result, some senior living facilities are changing to a model where a person can live for the last few decades of their lives on the same campus. They may live in a cottage or small home on the property initially, then move into an apartment when their ability to care for themselves begins to decline and caregivers step in with assistance. Stevens says this is part of the move towards holistic healthcare for seniors.

“We’re trying to keep people in one place and bringing in people as they are needed and wrapping services around people instead of treating every issue individually is gaining traction,” she said.

If you need help finding services, whether health care, housing, or other, for yourself or a loved one who is a senior citizen, call ALTCEW’s helpline at (509) 960-7281. Care coordinators at that number help to assess the needs of the caller and connect them to the most appropriate services.

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How much does health care drive regional economies?

A MultiCare provider listens to a patient’s heart.

Courtesy MultiCare

By Jean Arthur Marketing Correspondent

H

ealth care is the fastest-growing sector of the U.S. financial system, according to a 2022 U.S. Bureau of Labor Statistics report. It notes that “14.7 million people aged 16 and older were employed in health care occupations and about 8 in 10 workers were women.”

The health care industry is expected to continue growing. According to the Federal Reserve Healthcare Workforce Summit in May 2022, “In 1990, about 8 million Americans worked in health care; that figure has since doubled. That’s the largest single employment segment in our economy.”

Washington’s Department of Commerce considers “Life Sciences and Global Health” as one of the state’s key industries of which the department

encourages growth strategies.

What drives such growth is complicated, but factors include an aging population; new, life-saving and life-extending drugs and procedures; newly insured people, and in-migration from elsewhere in the U.S. to desirable regions such as the Inland Northwest.

Meeting such challenges includes, according to experts, expanding education opportunities for nurses, physicians and pharmacy students, while maintaining attractive work situations to draw and retain workers.

University of Idaho’s WWAMI program, a physician education program between the University of Washington School of Medicine and public universities in Washington, Wyoming, Alaska, Montana and Idaho, allows medical

students to train in their home state and offers opportunities to expose students to rural medicine. In Idaho, students begin their journey at University of Idaho, then gain additional training at clerkships set in urban, rural, or underserved areas across the state or the greater WWAMI region.

Each year, 40 Idaho students earn seats in the program at $83,550 per student, with scholarships and the state covering about half. WWAMI grads must agree to practice in Idaho for a minimum of four years or pay back the tuition. (The national average cost per medical student is $167,000.)

Idaho ranks among the states with the lowest number of practicing physicians per capita in the country. Notably, WWAMI grads who train in rural com-

munities often return to practice in rural communities once done with medical school.

The Idaho Board of Education’s December 2022 findings note that “growing a high-quality physician workforce creates additional jobs and revenue for Idaho. Each physician trained in Idaho, who then stays in Idaho to practice, adds approximately 12 jobs per physician and over $1,900,000 of economic impact in their communities.”

In the Panhandle area of the state, medical care significantly impacts the economy, says Samuel Wolkenhauer, a labor economist for the Idaho Department of Labor. He notes: “We do have economic impact estimates, and for 2022 our numbers have health care contributing $855 million to Northern Idaho’s

Gross Regional Product.”

Overall GDP for Idaho in 2022 was $109.5 billion, a 13.78 percent increase over 2021. Wolkenhauer adds that total GRP was $13.1 billion, and health care was about 6.5 percent of that total.

More to come According to the Peter G. Peterson Foundation’s July 2023 report, “The U.S. will spend a projected $4.7 trillion—or 18 percent of the national economy—on health care in 2023.”

The nonpartisan foundation’s report adds that Americans spend nearly double that of similar wealthy countries’ citizens with “health outcomes generally no better than those of other countries, and in some cases, worse, including in areas like life expectancy, infant mortality, and diabetes.”

Washington’s Office of Financial Management’s current “Economic and Revenue Outlook” notes “a public health care crisis with serious economic consequences” could be on its way in the near future. Washington’s Office of Financial Management also notes that “Over the past four years, 78% of Washington’s population growth has been due to in-migration.”

Hospitals and clinics also see inadequate numbers of nursing professionals. A 2021 Washington State Hospital Association survey found that hospitals need 6,100 more nurses to meet staffing needs. The Legislature passed a nurse staffing bill earlier this year to help address the shortage crisis, but the need is still strong.

Washington State Nurses Association finds 61,335 registered nursing jobs in the state, 101,239 active nursing licenses, and 54 percent considering leaving the profession.

According to the federal Bureau of Labor Statistics’ most recent study, “the median annual wage for registered nurses was $81,220 in May 2022.” The national job outlook for nurses with bachelor’s degrees is expected to grow by 6 percent by 2032.

The Bureau of Labor Statistics finds that for Washington, the annual mean wage for registered nurses ranges $87,990-$133,340. Idaho’s annual

mean wage, however, ranges $75,000$79,990.

Beginning this year, Washington State University offers pharmacy students a $10,000 a year scholarship if the students commit to practice instate for at least three years. The Rural Health Initiative’s $2.2 million donation is helping fund new pharmacists’ education in hopes they will practice in “pharmacy deserts,” mostly rural communities that lack enough pharmacists.

The Initiative also reduced the price tag for out-of-state pharmacy students to attract more pre-professionals to the career.

The Rural Health Initiative posts that “The state of Washington has almost .5 million, or 8 percent, of adult residents living in areas that are faced with a shortage of health professionals, with over 600 new providers needed to eliminate those gaps in access to care.”

Economic growth key According to the Federal Reserve Healthcare Workforce Summit in May 2022, “the tragic experience of the last two (COVID) years demonstrated not only how important the health-care sector is to our national fabric, but it is also extraordinarily important to our economy as well.”

One item which could slow economic growth in the health care industry and in many other sectors is the lack of childcare, according to Kids Count, a national data center, which finds that full-time infant care runs nearly $8,000/year while childcare workers earn about $5 per hour less than fastfood workers, as found by the Annie E. Casey Foundation.

The Idaho Voices for Children finds a need for 20,000 more placements among childcare facilities and that it is essential for the state and the country to support workforce through childcare funding, connecting back to the 8 in 10 workers who are women, who cannot work without good childcare.

H

Todd C. Hoopman, M.D., Medical Director Pulmonary Nodule and Lung Cancer Screening Clinic, Kootenai Health

ow long have you worked here?

We moved to Coeur d’Alene in April 2011, after my wife completed the Coeur d’Alene Ironman in 2010. We fell in love with Cd’A and knew it was where we wanted to live forever.

We have a Lung Nodule Clinic that came from humble beginnings and an idea that it was something we needed. In the seven years since its inception, we’ve nearly doubled our patient visits yearly and have been able to expand to other communities in Idaho to provide necessary clinical services.

What do you like about where you work?

I am thrilled to be part of a team committed to providing outstanding patient care across all medical specialties. I am surrounded by colleagues that are so well-trained and willing to share their knowledge and experience. I find patients to be such genuine people proud of their community. Their pride makes me work harder to meet their needs and expectations.

Why did you want to work in health care?

My father was diagnosed with Parkinson’s Disease at 41. Watching him struggle with its progression over 36 years showed me how important patient-physician relationships can be for health, both physical and mental. I witnessed firsthand how medical providers and medical advances can improve lives and give people chances to experience all that life has to offer. Part of me feels indebted to my father and his illness to provide the best care possible to honor his battle and perseverance.

How long have you worked in health care?

I entered medical school in 1995 and graduated in 1999. I began my career in the hospital and outpatient settings after graduation in 1999. I attended medical School at University of Texas Southwestern Medical School at Dallas. Internal Medicine Residency and Pulmonary/Critical Care Fellowship also at the University of Texas Southwestern Medical School at Dallas What do you like most about what you do?

I am challenged every day by situations that require a broad knowledge base, but also the willingness and ability to ‘think outside the box’ for creative solutions to unique situations. I especially appreciate the team approach. I am surrounded by team members who actively find ways to help patients and improve the health of our community.

What do you wish people knew more about your profession?

Pulmonary Medicine is a diverse specialty. Most pulmonary physicians also practice in the Intensive Care Unit. We can witness the sickest of patients and use that experience to better understand a multitude of illnesses.

Anything else you want readers to know?

As a physician it is fortunate to find that ‘one thing’ that drives you to do better, makes you come to work every day, and motivates you to find new ways to serve your community. A series of fortunate events in life led me to focus my practice on the diagnosis and management of lung nodules as well as ways to improve lung cancer screening. I know that I am doing what I was meant to do and will do for the rest of my career.

Pavel Nesenchuk, BSN, Registered Nurse, MultiCare Deaconess Hospital

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ow long have you worked here?

