by Jim Mimiaga
Journal Staff Writer

The Montezuma County Hospital District board appears not to be convinced that recruitment of a pediatrician to the area should be a priority.

Board member Randy Smith called a special meeting Wednesday with local physicians to gather support for bringing a child-care specialist to the area. A lack of available family physicians is a big problem for many families here, Smith said.

Appointments are difficult to get, and many doctors are not accepting any more Medicaid patients. That leaves limited options, often forcing parents with children who need simple antibiotics or stitches to rely on the emergency room, an expensive last resort.

A recent survey by the hospital shows a gap in care for children locally, but the idea for the district board to help find a pediatrician received short shrift. No physicians attended the meeting, and other board members were hesitant to spend money when there are more pressing concerns.

"I think the lack of surgeons at the hospital is a much more scary issue, and needs more of our attention," said board member Fred DeWitt.

Board Chair Susan Keck said that physician-recruitment issues should probably fall into the hands of Southwest Health System, the hospital management company. While there was general agreement that access to child care is a problem, the board suggested its role should be for more "bricks-and-mortar" type projects.

"I’m not against bringing in a pediatrician, but I see other needs like a community clinic in Mancos and the hospital’s expansion project as more pressing right now," said board member Lois Rutledge.

Smith suggested had suggested spending $10,000 to $15,000 on recruiting for a pediatrician, which the board attorney said would be a viable use of the district’s tax dollars, as long as it was done in coordination with SHS and did not involve subsidizing doctor pay or providing incentive bonuses.

In a letter to the board, Dr. Steven Bloink said family practitioners already saturate Cortez and cover children’s needs as best as possible. He believes that there is not enough volume to support a child-care specialist here, and if there were, he or she would be inundated with the critical and chronic-care cases, which typically are referred to larger hospitals at any rate.

"I fear recruitment of a pediatrician to the area would set someone up for failure," Bloink said. "Under the current scenario in Cortez, the pediatric patients are divided up amongst all the family physicians, who basically absorb the loss."

On a related note, Bloink was also critical of SHS efforts to recruit a family practitioner and internist to the region, arguing it was unfair and unethical for the hospital to provide salary guarantees, rent, insurance and moving expenses for the new recruits. The new doctors would not have to pay back the start-up costs if they stay for five years.

He said doctors needing help handling patient loads should take the initiative to attract a partner themselves with guarantees, and "not turn to the hospital for assistance."

"Since when does the hospital have such deep pockets?" asked Bloink.

Referring to a failed medical-office project shot down in 1998 by the county commissioners and community members because of financing risks, he wondered whether "the community will react much differently when they learn of these latest extravagances."

Southwest CEO Bob Peterson responded Friday that despite opposition from local doctors, hospitals must always recruit specialists to cover local medical needs, or risk going out of business.

"What he says is true, but if we still need an internist because we are lacking services there for the community, that is our job — to fulfill primary-care needs for the community," Peterson said.

As far as recruitment for a family doctor, Peterson asserted the action is necessary, explaining that when the patient loads for all family practices in the area are combined, there are still large gaps in overall access to care for the public.

"When you lump them all together, we are still short on pediatricians and obstetricians. That’s why it is important for us to recruit another family physician."