by Nick Dill, Student Reporter
Until July, Alva will be without a full-time private-practice doctor.
But starting July 13, Dr. Bryce Galbraith, DO, will arrive in Alva. Galbraith specializes in family practice.
The only full-time doctor in town, Dr. Philip Self, has deployed for nine months serving in the Navy in Afghanistan. Self’s office is located in the Professional Building downtown on the Square.
The shortage of doctors in rural communities like Alva is a common problem.
As of December 2018, more than 7,000 areas in the U.S. had health professional shortages, nearly 60% of which were in rural areas, according to npr.org.
Recruiting more doctors is a challenge.
Challenges
“One of the biggest challenges is our location. Being two to three hours from an airport seems to be a big deal,” Kandice Allen, CEO of Share Medical Center, said. “Typically, when we interview a male candidate, it’s not typically about him; it’s usually about the wife. What she’s going to do in her time off? How is she going to be able to spend that? And being in a small rural town like this, it’s a challenge.”
Another main challenge is the competitive job market.
“For every family practice physician that comes out, by the time they leave their residency, they have been offered over 900 positions,” Allen said. “You can imagine what we’re competing for.”
Small town life isn’t for everyone, said Alva Mayor Kelly Parker. The city owns the hospital.
Parker also said it is a challenge to recruit physicians. He said the hospital is established as a public trust to benefit the City of Alva, and visiting providers often praise it for the service it provides in such a remote and rural community.
The lack of doctors makes Share Medical Center limited in what it can do.
“I feel the biggest challenge would be specialties,” said Paige Kruckenberg, a physician assistant at Share Medical Center. “The problem here is you’re not going to get a cardiologist and dermatologist to be here all the time. So really getting people who need those special needs, [the challenge is] getting them to that. The closest thing is usually about an hour away, and if they’re low-income and can’t drive, then that’s a challenge.”
Allen said recruiting is another challenge.
“I don’t think anyone realizes our challenges,” Allen said. “We’re trying. We’ve had a recruiting firm retained for over a year. We’ve been through networking trying to recruit a physician, and it’s a huge challenge.”
Does Alva have enough help?
“I feel, for most basic medical needs, we are medically covered in Alva, at least as well as many towns our size,” Parker said.
Parker said Alva has seven mid-level providers between the hospital clinic, urgent care, emergency room, and Self’s downtown clinic. Self has Steve Madrid, a physician assistant, covering his practice while he is gone.
“Dr. Michael Lawrence serves Alva as chief of staff at Share Medical Center,” Parker said. Parker said Lawrence is in Alva eight days a month and works 24-hour shifts.
Several doctors have practices elsewhere but come to Alva to see patients.
“Dr. Dean Vaughan and Dr. Elizabeth Kinzie work in Alva, serving the nursing homes. Dr. Donald Ransom provides general surgery, and Dr. Chris Hummel offers eye surgery,” Parker said.
Vaughan works in Oklahoma City and specializes in family medicine. Kinzie works in Waynoka and specializes in internal medicine and psychiatry. Hummel works in Oklahoma City and is an ophthalmology specialist. Ransom, who practices in Medicine Lodge, Kansas, specializes in general surgery and does surgery at Share weekly.
Parker said Vaughan and Kinzie are at Share as needed for the nursing home residents.
Kruckenberg said she agrees that there is enough medical care to support the community of Alva.
“There’s three primary care providers: me and two nurse practitioners in our clinic,” Kruckenberg said. “Also, there’s the urgent care, and two providers over there, and the ER. I think with the population of our area … I do think we can provide that primary care easily.”
Kruckenberg said that, as far as family practice goes, Share is “set.” She said she and two others do family practice at the Share clinic.
Flu season is one of the busiest times for PAs, as they’re seeing 15 to 20 patients a day. But during the summer and breaks, it is a lot slower, Kruckenberg said.
As far as providers, Alva is covered, Allen said.
“I feel like we have enough mid-level providers, but some people want to see a doctor,” Allen said.
Allen said Self’s office is still open. Madrid is covering his practice until he gets back, so his patients are taken care of, she said.
What can a PA do without a doctor in town?
“For me as a PA, I can’t write a schedule Ⅱ drug, for example, like a narcotic, but other than that prescriptive authority, we’re free-range,” Kruckenberg said.
Kruckenberg said, as far as physician oversight goes, she does have to have a supervising physician, but they don’t have to be on-site when she does her practice.
“My supervising physician works in an ER, so I rarely see him,” she said. “The big thing that has to happen is that I have to be able to call him if I have a question. I text or call him anytime I’m concerned, like if I don’t know what’s going on or if I need some advice.”
Allen said it is crucial to recruit more doctors.
“The spin-off revenue from every physician that you get is over a million dollars,” Allen said. She said with Self leaving, the difference between physician practice and a mid-level practice is the way they practice. It does impact the bottom line.
Parker said the best way to get good doctors here is to raise them in Alva, send them off for their education, and then bring them back to a community which they are already fond of.
Some benefits with healthcare in Alva occur with the hospital being in a town with a university, Allen said.
Share is a clinical rotation site for Northwestern Oklahoma State University nursing students and for students at Northwest Career Tech. Share hosts LPN clinic rotations, and hires students from those programs.
Parker agrees with Allen and said being in a school community is actually a benefit to the medical center. Allen said she believes the university would say the same about being in a community with a hospital.
An example of this is Kruckenberg. She graduated from NWOSU with a bachelor’s degree in biology and health sciences in 2015, and she earned her PA degree at the University of Oklahoma in Oklahoma City at the Health Sciences Center. She then returned to Alva to work.
“I love my job because I get to help people every day, and just seeing someone get better, and feel better, and seeing them smile is one of the big things for me,” Kruckenberg said.