Eleven years. Seven of those years, I was on the surgical floor and four-plus years on the Progressive Care Unit.

What do you like about where you work?

MultiCare treats its employees very well and has a good work environment.

After 11 years, I’m very happy to work here.

I love talking with patients and family members. The hospital, for many, is a time when “life” gets put on pause to focus on physical health. I love learning about people’s life experiences and where they are in life today. The best part of my job is when I discharge a patient.

Where did you study?

Washington State University College of Nursing.

Why did you want to work in health care?

Early in my life, I learned that physical health is fragile and I was exposed to health care from a patient’s point of view. I became determined to become a nurse.

What’s something you wish people could know more about nursing?

I get to be a part of phenomenal treatments that extend life and improve its quality. Having said this, I have seen even the highest-skilled physicians reach a point where there is nothing they can do. This is a humbling experience, and I am reminded of the reality that life is very short and passes quickly and will come to an end. I believe the Creator of our human body has a higher and greater purpose that goes beyond this life and is everlasting.

Anything else you want readers to know?

No matter how strong, healthy, and able one may be today, there will come a vulnerable time when the human mind and body will not be capable of doing what it used to. Family is your greatest advocate, and sometimes your nurse is as well.

Ashley Manning, PA-C, Kootenai Clinic Cancer ServicesSandpoint

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ow long have you worked here?

A little over 2 years.

What do you like about where you work?

The people I work with on a day-to-day basis. Our staff, including physicians, nurses, MAs, schedulers and front desk, are top-notch. Everyone is so compassionate and caring. We are a great team working together with the goal of providing terrific patient care.

I have worked with cancer patients my entire career and I cannot see myself doing anything different. It is so incredibly rewarding to care for people who in some of the most difficult times in their lives. Cancer patients are so special and have a unique perspective on life. The medicine itself is also ever-changing and so fascinating. I learn so much every day.

How long have you worked in health care?

15 years.

Where did you study?

Undergraduate degree from the University of Texas at Austin and graduate degree in PA studies at Pacific University in Forest Grove, Oregon. One-year post-graduate program at MD Anderson Cancer Center in Houston.

Why did you want to work in health care?

My mom has been an oncology nurse for over 40 years. I saw what an impact she made on her patients and she was a big influence on my career choice. We

briefly worked together when I was a CAN, and there I was exposed to caring for cancer patients. I realized quickly that this was my passion and I knew that being a PA would be the perfect role.

What’s something you wish people could know more about your profession?

Many aren’t sure what physician assistants do. We are providers that practice fairly independently (albeit licensed under a physician). We typically have more time to provide patient education compared to physicians, and I think patients really appreciate that. With increasing physician shortages, PAs and nurse practitioners will become even more important in the care of our aging population.

Anything else you want readers to know?

Being a PA is such a wonderful career choice. You get to play a big role in helping people, but you can also have a good work-life balance. I have a husband and 3-year-old son and enjoy getting to spend as much time with them as possible. We moved to Sandpoint two years ago and absolutely love the beauty and small-town atmosphere.

How long have you worked in health care?

11 years from radiology tech, Intensive Care Unit CNA, giftshop attendant, coffee shop barista, to the latter seven years of Neuro-ICU/Neuro-Trauma ICU/Covid ICU, Neuro Interventional Radiology RN, and now Stroke Coordinator.

Kate Knight, Stroke Program Coordinator, Kootenai Health

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ow long have you worked here?

In April 2021, I was fortunate to find an opening for a stroke program coordinator. After months of long and challenging work as a traveling ICU nurse during COVID-19, I was ready to settle down to a place I could call home.

What do you like about where you work?

I always enjoyed my visits to the Northwest to see family in the Sandpoint area. The natural beauty and friendliness of people left a lasting impression. It gives you a feeling of belonging. I also

see this at Kootenai Health. People seem to be connected to each other one way or another. It’s a feeling of being part of a family when you enter our hospital.

Being a nurse, with the bonus of being a Stroke Coordinator, is not only a fulfilling position, but you can physically see the work that is being done. You can see the patient improving, the data of initiatives pushed improving patient care, and nurses improving their assessments and care because of the education you provided. It is a causeeffect type of role. It not only helps people on their worst days, but gives a rewarding feeling that many jobs can’t give.

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Where did you study?

Nicholls State University, in Thibodaux, Louisiana, where I acquired my Bachelor’s degree in Nursing with honors. I enhanced my knowledge by getting certified in Neuro-Nursing and obtaining my Master’s degree with honors from Chamberlain University.

Why did you want to work in health care?

I was a rambunctious 13-year-old teenager when Hurricane Katrina pummeled Louisiana. My three aunts who held leadership roles in nursing at local hospitals stayed with us before they repaired their homes. Their compassion, drive, and motivation to help people shaped my decision in

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steering away from law school and into nursing school. I wanted to be a part of the reason a person had an uplifting, compassionate experience.

What do you wish people could know more about your profession?

Patients touch our lives, just as frequently as we touch their lives.

Patients and their families have a huge impact. We remember patients we have lost and their families. We remember the amazing miracle stories that we were a part of.

Anything else you want readers to know?

The field of stroke and neurology is ever-changing. It is exciting and challenging. I am proud to be part of this change and encourage anyone who likes a challenge to pursue this field. It is rewarding and definitely not boring!

If anyone decides to pursue a career in nursing, always start your day off with “why did you pick nursing.” Your why will help you have patience and perform compassionate care. People get caught up in the day-to-day and bringing that back is sometimes all you need.

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“What’s The Chance This Will Work For Me?” Chiropractic has been around for over a hundred years, and has been used to help everyone from tiny babies to the elderly.

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“Manipulation [chiropractic adjustments], with or without exercise, improved symptoms more than medical care did after both 3 and 12 months.”– British Medical Journal “Chiropractor’s manipulation of the spine was more helpful than any of the following: traction, massage, biofeedback, acupuncture, injection of steroids into the spine and back corsets, and ultrasound.” -- Stanley Bigos, MD, Professor of Orthopedic Surgery This means in just a matter of weeks you could be back on the golf course, enjoying your love life, or traveling again.

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The Single Most Important Solution To Your Nerve, Neck and Back Pain It’s time for you to find out if chiropractic will be your nerve, neck and back pain solution.

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Pain Shouldn’t Hold You Back From the Important Things in Life Tell the receptionist you’d like to come in for the Nerve, Neck and Back Pain Evaluation before October 30th, 2023 I look forward to helping you get rid of your pain so you can start living a healthier, more joyful life.

Sincerely, Dr. Scott Maystrovich, D.C. P.S. You’ve got too many dreams left undone. Too many special moments waiting to be experienced. Life is too short to let pain slow you down.

Don’t live another day like this. Call and schedule for your evaluation. 509-482-1982.

MultiCare offers a training program for nursing assistant and medical assistant students.

Courtesy MultiCare

Want to learn health care? You don’t have to go far Region boasts plenty of training opportunities

By Tracy Damon Marketing Correspondent

T

he nationwide worker shortage in pretty much every field is nothing new to the health care industry.

For decades, experts have said there aren’t enough doctors, nurses, and other health care professionals to keep up with a growing population that needs these services.

This situation is expected to get worse: by 2030, the World Health Organization is predicting a shortfall of 15 million health care workers worldwide.

To combat this, colleges and health care companies are looking for more ways to partner in training and hiring skilled health workers at all levels.

This includes the Inland Northwest, where there are innovative efforts taking place to recruit future workers in medical fields. Some providers are even teaming up to develop a pipeline directly from school to employment, or at least connecting potential industry workers with various tools to be part of this world.

One example is Washington State University, which offers undergraduate, graduate and professional programs through its College of Nursing.

In early 2023, WSU and Providence announced a partnership to establish the first pediatric medical residency in

Eastern Washington. The goal of this program is to improve overall children’s health care in the area and to foster aspiring doctors from WSU’s Elson S. Floyd College of Medicine.

Six residents per year will be admitted to the three-year program, with the first residents scheduled to join the program in summer 2024. Training will be provided in pediatric specialties, community pediatrics, child advocacy, adolescent medicine, developmentalbehavioral pediatrics and mental health.

This program is based primarily at Providence Sacred Heart Children’s Hospital with outpatient experiences at pediatric clinics throughout the community.

WSU also partners with the University of Washington’s School of Medicine on a medical education program to increase the ability of both schools to attract students.

Through this program, students spend the first two years of classes on the WSU Spokane campus; with the last two years of training at a WSU campus in Everett, Spokane, Tri-Cities or Vancouver.

