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Local Hospitals Aim to Solve Doctor Dilemma

GRAND JUNCTION, Colo. - Living in a rural area has its benefits, but the lack of specialty healthcare can be a struggle for some people living on the Western Slope. One local family is planning on moving to the Front Range because their medical needs can't be met, but local hospitals are devising a multitude of strategies to address this widespread issue.

Two years ago, Scott Dragos' once active lifestyle came to a halt. Scott's wife, Amanda Dragos, said, "it got to the point before we started using the wheelchair that he was falling 10 or more times a day." Scott had gone his entire life without breaking a bone, until the age of 42, when he broke both of his legs and three toes.

Scott's injuries were linked to a rare mitochondrial disease called MERRF, or Myoclonic Epilepsy with Ragged Red Fibers. According to the U.S. National Library of Medicine, MERRF is one of many mitochondrial disorders that affect 1 in every 5,000 people. "It causes seizures, tremors, dementia, loss of muscle tone, drop attacks," said Amanda. But Scott isn't the only one under his roof with health issues, his wife Amanda was initially diagnosed with Lupus and has an undifferentiated connective tissue disease. "Mine causes joint pain, joint swelling, rashes, I take immunosuppressive therapy for that," said Amanda. Immunosuppressive therapy requires a rheumatologist, and Amanda was under the care of one at St. Mary's Medical Center until she left this summer. The couple also recently lost their cardiologist.

The Dragos family isn't alone in their struggle to find specialty care, Sara Rogers has a child with type one diabetes, which means they're in need of a pediatric endocrinologist. "There are diabetes educators here, which are great, but they can't prescribe and manage insulin, a lot of them can't unless they have a higher degree," said Rogers. This means Rogers has to travel to the Barbara Davis Center for Childhood Diabetes in Denver for her sons quarterly appointment, unless they're able to get a telemedicine appointment at St. Mary's or Grand River Health in Rifle.

Roger's isn't the only one having to make that four and a half hour trek through the mountains. The Dragos family makes that trip too often. "The drive back and forth to Denver takes a toll on Scott," said Amanda. Such a toll, that the Dragos family are now re-adjusting their life to serve their medical needs. 

Chris Thomas, CEO of Community Hospital says, "it can be a real inconvenience to have to go to Denver for healthcare." Thomas partially attributes the lack of specialty care in western Colorado to our population size, "there's 150,000 people in the Grand Valley and for some of these subspecialist's, it takes a large population to support that."

That's not the only issue, there's also a shortage of medical specialists across the nation. Dan Prinster, Vice President of Planning and Business Development at St. Mary's said, "the lack of specialty care is something that's been a challenge nationally, and also a more particular challenge for rural areas, like rural western Colorado." But the more specialized the care, the more limited the supply. "These specialized medical programs like rheumatology, endocrinology and others, they're in huge demand and there's not as many students going into that area," said Prinster. St. Mary's has decided to focus on trying to recruit specialists who are interested in the lifestyle we have to offer. "We have a couple selling points in western Colorado, we have our environment, we have the people that want to be outdoors," said Prinster.

Prinster also discussed larger-scale solutions to the issue that rural hospitals when it comes to specialty care. He mentioned that placing satellite campuses of medical schools in rural areas is a proven way to increase the amount of specialists in a community like ours, and that's because it allows medical students to live and get their degree in a rural community, which makes it more likely that those graduates would go on to practice medicine in a rural community.

Another, more immediate, solution is occasionally bringing in specialists from nearby metro areas to treat patients in need. "If you can't recruit a full time specialist, then what we try to do is accommodate a part-time specialist by signing contracts to have them come on a periodic basis," said Prinster. However, the key solution for this issue may be Telemedicine, where hospitals use robots that connect doctors with patients through video chat, which allows them to get the information they need without having to travel. Carmen Shippley, Executive Director of St. Mary's Hospital Foundation said, "it's a lot more cost effective to get something like that set up than trying to recruit a particular specialist that may be incredibly hard to find anywhere in the country." Shippley highlights the advantage of the high-tech camera on the machine, "some of the cameras on this equipment can dial into the pupil on your eye, so there's really very little limitations."

The Telehealth camera and process is something that Rogers and her son are familiar with. "We talk to the doctor over video, go through dosaging, you know, kind of things to work on, things that are going good, and then we get a print out at the end of the day that's like a summary of everything that we've done." But this cutting edge technology has its limits for someone with such a rare condition, leaving Scott with a less than perfect option. For a man whose life has changed so drastically, one thing that remained constant is his family, which motivates him to keep going.


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