A long-stalled recruitment effort by Southwest Memorial Hospital received a break last month when the federal government designated Montezuma County as a physician-shortage area.

The designation helps attract doctors and specialists to the area by offering them relief on student loans of up to $25,000 per year. In exchange, the doctors agree to set up practice for a minimum of three years.

Such incentive is essential, said Southwest’s CEO Bob Peterson, for expanding the pool of candidates to fill significant gaps in community health coverage.

"This will make a big-time difference in bringing eligible people in that we need," Peterson said. "New docs are getting very savvy, and they look for under-served rural areas so that they can get their schooling loans, typically at $100,000 or more, paid down."

Southwest has been losing patients, and revenue, to nearby hospitals because of the shortage of service providers here, including surgeons.

Peterson said that the opportunities brought on by the Health Physician Shortage Area designation will help bring another obstetrician-gynecologist, primary-care physician and pediatrician to the county, providers sought after for some time.

At times, difficulties in getting an appointment can be severe, especially for new pregnancies, ceasarean section procedures and pediatric care.

"My wife had to go to Durango to get an appointment," complained Randy Smith, a director with the Montezuma County Hospital District. "It is not right when you can’t even use your own local hospital."

Peterson said he has been "feeling the heat" from the community and hospital governing boards to bring doctors aboard, in particular a third surgeon. Without one, Southwest often is forced to go on "surgery divert" because there is not enough staff to cover on-call surgeon shifts 24 hours a day, seven days per week.

Again, revenues leave the area, such as when a patient at the Vista Grande Nursing Home, which is next door to Southwest, recently had to be transported by local ambulance to Mercy Medical Center in Durango.

"It’s been tough," Peterson said. "But we have had some success like a new primary-care doc, Dr. Johnson, has joined Dr. Heyl’s practice."

Unfortunately, the HIPSA designation does not offer loan-repayment benefits to surgeons, said Lindy Nelson, director of the primary-care office under the Colorado Department of Health and Environment.

The program only offers benefits, stipulated by the National Health Service Corp, for nurse practitioners, mid-wives, physician assistants, internal medicine specialists, primary-care physicians, obstetricians, and family practitioners."

Retaining medical students completing their residency requirements at Southwest, typically the last hurdle before graduation, will be improved with HIPSA.

"We lost a good doc that wanted to stay but he was forced to leave and practice in an under-served area because of loans," Peterson said. "With this we are definitely more attractive to the medical profession."

Nelson credited Valley Wide Health Services, a low-cost health-clinic organization, for bringing the needs here to the state health department’s attention.

Valley Wide, based in Alamosa and now in Durango, is also poised to offer a sliding-scale medical-care clinic in Mancos.

"They knew this designation would help them, and we require that request for a study to look into it," Nelson said.

The CDHE conducted a survey of primary-care providers to determine how many Medicaid or no-insurance patients are served locally. That data is then compared against poverty statistics, revealing enough of a gap in care for the poor to qualify the county as a shortage region.

"Your county was designated based on a low-income population," Nelson said.

"The ratio showed that physician patient loads for Medicaid or no-insurance categories was inadequate for that total population."

The March 27 designation fell under the radar screen of hospital officials and board members, who just this month discussed the need for it, unaware it had already happened.

Once awarded, it was quietly added to the list of qualified counties on the CDHE website, and discovered by Mancos-Times Tribune editor Tom Vaughan this week.