“Students learn in a variety of hospitals and health care settings, allowing them to receive training in the kinds of environments where they will ultimately practice as physicians,” Kim Blakeley, Director of Strategic Marketing & Communications for UWSOM, wrote in an email.

Through this program, students can take advantage of a variety of training opportunities, including in Graduate Medical Education; post-doctoral training and biomedical graduate education programs in Research Graduate Education; rehabilitation medicine, occupational therapy, prosthetics and orthotics, physical therapy, and rehabilitation science in Rehab Medicine Degrees, and others.

In addition, UWSOM has a five state program known as WWAMI, an acronym corresponding with the first initials of the state served by the school; Washington, Wyoming, Alaska, Montana, and Idaho.

“Through partnering with universities in each of the states, duplicative costs are reduced, and students are able to get a

UW medical degree in their home state.

When WWAMI was started, back in the early 1970s, there weren’t any other medical schools in the WWAMI states,” Blakeley said.

In Washington, the home base for the program is the UW Seattle campus in western Washington and Gonzaga University in Eastern Washington.

Other partners include the University of Wyoming, University of Alaska Anchorage, Montana State University, and University of Idaho.

“All students, regardless of where they reside for their Foundations (basic initial) training, are UWSOM students and receive MD degrees from UW,” said Blakeley.

Providence Healthcare’s Certified Nursing Assistant Training Program is a collaboration with Spokane’s Providence Sacred Heart Medical Center. Participants gain on-the-job work experience, classroom education, and clinical training throughout the six-week program. Training consists of simultaneous classroom and lab training for the first three weeks, then clinical rotations and review sessions the following three weeks. Students graduate eligible to work in direct patient care alongside medical providers in both acute and long-term care facilities.

MultiCare Health System-Inland Northwest Region partners with Sparrow Healthcare Education and COPE Health Solutions on medical assistant and nurse assistant education programs. Sparrow teaches the course work outside of western Washington while COPE teaches in the Puget Sound region.

“The courses in both regions are essentially the same to comply with the standard of the state for those occupations,” said Kevin Maloney, who works in marketing for MultiCare.

About 30 students per year go through the medical assistant program and about 60 complete the nurse assistant program annually.

Students are paid to participate in the education phase of the program and come out with a job waiting for them with MultiCare.

“They agree to work for MultiCare for

two years in the MA program and it is a one-year commitment for those on the NA track,” said Maloney.

Other area healthcare education or training programs include Spokane Community College’s nursing program that trains students as registered nurses for a variety of health care settings.

Training includes nursing courses, hands-on practice in the nursing simulation laboratory, computerassisted instruction and supervised clinical experiences. Program graduates often continue on to a bachelor’s of science degree in nursing program at a four-year university.

SCC also offers a medical assistant program, a bachelor of science in respiratory care, an associate in applied science surgical technician degree, an associate in applied science in Echocardiography, and an emergency medical technician certificate.

North Idaho College’s 11-month Practical Nursing program prepares students for entry-level employment as practical nurses in hospitals, urgent care clinics, physician offices, home health care, and long-term facilities. The curriculum includes basics of nursing, including medical and surgical nursing, maternal, care of infants and children, psychiatric nursing, pharmacology, and geriatrics.

Many program graduates continue their education to become a registered nurse. This program is offered in cooperation with clinical facilities in Idaho and Washington and the Idaho and Washington Boards of Nursing.

Eastern Washington University recently launched a Bachelor of Science in Nursing program; the result of both a shortage of nurses in the community and not enough programs to train nurses.

“Everyone has already heard a lot about the current nursing shortage, but we also have a lot of students interested in nursing degrees and they’re turned away just because there are too few programs to meet the demand,” said Donna Bachand, PhD, RN, Director of

the Nursing Program and Professor at EWU. The program prepares students for diverse regional healthcare careers.

“There are so many options besides just big hospitals in the area,” Bachand said. “We try to expose them to a broad range of clinical experiences so they can get an idea where they want to be after graduation.”

The first class, 40 students, was admitted to EWU’s program in August and 40 more will be admitted in January.

“We really want to prepare our grads to serve our local community. Many of our clinic settings in and around Spokane serve the under-served. We are in a pretty rural area. You don’t have to drive far outside of Spokane proper to hit the country. We looked at the needs of the region when we built the curriculum.”

The school also looked at the needs of local residents hoping to get into the health care industry.

“EWU is affordable and accessible,” said Bachand. “We don’t compete with the other universities; we complement each other.”

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For those who need financial assistance and resources to get into the medical industry, the group Nursing Students of Washington (NSWS: a chapter of the National Student Nurses Association) supports nursing and nursing students through education, scholarship, legislation, and networking.

NSWS membership is open to anyone enrolled in an accredited Washington State nursing school, nursing school faculty, and pre-nursing students.

Among other services, NSWS shares nursing scholarships and resources on its website at www.nsws.org/ scholarships.

The Washington Center for Nursing has a similar service on its website at wcnursing.org/be-a-nurse/scholarshipsloans-grants/.

Gentle, Effective, Collaborative Care Partnering with the Local Medical Community Offering a variety of modern techniques and services including: • Low Force and Traditional Chiropractic Care • Medical Massage • Graston Instrument Assisted Soft Tissue Therapy • Prenatal and Postnatal Chiropractic and Massage

• Cranial Sacral Therapy • Fascial Decompression (Cupping) • Advanced-Training Low Force Pediatric Chiropractic • Veteran’s Community Care • In-Office Physical Therapy and Physical Medicine and Rehabilitation

WOLF CHIROPRACTIC & MASSAGE

509.892.9800 www.wolfchiro.net

ments in which we live can influence our health.

The word medicine refers to a field that combines scientific knowledge and clinical experience in the care of patients.

This includes diagnosing, preventing, treating, and alleviating injuries or diseases, while promoting overall health.

It encompasses a wide range of healthcare practices developed to preserve and restore health through the prevention and management of illness.

“Wellness strategies can include items such as a healthy diet, physical activity, hydration, minimizing screen time and restful sleep help to prevent disease and optimize our health and vitality,” explains Gina Wolf, DC, owner of Wolf Chiropractic Center in Spokane. “By contrast, treatments, whether traditional or alternative, are interventions that need to be mobilized after symptoms have already started. It’s much easier to maintain our health than to try to get it back once we’ve lost it.”

An excellent example of this is Occupational Medicine, which is focused on the treatment of work-related injuries and illnesses. Physicians trained in occupational medicine work closely with organizaDr. Nick Wolf from Wolf Chiropractic tions such as OSHA and the Department works with a patient. of Labor & Industries. They also work Courtesy Wolf Chiropractic directly with employers to keep employees safe and healthy on the job.

Northwest Return to Work, located in Lynnwood, is a leading provider of comprehensive work-related rehabilitation and evaluation services in Washington.

When someone is injured on the job, it is not just about their injury or symptoms, it’s about their livelihood, since everything in their life is affected. At es. They want non-opioid options for chronic pain, plant-based treatments, and NWRTW all treatment is based entirely on the client’s ability to return to some comprehensive, holistic care. type of work. To do that, NRTW treats Wellness—often referred to as alterthe person, not the injury. Depending on native or functional—medicine, is the the type of injury there can be long-term approach, practice, and various therapies chronic pain or mental complications. that promote overall well-being, illness Therefore, providers are encouraged to prevention, and the management of keep clients at the center of care, incorhealth conditions (such as pain) through porating naturopathic medicine, physimethods other than traditional medical cal and occupational therapy, massage treatments. Wellness medicine is not about going to a doctor, being diagnosed, therapy, acupuncture, chiropractic, and and receiving treatment like a magic pill, alternative pain treatments to help them find ways to move forward and continue but about our approach to life, and how the physical, social, and cultural environ- to earn a living.

Looking ahead New opportunities for wellness options to supplement traditional care

By Kate A. Miner Marketing Correspondent

I

t is no secret that a more holistic approach to health care is happening, with a growing demand for alternative medicines and wellness treatments.

With the rise of chronic diseases and long-term pain, patients feel that conventional allopathic medicine—treating symptoms and diseases using pharmaceuticals, radiation, or surgery—is no longer the only answer. Patients are looking for health care providers who will understand their individual needs and work with them to create a personalized treatment plan that takes into consideration their lifestyle and unique circumstanc-

The brain injury rehabilitation program at NWRTW is considered one of the better ones for injured workers in Washington, and Labor and Industries will cover the cost of housing for eligible patients throughout the state to attend.

“Understanding someone’s specific needs is what we’re all about,” says Josh Cobbley, owner of NWRTW. “Which is why we help clients manage not only the physical but the emotional struggles of a work injury.”

