Diminishing options – Strained medical practices present challenges

December 2022 Posted in Your Health
The former Family Medical Group of Silverton office now open under Legacy Medical Group – Silverton Family Medicine management. Pictured: Whitney Rumgay (Clinic Manager) and Christina Rosborough (Director Medical Group Primary Care for Legacy Health).

The former Family Medical Group of Silverton office now open under Legacy Medical Group – Silverton Family Medicine management. Pictured: Whitney Rumgay (Clinic Manager) and Christina Rosborough (Director Medical Group Primary Care for Legacy Health).

By Melissa Wagoner

When Kristen Storer received notice that her family’s primary care physician, Dr. Tim Peters, would be retiring early due to staffing shortages at his clinic, Northwest Family Medicine in Silverton, she was dismayed. 

“I kind of panicked because they didn’t give very much notice,” Storer said. 

Reliant on monthly prescriptions for her husband’s ADHD, Storer knew the family would need to find a new doctor fast, but when she began searching for a replacement in Silverton, she came up empty-handed. 

“I put a notice on Silverton Connections asking for recommendations, but every person was filled up,” she said. “So, I called Woodburn and found one.”

Grateful to have found a doctor, Storer was nevertheless dismayed at both the drive now required to see her new doctor as well as the months it will be before she attends her first meet-and-greet appointment.

“I even called a few Keizer places, but they were full,” she said. 

Storer is far from alone, a shortage of primary care providers has been noted across the area as Northwest Family Medicine – opened in 1991 – closes and the Family Medical Group of Silverton restructures under the umbrella Legacy Health. 

“If you’re not affected then you know someone,” Janet Murphy, a patient of Dr. Rob Larson – a practitioner at Northwest Family Medicine prior to its closure – said. “I’ve seen news programs talking about this happening in other places, but you never think it’ll happen to you.”

Suffering from a vision impairment that makes it impossible for her to drive means continuing to see Dr. Larson – now a physician with Kaiser Permanente in Keizer – impossible, a situation Murphy bemoans. 

“He’s a really good doctor,” she said. “And he’s seen me through life and death care.”

Finding a new doctor wasn’t easy. 

“All the doctors around here already had full caseloads,” she said. 

Which means she had to take the next-best thing, a doctor at Legacy Medical Group in Mount Angel. 

“I haven’t met him, but I hear he’s a fine doctor,” Murphy said, admitting that at this point her doctor’s abilities are the least of her worries, instead getting to the clinic is what’s on her mind. 

“I’ve lost my base of security,” she explained. “Because now I’ll have to depend on friends.”

That’s because the Legacy’s Care Van, which is available to transport patients like Murphy to the Legacy clinics in the region, currently only runs two days each week during limited hours. 

“I’ve always made my life in Silverton, and this is the first real issue I’ve had,” Murphy said. She prides herself on her ability to navigate Silverton’s streets on foot. 

Transportation is one of many potential problems the community is facing as the number of primary care physicians dips and the caseloads for those still practicing continues to fill. 

“I’m worried,” Dr. Rodney Orr – a primary care physician for Family Medical Group of Silverton, who recently retired after 43 years – said. “Because it’s a bleak outlook.”

And he’s not just talking about the future for patients, but that of physicians as well. 

“Primary care is a relationship business,” he explained. “But the system doesn’t make it easy for us to give personalized care.”

That was a problem for Orr because the ability to provide that level of care was what brought him to primary care in the first place. 

“It’s a real advantage over seeing someone cold in urgent care,” he explained. “A lot of [my patients] are like family members.”

But over the past several years the business-end of running two clinics – one in Silverton and one in Molalla – became more and more difficult. 

“We couldn’t recruit any new providers,” Orr said. And they couldn’t keep the ones they did have on staff. 

“At our office in Molalla we went from seeing 60 patients to 16 because we lost providers,” he said. 

While some of those staffing issues centered around the COVID vaccine protocols that were put into place in 2021, these were only the tip of the iceberg. The primary reasons behind the clinics’ struggles were far more complex.

“Primary care has been undercompensated for many years,” Orr began, listing hours of paperwork, fighting with insurance companies, significantly lower reimbursements for Medicare and Medicaid patients and higher overhead costs as factors that made running a private clinic not only stressful but also cost-prohibitive. 

It’s all part of what Orr refers to as a “cultural change.”

“Because the real breakdown is medical school, which doesn’t value primary care,” he explained. 

Confronted with “the attitude that the people who can’t make it go into primary care,” as well as the significantly higher income rates of a specialist versus a primary care physician, fewer medical students are opting to make the choice to go into primary care, according to Orr. 

He sees the entire medical school system as one in need of an overhaul.

“Why does a state whose population has increased 20 to 30 percent have a medical school whose population is the same?” he asked. 

It’s a problem, which Orr doesn’t think will be remedied any time soon.

“I’m worried,” he admitted. “Because I have a daughter who wants to go into medicine.”

He’s also worried because he’s leaving primary care, a career about which he was passionate, at a time when the need for more doctors is higher than ever.

“I was ready,” he said of his decision to retire now. “But I’m going to miss the patients tremendously.”

It helps that the clinics themselves won’t be closing, but rather restructuring under the capable direction of his wife, fellow primary care physician, Dr. Shandra Greig, and under the Legacy Health name.

“There is no denying that the last several years have taken a toll on all aspects of our health care system,” Greig said in a press release announcing the transition. 

“When deciding to join Legacy Health, we thought long and hard about what was best for our patients and our staff. We view this partnership with Legacy as a way to deepen our relationship with the community and to give our patients and their families additional levels of health care options.”

While it’s undeniable that these care options are what the community desperately needs, the overarching problem – not enough local primary care physicians – and the myriad of issues that led to that problem remain unchanged. 

“There’s a solution,” Orr said. “But it has to come from the top.”

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