A similar treatment facility is Wolf Chiropractic in Spokane, which provides chiropractic, massage, acupuncture, physical therapy, and physical medicine.

“We have a primary care physician shortage in our community and across our nation,” says owner Wolf. “Our mission is to partner with the medical community, not as an ‘alternative’ but as a trusted resource for non-pharmacologic management of musculoskeletal conditions.

It’s a win-win. Primary care can focus on the patient’s complex medical needs and with our collaborative approach, we help patients move and feel their best.”

Both NWRTW and Wolf Chiropractic know that treatments like chiropractic, massage, acupuncture, and physical therapy can have a meaningful impact long-term, which is why they work in a polychronic partnership with individuals and doctors in the medical community.

They understand that traditional medicine is the hub of a wheel, and they are the spokes. Someone may have to have surgery, but after that, they help the person get back to a normal life and a healthier life. The person may have ongoing pain, but these organizations help find ways to alleviate, cope with, and minimize pain without additional medication or ongoing medical treatment.

“When patients feel they are at the end of their rope, we give them hope. We are advocates of helping people live better lives,” says Wolf.

Another aspect of modern wellness is keeping people healthy while they are working. The Washington State Department of Health calls this approach “Worksite Wellness.” According to the DOH, employees spend about 36 percent of their total waking hours at work.

Worksite wellness programs are encouraged to provide employees opportunities to improve their health, reduce risk of chronic disease, and reduce health care costs.

Kootenai Health, based in Coeur d’Alene, Idaho, provides a comprehensive range of medical services to patients throughout the Inland Northwest and has over 4,000 employees. This includes guidance in overall health, fitness, nutrition, stress management, weight loss, mental health, and even sleep. One of its services includes MyHealth, a well-regarded worksite wellness program led by a team of dedicated individuals and coaches. It utilizes an app called Virgin Pulse which powers a platform where users can learn about any wellness topic and take “journeys” (mini courses) online or in person with a coach. The coaches hold classes and work one-on-one with employees. Employees can earn reward points that help alleviate the cost of supplements or health care expenses for themselves and their families. They even have access to in-house group exercise and massage services.

Kootenai’s MyHealth program has been recognized for not only being robust and highly comprehensive for employees but also for the community. Services include providing biometric screening for businesses, subsidizing team walking/running events, gardening challenges, and other community-based health events. The program is managed by Derek Andersen MA, BSN, RN, along with Jason Crouse M.S., CWC, and Megan Rasmussen MS, RDN, CHC. “MyHealth services have generated a new inspiration for me in my work/ life balance,” says Kootenai employee Mandy Matheney. “Since starting with Kootenai Health over five years ago I have partaken in various challenges that encourage more daily steps, better hydration, positive lifestyle changes, as well as quick daily health check-in cards and community-involved activities.”

Despite its growing popularity, wellness medicine still faces challenges as it tries to integrate into mainstream health care. One of the biggest challenges is limited insurance coverage. This is why organizations such as NWRTW and

Wolf Chiropractic try to bring together the local medical community, government-funded programs, and employers.

According to Spokane Regional Health District health officer, Dr. Francisco Velázquez, “the collaboration between community and public health can empower communities to address issues impacting their health and well-being.

Public health can convene partners, identify actionable efforts to increase the availability of and access to health-assuring services, offer resources, and then develop strategies to use those resources.”

This integrative approach to medicine is inevitable. Health care, at its core, is about caring, not business—and the cultural shift must begin with community, as Velázquez suggests. COVID-19, the opioid crisis, and the diabetes epidemic (claiming an estimated 6.7 million lives around the world last year) are just a few examples of why our health care system needs to change. We must acknowledge, given our collective interest in health, that achieving optimal well-being involves identifying all factors that impact our wellness, he said.

The Metabolic Institute, the longest-established, certified functional medicine clinic in Spokane, is an excellent example of integrative medicine. The staff takes a science-based approach to treating chronic illnesses and conditions such as autoimmune diseases, integrative oncology, chronic fatigue syndrome, fibromyalgia, digestive conditions, hormone imbalances, and nutritional deficiencies.

“All of our internal systems are connected,” explains owner Debbie J. Judd, ARNP, FAARFM, ABAAHP. “When something in our life occurs, such as illness, divorce, or loss, one of these systems can become out-of-balance, which means all of them are out-of-balance.

Through proper testing, we can identify these imbalances, and then work with patients to correct them through a holistic, personalized, and metabolic approach towards optimal health. Functional medicine is about blending technology with the way medicine used to be. It is a personalized whole-body system approach to identify and treat root causes of chronic illnesses such as heart disease, cancers,

diabetes, and Alzheimer’s disease.”

It’s important to note that wellness strategies, such as proper nutrition, exercise, mind-body practices such as yoga or meditation, and alternative medicines, such as acupuncture, chiropractic care, massage, energy healing, or natural and homeopathic remedies, have been part of healing since prehistoric times and integrating wellness or alternative medicine into mainstream health care is not new.

What’s shifting, is that wellness is moving to the forefront, a shift that some in the health care community recognize and applaud. Caregivers would prefer to see us healthy and happy; they want more time to talk to and examine patients, consult with other medical professionals, provide more comprehensive testing, and carefully consider all medications and/ or treatments for their patients. To do this we—as individuals—need to be more mindful of our health. The goal? Stay healthy and enjoy life to its fullest.

Information for programs referred to in this article: Northwest Return to Work, Lynnwood www.nwrtw.com/ Wolf Chiropractic, Spokane Valley wolfchiro.net The Metabolic Institute, Spokane themetabolic-institute.com/ Kootenai MyHealth Wellness Guide www.kh.org/wp-content/uploads/2018/02/2018-WellnessGuide.pdf Worksite Wellness information provided by the Spokane Regional Health District: srhd.org/health-topics/workplace/ worksite-wellness Gina Wolf from Wolf Chiropractic says today’s providers and patients should think in terms of overall wellness strategies.

Health care providers go beyond traditional walls Community outreach efforts becoming more vital A Providence nurse works at an outreach event.

Courtesy Providence

By Dan Webster Marketing Correspondent

W

hen the term “health care organization” is mentioned, several meanings come to mind. Prominent among them, of course, are doctors, nurses and clinics, not to mention medical procedures.

These days, however, your typical health care group offers services aimed at more than individual medical

needs. Among the several different organizations providing care around the Inland Northwest, the one common emphasis they tend to share is the desire to engage the community as a whole.

As Jessica Knapp, a communications consultant with Kaiser Permanente, explained, “What we want to do is make sure our community, and the members of

our community, have equal access to all of the things that they need to improve their health – to improve their mental health and to improve their social health.”

One major way an organization fulfills its community outreach mission is by providing grants. Providence Health Care, for example, reports that in 2022 it provided “$20 million in charity care for

patients in the Inland Northwest alone.”

Some of those funds go to support the downtown Spokane Providence Community Clinic. Part of Providence’s Community Benefit Program, the clinic serves some 1,400 people annually.

Many of those served, though not all, are “uninsured or under-insured or experiencing chronic homelessness.”

In 2020, Kaiser Permanente provided a $590,000 grant to open a comprehensive health clinic at Rogers High School.

“Our work in schools really began back in 2018,” said Jill Patnode, Kaiser Permanente’s senior community health manager. That was when, she said, the organization partnered with the nonprofit Alliance for a Healthier Generation.

“But where we really dove deep into was school-based health centers,” Patnode added.

As reported by The SpokesmanReview, the Rogers High School clinic – as operated by Community Health Associates of Spokane (CHAS) – was devised as a three-year program aimed at providing “a variety of health care services to students, including medical, behavioral and dental care” as well as other much-needed services.

“We get a number of kids with the flu because they don’t have access to flu shots,” then-Principal Lori Wyborney told Spokesman-Review staff writer Jim Allen. Many Rogers students suffer from respiratory ailments, Wyborney said, adding that the clinic “will cut down on some of that and help with attendance.”

Giving money is one thing, but health care organizations find other ways of soliciting community involvement as well.

Providence is the official health care sponsor for the Lilac Bloomsday Race.

And, according to material provided

by Ariana Barrey, Providence’s communications manager, the organization is in its second year of providing a “free behavioral health program for teens” at Spokane’s Dr. Martin Luther King Jr. Community Center.

Coeur d’Alene’s Kootenai Health Foundation holds an annual four-day Festival of Trees event, which serves the dual purpose of engaging the community around Christmas festivities and raising funds for a variety of Kootenai Health’s services.

In a more hands-on sense, Kootenai Health hosted a health tent to offer treatment as needed at June’s Ironman Coeur d’Alene competition. Besides being prepared to handle problems caused by dehydration, nausea, exhaustion and low sodium, the staff was also on hand to give more serious treatment, such as inserting IVs or

dispensing medication.

Speaking of engaging the community, MultiCare Health System has for seven years held an annual “Bridge to Brunch 5K run/walk,” with proceeds going to the MultiCare Inland Northwest Foundation.

The multiple kinds of programs funded by the Foundation included a recent free Infant CPR class held at Deaconess Hospital.

In addition to offering a range of health care services, CHAS – which is funded both by federal and private sources (through the CHAS Health Foundation) – sponsors a number of health equity programs. Among them are school and homeless outreach, LGBTQ support, prenatal groups for mothers and babies … and so on.

Athletic trainers from Shriners Children’s Spokane worked during this past summer with student-athletes from Spokane Public Schools to help them avoid sports-related injuries. As the Shriners website reports, the presence of the trainers “is a tangible example of the collective dedication to supporting young athletes and the community.”

And, too, a variety of community outreach programs are offered through the Spokane Regional Health District.

The agency, which since 1970 has served both Spokane City and Spokane County, provides a diverse list of public information and resources. For example, are you interested in knowing what illnesses can be transmitted by animals or insects? The district’s experts are available to educate the public on this and any number of other topics.

The idea behind such outreach programs, Kaiser Permanente’s Knapp said, is to consider “the community as a whole” instead of focusing solely on each organization’s paying members.

The reasoning of her organization, she says, comes down to one simple fact.

“Our Kaiser Permanente members live in these communities,” she said. “And if you’re living in an unhealthy community, I don’t care how healthy you are, you’re probably going to get ill. So we need to keep our communities healthy.”

The Health Apprentice program through CHAS Health allows students to work alongside health care professionals..

Courtesy CHAS Health

5th Annual

active living

Saturday, April 20, 2024

10 a.m.- 2:30 p.m.

Spokane’s premier active living expo highlighting health and wellness, travel and leisure, and retirement planning for everyone age 55+ and their loved ones.

brought to you by For more information, please contact events@spokesman.com or contact your Multimedia Sales Executive

Solitha (Jacquie) Holloway, MBA, CHS, Manager, Nutrition and Hospitality, MultiCare

H

ow long have you worked here?

6 years

What do you like about where you work?

I love the variety of people I get to interact with daily, from patients and families to staff and health care professionals. I appreciate the collaborative environment and opportunity to work with a diverse group of people. I also get to work with a great team of dedicated food service professionals to create nutritious and delicious meals that meet the dietary needs of our patients to ensure they receive the best possible care. I work closely with our chefs to develop innovative recipes that are healthy and enjoyable.

It’s gratifying to see the positive changes when people are given proper nutritional advice and support knowing I’m helping improve our patient’s quality of life.

I love that I get to help people make positive changes to their health and well-being through nutrition. Working with various people from all walks of life, I get to see the positive impact nutrition can have. I also enjoy the challenge of developing innovative nutrition programs, and initiatives that can help improve patient outcomes. I am passionate about providing the highest quality of food and service to our patients and families, and I strive to ensure that all food is safe, nutritious, and delicious.

How long have you worked in health care?

6 years

Where did you study?

American Military University Why did you want to work in health care?

I have a passion for helping people and positively impacting lives. Health care is one of the most important and rewarding fields to work in, and I am excited to use my skills and knowledge to make a difference. Helping people to live healthier and happier lives is an incredibly noble profession.

What’s something you wish people could know more about your profession?

The complexity of managing a food service operation in a hospital. It is not just about food but also about managing a large staff, ensuring that food is safe and nutritious, and providing high-quality service to patients, staff, and visitors.

It is a challenging job that requires great knowledge and skill in food safety, nutrition, customer service, and financial management. I am responsible for ensuring that the food served meets all nutritional requirements and is of the highest quality. It consists of staying current on the latest nutrition research and trends, as well as developing and implementing nutrition policies and procedures.

Anything else you want readers to know?

I am from St. Vincent and the Grenadines and a retired Air Force veteran. I recently earned my Master’s Degree in Business Administration from American Military University.

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Lauren Drury, Physical Therapist, Shriners Children’s

H

ow long have you worked here?

Since February 2019

What do you like about where you work?

I enjoy helping kids get back to doing all the activities kids should be able to do. No matter their abilities, all kids deserve to be able to play, explore, and learn.

How long have you worked in health care?

Since 2013 Where did you study?

Undergraduate at Eastern Washington University, and graduate school at University of Puget Sound What do you like most about what you do?

I love giving patients the tools they need to improve their health with exercise and specific activities. It empowers patients to make changes in an active way.

Why did you want to work in health care?

I loved learning about muscles and bones, and I am very much a people person. I wanted to do something that interested me and also helped humanity.

What’s something you wish people could know more about your profession?

Physical therapists are not all the same, some have certain specialties, others have different experiences. If you have tried working with one and it did not help, try to find the right fit. They are trained to help you get back to living your life without pain, and if needed, with other adaptations to maximize independence and function.

Anything else you want readers to know?

I tell my patients that physical therapy is physical, not passive: it will only help if you put in the work. I am willing to work as hard as possible for my patients, but they have to also want to help themselves.

Thomas Thompson, Environmental Services Technician Providence Sacred Heart Children’s Hospital

H

ow long have you worked here?

I celebrate 21 years this November. I’ve spent almost all that time working on the pediatric unit.

What do you like about where you work?

I love working for Providence because of the caregivers and the kids. If I can get the kids to smile or laugh, I’ve done my job. Working as an environmental services technician is about much more than cleaning rooms. It’s about making a difference in the lives of our patients.

I love making someone’s day, making them smile, making them laugh. Even when I’m busy cleaning, I’ll take time to do something silly to make a patient laugh. They love my improvisation and funny voices.

How long have you worked in health care?

Nearly 21 years, all with Providence.

Where did you study?

I am a high school graduate who took some college classes, but my path went a different direction. I’m so glad it led me here.

Why did you want to work in health care?

At first, I didn’t think this job would be my cup of tea, but now it’s my cup of hot chocolate. I love it. It’s hard work, but I believe I was guided here for a specific reason, to make a difference.

What’s something you wish people could know more about your profession?

I wish more people knew about the impact EVS makes on people, even just cleaning rooms. There is so much caring, making sure people have a clean room and they feel noticed. No matter what is going on with them, we’re there to help. We truly care about our patients and the work we do to make the hospital safe and comfortable.

Anything else you want readers to know?

My job may seem like simple housekeeping, but it’s so much more. A while back, a child called me the hospital clown and that was a true compliment.

If I made her laugh and smile, and she called me a clown. I’ve done my job.

Chauntell Lieske, executive director of Spokane chapter of National Alliance on Mental Health.

Are we hitting the mental health mark?

Experts say current system needs improvement

By Tracy Damon Marketing Correspondent

O

n paper, the Spokane-Coeur d’Alene region appears to have a decent amount of mental health services (see list at end of this article.’), but those who work in this field say that’s not necessarily the case.

“It looks like there’s a lot, but if you dig down and try to see a counselor, you’re going to hit a wait list,” said Chauntell Lieske, executive director at the National Alliance on Mental Health in Spokane.

“That’s for those of us who have insurance. There’s already a barrier there with the wait list, and now you have to think about what insurance they take and will they even take your insurance.”

NAMI offers support and educational programs for families and individuals living with mental health conditions.

Lieske emphasizes that people who use NAMI’s services are far from alone: everyone who works or volunteers shares similar stories.

“We have three staff and 29 volunteers who all live with a mental health

condition or have a family member living with mental health conditions,” she said.

Even with this support, there are so many varieties of mental illness and circumstances that Lieske says it can still be difficult to effectively help every client.

“I think our systems have really good intentions but there are cracks: when I got into mental health I was like ‘Holy fractured system!’ I can’t figure this out and I’m not in a mental health crisis right now, so how can others figure it out?”

For this reason, Lieske created a new position at NAMI, a “mental health navigator” who is asked to assess the circumstances of each client and connect them to area resources specific to their situation.

Circumstances can include being in trouble with the law, being a minor, financial hardships, and not having insurance. The latter two don’t mean that someone can’t get treatment, but that there are more challenges to find consistent treatment since nonprofit services that provide counseling and other services on a sliding fee basis often have high turnover rates and don’t always pay competitively.

According to the employment website GlassDoor, the estimated total pay for a social worker is around $58,000 per year.

This is the median though, so most social workers come out of college making less, and may also carry student loans.

GlassDoor says the median pay for social workers in Washington is about $64,000 per year.

Along with slightly higher than average wages for social workers, Lieske says the area is actually ahead of other states in terms of some services.

Washington was one of first states to build infrastructure for 988, the suicide and crisis hotline. The Co-Responder program that pairs mental health professionals with first responders to provide intervention and stabilization services to individuals with mental health and substance disorders was started in 2019 and is going strong.

According to a NAMI blog post, 79 percent of almost 5,000 people served by this program in 2022 had an outcome other than going to the hospital or jail.

Another way Spokane is not lagging when it comes to mental health is that we have a healthy number of people attending social work programs at area schools.

Unfortunately, many of those will likely leave the fields since wages for social workers in our area are low and the burnout rate can be high.

“There’s now scientific research of vicarious trauma,” Lieske said.

Vicarious trauma is when counselors or first responders experience stress and anxiety from hearing the traumatic experiences of others.

“Anytime you’re hearing trauma from someone else your brain chemistry changes, kind of like it happened to you,” said Lieske.

The National Institute of Health estimates that 1-5 adults live with a mental illness and 1-3 youth. Lieske blames the high rates in young people partially on the state of the world today along with social media.

“Nothing is wrong with social media per se but there’s online bullying and they’re looking at the Instagram life and comparing themselves to what’s not real,” she said. “They say social media brings people together but it also isolates people.”

That isolation was particularly pronounced during the COVID pandemic, although Lieske doesn’t believe it is the root of the high levels of mental health issues now.

“I think COVID, in its’ COVID-y way, shined a light on things that were already there,” she said.

She experienced this first-hand, being home with two young children. She thought she was fine at first but started experiencing physical signs of anxiety.

“I can’t imagine how the families that don’t have the resources deal with stress.

My family did and it was still scary,” she said.

Which is why Lieske and others in NAMI are working to normalize mental health issues “I think we are talking about it (mental illness) more but at the same time I still think there’s a stigma. There’s still a lot of education to do.”

MENTAL HEALTH SERVICE PROVIDERS IN THE AREA • Eastern State Hospital provides evaluation and inpatient treatment for individuals with serious or longterm mental illness referred to the hospital through a behavioral health organization or the court system. www.dshs.wa.gov/bha/division-state

hospitals/eastern-state-hospital overview • F rontier Behavioral Health is a nonprofit that provides behavioral healthcare and related services to individuals of all ages in collaboration with community partners. fbhwa.org/ • Kootenai Health Behavioral Health specializes in inpatient psychiatric acute care and serves northern Idaho, eastern Washington, and Montana. www.kh.org/behavioral-health/ • Mental Wellness Center of Coeur d’Alene provides outpatient behavioral health treatment to empower individuals of all ages to improve quality of life. www.mentalwellnesscliniccda.com/ • MultiCare Rockwood Clinic Behavioral Health treats children and adults for short-term mental health needs and offers adult, child and family counseling; depression, grief, and loss treatment; and stress and anxiety management.www.multicare.org/ location/multicare-rockwood-mainclinic/behavioral-health/ • National Alliance on Mental Illness (NAMI) Spokane offers education programs, support groups, and advocacy at no cost. namispokane.org/ • National Alliance on Mental Illness (NAMI) Coeur d’Alene offers similar services for North Idaho, including education, support, and advocacy. cdanami.org/ • CHAS Health provides behavioral health services to people of all ages, regardless of income or having health insurance. chas.org/ • Providence Sacred Heart Medical Center psychiatry provides outpatient and short-term inpatient mental health services, including emergency, pediatric, and geriatric care. www.providence.org/locations/wa/ sacred-heart-medical-center/psychiatry In addition, there are many private companies offering mental health care and counseling, including online options.

Brittany Zimmerman, BSN Registered Nurse, MultiCare Valley Hospital - Critical Care Unit

H

ow long have you worked here?

7 years

What do you like about where you work?

That I can come to work every day and love my job. It is rewarding working with a wide variety of people. My unit has an amazing culture uncommon in the Critical Care setting. We work as a team to provide the best care we can to our patients. My Manager and Director are also extremely understanding and supportive in everything I do which reflects on our culture. We also love to joke around, so hearing laughter and seeing smiles on people’s faces is also a huge bonus.

How long have you worked in health care?

I have been a nurse since 2016. I have worked at Deaconess and Valley hospital.

Where did you study?

Eastern Washington University and Washington State University.

What do you like most about what you do?

Watching the healing process, especially when a patient is walking out of our Critical Care Unit. It is so rewarding helping others and working hard to improve patient outcomes. I like making a positive impact on someone’s life.

Why did you want to work in health care?

My dad worked in HR for multiple hospitals after retiring from the military.

I was able to shadow him when I was in middle school and decided nursing might be for me. I wanted to help improve the lives of others any way that I could and something called to me when shadowing nurse practitioners and registered nurses.

I have never once regretted my decision and I think I was put on this earth to help heal others.

What’s something you wish people could know more about your profession?

How rewarding the nursing profession is. I especially love Critical Care. You can see a difference with interventions in as little as minutes. My career allows me to see people in all walks of life, at the highest of highs and the lowest of lows. I truly feel like I make an impact.

Anything else you want readers to know?

Even as a Frontline Nurse you can make a difference. You can be involved in your community, support others, and expand your horizons all while doing bedside nursing. Valley Hospital Critical Care Unit is the best, and I wouldn’t be where I am without the people I work with.

Dawn Nixon-LaCaze, Orthotic Fitter Shriners POPS Department

(Pediatric Orthotic and Prosthetic Services)

H

ow long have you worked here?

8.5 years

What do you like about where you work?

As a patient parent first for many years, I was able to feel first-hand the love and care provided to patients and families. I love knowing I can have a hand in making sure people leave here feeling taken care of and cared for completely. I also know that as the parent of a special needs child my work family always has my back.

How long have you worked in health care?

I have been in various forms of health care for 18 years.

Where did you study?

I am a board-certified Fitter of Orthotics through ABC, The American Board for Certification in Orthotics, Prosthetics and Pedorthics. The majority of my knowledge comes from life experience and on-the-job training.

What do you like most about what you do?

Creating the bond with our patients and families and being a part of their journey is the best part. Watching children with limb loss walk for the first time is pretty special too.

Why did you want to work in health care?

I happened into health care by accident.

It turned out that I had a thirst for knowledge, not for school, and I worked my way up to where I am.

What’s something you wish people could know more about your profession?

There are so many options and possibilities for children with orthopedic needs that we can tap into, and limitations or loss of function are not the end of the road. It is just a journey onto different roads with some amazing views.

Dr. Lisa McGill-Vargas

H

Medical Director, Providence Sacred Heart Children’s Hospital Neonatologist and Neonatal Intensive Care Unit Medical Director. Affiliated physician with Providence employed by Pediatrix Neonatology of Eastern Washington.

ow long have you worked at Providence?

I started working at Providence Sacred Heart Children’s Hospital in 2016 as a Pediatrix Neonatology of Eastern Washington neonatologist.

What do you like about where you work?

The opportunity to work with such a great team. We have phenomenal neonatologists, neonatal nurse practitioners, nurses, respiratory therapists, dieticians, and more. Having such an advanced pediatric surgical team, pediatric cardiology group, maternal fetal medicine program, and other specialties is why so many babies and pregnant

people are transferred here.

Caring for these babies is what I love most. They are some of the strongest patients and what they overcome is amazing.

Providence Sacred Heart Children’s Hospital has the only level 4 neonatal ICU in the area, so we have the technology and expertise to care for some the smallest and sickest babies. It is such an honor to be able to take care of them, see them get better and go home. It is so rewarding.

How long have you worked in health care?

Since 2014. My first position after completing my residency and fellowship

was at the University of Texas Health Science Center conducting research and working at the University NICU, providing neonatal care and teaching medical students, residents and neonatal fellows.

Having a baby in the NICU is really hard for parents. What’s important for our community to know is that we have this amazing resource. In addition to families from Spokane, we take care of babies from Idaho, Montana, and Eastern Washington. Each night these parents Where did you study? go home or to the Ronald McDonald I earned my undergraduate degree from House, leaving their baby and a big piece Walla Walla University, then completed of their heart in the hospital. Our team medical school at Loma Linda University. is aware of the responsibility of taking I did my residency and fellowship care of someone’s fragile baby. We are so training at University of Texas Health grateful for their trust.

Science in San Antonio.

Why did you want to work in health Anything else you want readers to care? know?

I wanted to do something that made The NICU is one part of this incredible a difference. I remember the moment network of services and pediatric I realized I wanted to become a specialties at Providence Sacred Heart neonatologist. It was during my residency Children’s Hospital. I’m so grateful for rotation in the NICU, and I helped a very the legacy we have in this community tiny baby start to breathe in the delivery from the last 20 years. room. I spent eight weeks on that rotation This isn’t just about babies surviving, and got to see that baby grow stronger it’s about helping them thrive. Our and eventually thrive. That is what this team of specialists, across Providence work is all about, doing something that Sacred Heart Children’s Hospital and our has a long-standing impact. pediatric clinics, will do whatever we can to help set these babies up for a long, What’s something you wish people healthy life. I feel thankful that we have could know more about your this team of passionate, caring people. profession?

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Why the Spokane area is unique for health care Convergence of many factors leads to high employment, delivery options

One interesting progarm at Providence is BEST, which teaches parents, families, and caregivers proven ways to influence and promote positive behavior.

By Kate Miner Marketing Correspondent

H

ealth care is one of the fastest-growing industries in the Inland Northwest.

We’ve become a regional hub for health services, with thousands of jobs and a diverse, extensive combination of hospitals, research facilities, labs, schools, and clinics.

It is home to the Washington State University Medical School and a joint venture between the University of Washington and Gonzaga University. Medical professionals provide care throughout Eastern Washington and North Idaho, even Eastern Montana and Northeastern Oregon.

Spokane and Kootenai County have been recognized as top places to live, and a lot of that has to do with health care access. The UW

Medical Center has been ranked as one of the best of its kind, and there are numerous resources to ensure residents receive quality care.

Regional hospitals and medical facilities are well-equipped, and the doctor-to-patient ratio is above the U.S. average.

“Spokane has a highly sophisticated health care network,” says Spokane Regional Health District Health Officer Dr. Francisco Velázquez. “Public health works at that same high level when convening, collaborating, working pro-actively with stakeholders and knowing when we’re needed to engage for the benefit of our community’s well-being.”

The health care industry, however, has been facing significant financial and staffing challenges, which were exacerbated by the COVID-19 pandemic. But there are solid

examples where the future looks encouraging.

An apprenticeship program offered by CHAS Health is a great example of how the community comes together to train future professionals. It’s a unique, earnwhile-you-learn program blending formal education and on-the-job training in a clinical environment.

Partnering with peers within the health care community, such as Providence, plus ESL programs, immigration personnel, and the Community Health Association, CHAS started working with Washington’s Labor and Industries in 2016 to launch its apprenticeship program.

In 2024 CHAS will open a 91,700-square-foot training facility called the CHAS Health Learning Institute, offering telehealth

capabilities for students from rural areas. It also includes a partnership with Eastern Washington University to provide scholarships and tuition reimbursement.

MultiCare, another provider, has identified opportunities to increase efficiency while providing superior care, by embracing technology.

Clinical services are offered virtually and in person and have expanded to include endocrinology and OBGYN. MultiCare Deaconess Hospital has also launched a pilot program incorporating virtual nurses for hospitalized patients. This helps free up in-person care teams.

In 2023 MultiCare became the region’s first hospital to introduce Moxi, a 4-foot, 6-inch selfpropelled robot which performs basic chores traditionally handled by nurses like delivering lab

Courtesy Providence

samples and picking up supplies or medicine.

“Deaconess is incorporating technology and innovative solutions to address nurse staffing shortages,” says Jennifer Graham, Deaconess Hospital’s Nurse Executive.

“Our goal is to allow every nurse to practice at the top of their training. Ultimately, this creates an environment that allows nurses to thrive and do what they love, which is caring for patients.”

Providence is one of the region’s largest health care providers, serving patients across Washington, Montana, Idaho, and Oregon, regardless of ability to pay. In 2022, its total benefit to the Inland Northwest, including investments in strategic partnerships, health research, subsidized health services, and free or discounted care, totaled $189 million.

“Providence plays a vital role in the wellbeing of our community. We have centers of excellence for cardiology, neuroscience, and cancer, and we’re home to the region’s only children’s hospital, with more than 30 pediatric specialties and the area’s only pediatric emergency department,” said Susan Stacey, Providence Chief Executive for the Inland NW. The Providence Center for Congenital Heart Disease was one of the first in the country to be nationally accredited as a comprehensive care center, treating children and adults with congenital heart disease in the Inland Northwest.

The nationally-recognized Providence Adult and Teen Congenital Heart Program (PATCH) was one of the first nationally accredited ACHD programs recognized as an Adult Congenital Heart Association ACHD Comprehensive Care Program.

PATCH serves as the primary center for complex congenital heart disease care and congenital cardiac surgery for Providence, with several satellite clinics.

Kootenai Health is also about supporting the community and promoting the health and well-being of North Idaho -- and beyond— by working with remote medical facilities, providing free medical transportation, and free or low-cost health screenings.

One of these programs, provided through the Lung and Asthma Clinic, is Pulmonary Function Testing led by Dr. Todd Hoopman. Working with other regional medical providers, including cardiologists, cardiothoracic surgeons, and oncologists, PFT arranges state-of-the-art diagnostic services including CT scans, PET scans, bronchoscopy, and polysomnography (sleep studies).

Hoopman saiad the goal is to provide screening to those at risk for lung cancer early enough that treatment can begin before cancer takes hold.

“Health care providers constantly strive to improve our patients’ health and save lives,” Hoopman said. “Lung cancer screening is one of the most important tools we have to improve the lives of at-risk patients. “ Another area of innovation at Kootenai Health is births and OBGYN services.

Last year there were 2,000 births here, and this year, as of early September, it’s already exceeded 2,100. Kim Jorgensen, MBA, BSN, RN, Director of Women’s and Children’s Services, oversees Kootenai Health’s labor and delivery, postpartum, the Neonatal Intensive Care Unit and pediatrics. Brenna McCrummen, MD, Chair of the OB/GYN Department, manages outpatient care.

Kootenai continues to expand outreach to rural areas with certified nurse midwives for delivery, but also comprehensive care to women at any age, from puberty to menopause. Kootenai hopes to find new ways to bridge the distance for emergencies

by offering programs with better access to hospitals. Currently, it utilizes Life Flight for emergency transport in remote areas and offers a hospitality center in Coeur d’Alene, a Ronald McDonald House, for families with NICU babies.

“We provide options for contraception, abnormal bleeding and pain, cervical cancer screening, prenatal care and birth options for low and high-risk pregnancies, sexual and hormonal health, prolapse, and more,” says McCrummen. “We are committed to providing the best care for women in our region by expanding services to areas in need, and making sure access to preventative screenings, prenatal care, and gynecological surgical options remain a priority.”

The Native Project, another collaborative health care leader in the greater Spokane community, provides comprehensive care to anyone—with an emphasis on American Indian health. It accepts most insurances, or offers a sliding scale if needed, and no co-pay with proof of tribal descent.

The Native Project embraces action, education, culture, and spiritual wellness.

Practicing “Sacred Hospitality,” its philosophy has roots in holistic care and promotes drug-free lifestyles. The program offers medical care, chronic disease management, dental, and behavioral health services.

Patient care uses a team-based approach, working with all providers to develop a culturally appropriate plan based on age, gender, ethnicity, and life circumstances.

When describing the Spokane Health District, Health Officer Velázquez explains that innovation is one of SRHD’s core values.

“We are constantly looking for ways to improve our processes, public health policy, and programs to increase equitable communication and healthcare access in our community,” he said.

Examples include the early adoption of wastewater data to track COVID-19 transmission, encouragement of policy changes that include doula support for pregnant mothers, and ongoing efforts with community partners and state government to expand internet access in rural communities.

Each program has a direct impact on equitable access and preparedness focused locally.

The SRHD website (https://srhd.org/) has a wealth of information that can connect the community with general info plus specific reports and surveys, education, community screenings and health fairs, how-to programs, and services.

“An important role of SRHD is to recognize diverse populations, whether that’s race, age, sexual preference, gender identity, or socioeconomic status,” Velázquez said.

“We work directly with those populations through partner organizations and by utilizing community health workers who are part of

the community, know barriers firsthand, and can help health and service providers provide equitable and culturally-appropriate care and communication.”

More Information about Healthy Living in the Spokane region: countyhealthinsights.org/county/spokane/ quality-of-life/ countyhealthinsights.org/county/spokane/ quality-of-life/2022-2/

srhd.org/health-topics/healthy-living/healthequity

CHAS Health offers an innovative heath apprentice program that allows students to learn on the job and in the classroom.

Courtesy CHAS Health

Eric L. Wallace, D.O., Director of Interventional Cardiology, Kootenai Heart Clinics, Kootenai Health

Andie Daisley, Certified Child Life Specialist Providence Sacred Heart Children’s Hospital

H

ow long have you worked Providence?

I started my clinical training here in fall 2016. I officially joined the hospital staff in spring 2018.

What do you like about where you work?

I really love our Child Life team. We’ve been through so much together, and the work can be challenging. It’s a body, mind, and soul thing. It’s also rewarding to work with teams from across the children’s hospital. I primarily work in the pediatric emergency department and am on call in evenings to support other departments. I may go to the pediatric intensive care unit or be there for a sibling visit in the neonatal intensive care unit.

I feel like I get to do every part of Child Life, and interact with a variety of multidisciplinary teams, which is a unique opportunity.

How long have you worked in health care?

Since 2018 when I started as a certified child life specialist.

Where did you study?

I earned my undergraduate degree in human services with a focus on sociology and psychology from Western Washington University. I completed my child life certification as a postbaccalaureate student at Eastern Washington University.

What do you like most about what you do?

Working with children and their families. It is such an honor to be invited into their stories, whether a kid needs stitches in our pediatric emergency department, or a family received a devastating diagnosis. Any of those things can be traumatic to a child or family. I really love the opportunity to hopefully make it an easier experience.

I get to meet people from all over our community. That’s a gift, too.

Why did you want to work in health care?

I was a patient at Providence Sacred Heart Medical Center when I was 5.

Sacred Heart Children’s Hospital hadn’t even been established. It was scary, but there were child life specialists there. I remember coloring in the playroom with child life specialists and getting a stuffed animal that had an IV just like mine.

That experience had an impact, but it wasn’t until after I completed my bachelor’s degree that I really found my calling to work as a child life specialist.

The way all the pieces fell together was amazing.

What’s something you wish people could know more about your profession?

We are here to help families and we have a robust team, especially for the size of our hospital. We are specially trained in child development, coping, and supporting children through trauma and grief. I want families to know that if they walk through our doors, feel empowered to advocate for your child, ask for help when you need it, and know that we are here to support you.

Anything else you want readers to know?

We are here to make the hospital an easier place to be by normalizing experiences and engaging in a child’s No. 1 language, which is play. I am thankful that Providence Sacred Heart Children’s Hospital is here because it is such an important resource. We couldn’t do what we do without the support of our community and the Providence Inland Northwest Foundation.

We’re celebrating the hospital’s 20th birthday this year, and I know we’re here because of our community. I’m excited to see that support continue.

H

ow long have you worked here?

Eight years.

What do you like about where you work?

I was drawn back to this area with my familiarity of the Inland Northwest and desire to live in an outdoor community.

Kootenai Health was a perfect fit.

Although the region has seen tremendous growth, it remains a great place to raise a family.

Professionally, with the growth, we have retained and recruited experienced likeminded colleagues committed to providing the highest level of cardiovascular care. This has led to the development of numerous programs and expansion of services. One of our goals is to offer comprehensive cardiac care close to home.

How long have you worked in health care?

I graduated medical school in 2006 and have been working as a physician for 17 years. I was an EMT for 4 years prior.

Where did you study?

I was born and raised in western Washington and received my undergraduate degree from Eastern Washington University. I attended the Kansas City University of Medicine and Biosciences. I completed my Internal Medicine residency at Wake Forest University, and later served as faculty. I spent five years at the University of Kentucky for general cardiology, interventional cardiology, and a year of specialty training in peripheral and structural heart disease.

What do you like most about what you do?

I remain fascinated with the heart and cardiovascular system. Our specialty has experienced significant technological advancements in the last decade. We can now expand treatment options not

previously available, often minimally invasive. We have witnessed improvement in patient outcomes and improving quality of life.

Cardiology combines preventative care, advanced imaging, and invasive procedures. While I would much rather prevent heart disease, the ability to be there for people in a cardiac emergency remains rewarding.

Why did you want to work in health care?

I began my health care journey as an EMT. I realized that applying knowledge and skills during emergent situations and facilitating getting patients to the hospital was rewarding. My interest in the human body grew and I was encouraged to consider medicine. Once I was exposed to cardiology, I knew it was the right fit.

What’s something you wish people could know more about your profession?

Physicians respond best to patient transparency. If a patient is honest with their beliefs and preferences, we can align treatment options. We understand that occasionally the best treatment plans are complex, difficult, associated with side effects, and can be expensive. While it may be the best treatment on paper, please communicate if something is not going well. Oftentimes “Plan B” may be a suitable alternative if it is something you can stick to and agree with. If we are not open with each other, you may not be receiving the best individualized care possible.

Anything else you want readers to know?

Most physicians and medical facilities strive for excellence. Most people have positive encounters with the medical field during a time of need. Conditions that once had limited options are treatable, often close to home. If you have been neglecting an issue due to past experiences, consider a new evaluation.

Often time, new eyes, or a different office staff can create a different experience, hopefully, a positive one that improves your quality of life.

Amanda Dugger, Youth Cannabis Commercial Tobacco Program Coordinator, Spokane Regional Health District

H

ow long have you worked here?

Almost two years now.

What do you like about where you work?

That my team and I all work together to improve the health and well-being of our community. When one of us needs help or is looking for resources, I know we will be there to offer the support.

How long have you worked in public health?

While I’ve been at SRHD for the last two years, I’ve been in public health for the last 10 years to help prevent substance misuse of commercial tobacco, nicotine, and cannabis.

Substance misuse can affect anyone, from youth to teens and adults.

Where did you study?

The University of Phoenix with a master’s in psychology. I have also received multiple certificates in substance misuse prevention.

What do you like most about what you do?

Working within my community to raise awareness and educate on the effects that tobacco, nicotine, and cannabis can have. I have been invited to high schools and middle schools to share presentations on vaping and cannabis prevention. Some might not realize the serious health effects these substances can have on physical and mental wellbeing, so I take pride in knowing the work I do can encourage others to make healthier lifestyle choices.

Why did you want to work in public health?

I wanted to not only to help prevent substance misuse but also to offer support and resources to those struggling with addiction or working towards recovery. I also wanted to support families who have lost a loved one to substance misuse.

What’s something you wish people could know more about your profession?

People shouldn’t be afraid to ask for help! We are always looking for ways to support and share resources.

If you or someone you know is struggling with substance misuse, help is available. Find resources for treatment, recovery, and support at addictionhelpfinder.org.

Anything else you want readers to know?

Continued collaboration with community partners is vital for spreading awareness and education on substance misuse and prevention.

This spring, we had the opportunity to partner with the Drug Enforcement Administration to host an educational event called “Hidden in Plain Sight.”

It was at multiple high schools in Spokane to educate parents on the effects of teen substance use and how to spot potential signs of misuse. We’re thankful for those we’ve worked with in the past and we look forward to those we’ll work with in the future!

Rumyana Kudeva, DSW, MPH, LICSW, Early Childhood Specialist, Spokane Regional Health District

H

ow long have you worked here?

2.5 years

What do you like about where you work?

My team is made up of incredible, bright, and compassionate public health professionals. I have learned so much from them. I love their passion for strengthening community resilience. They have inspired me to think positively about what is possible and see opportunities where I have previously seen gaps and deficiencies.

I like getting to know the many communities in Spokane for their strengths, resilience, and aspirations for creating a city that’s welcoming to all.

I have met many incredible people who work with families and young children, and I love the opportunity to learn from them and dream big.

How long have you worked in public health?

2.5 years. It’s is a new field for me -- I pivoted from being a Higher Ed Social Work educator during the pandemic.

Where did you study?

I graduated with my Master of Social Work from Sofia University in my home country of Bulgaria, my Doctor of Social Work at the University of Pennsylvania, and recently my Master of Public Health at Eastern Washington University.

Why did you want to work in public health?

As a social worker and mental health provider, I saw that even though people benefit from direct 1:1 services, that is not enough to support their well-being.

Public health is concerned with creating systems, policy, and environmental changes so people can achieve optimal health and live in communities where they feel welcomed and accepted. I want to work toward creating resilient communities where all families feel supported to raise healthy, thriving children. The public health field gave me the opportunity to apply my knowledge and skills about strengthsbased approaches like the Healthy Outcomes from Positive Experiences framework.

What’s something you wish people could know more about your profession?

Public health is more than environmental health or disease and outbreak prevention. At the core is the idea that we have a joint interest and responsibility to create a safe, healthy, equitable community where people can achieve optimal health. Public health is prevention, health promotion, and collaboration with partners, working across sectors to create a resilient community for everyone.

Anything else you want readers to know?

We all have an important role to play in creating a resilient community for families and children to thrive. We may feel overwhelmed or discouraged by the magnitude of the issues we want to address or change. It’s important to work together toward achieving our goals because communities know what they need and what works.

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