IHS doctors will no longer cover hospital


Change goes into effect Aug. 15

Beginning next week, the five doctors at the Indian Health Services clinic in Warm Springs will no longer be assisting patients hospitalized at St. Charles Madras.

Hospital CEO Jeanie Gentry explained that IHS doctors typically only work in IHS facilities — except in Madras. "We were the only place in the country (where IHS doctors were attending patients in a nonIHS hospital)," she said.

St. Charles Madras, formerly Mountain View Hospital, was content with the longtime arrangement, but the IHS was not.

"They've been under increasing pressure from IHS to stop doing that, and (instead) meet the needs of patients in the clinic," said Gentry.

The five doctors who had inpatient privileges at St. Charles Madras, but will no longer be serving patients there are: Dr. Tom Creelman, Dr. Miles Rudd, Dr. Rachel Locker, Dr. Chris Keane, and Dr. Meghan Lelonek.

"Starting Aug. 15, when patients come to the ER and need to be admitted, they won't be seeing those doctors," said Gentry. "They will be seeing one of our doctors from Madras Medical Group or Mosaic."

However, she added, "Dr. Marilyn Waller-Niewold will still come here to do surgeries." Waller-Niewold is chief of podiatry at the Warm Springs clinic.

Dr. Rudd, who has worked at the Warm Springs clinic for the past 19 years, said there were discussions about having doctors stop providing hospital care when he first arrived.

"More intensive efforts toward that really got off the ground about three years ago," he said, primarily because of the impact it has on the doctors' ability to be in the clinic seeing patients.

"Hospital care is pretty intensive, and you can be tied up with one patient for many hours, when in the clinic, you could have seen a dozen patients," said Rudd.

The doctors who will be covering the inpatient care formerly handled by the IHS doctors will be Drs. Gary Plant, Kristine Delamarter and Matt Foster, all of Madras Medical Group, and Drs. Sam Crane and Wendy Grace of Mosaic Medical. Dr. Grace is scheduled to start work at Mosaic Medical on Aug. 19.

The 25-bed hospital averages 10-11 patients in the hospital at any given time, according to Gentry. Five of the 25 beds are for obstetrics.

The five IHS doctors and the five Madras doctors have been meeting regularly to ensure that the transition goes smoothly. "They've looked at the number of patients, and those five doctors are confident that they can handle it," she said.

In addition, St. Charles Health System is actively recruiting more doctors to work at the St. Charles Madras medical clinic — Medical and Surgical Associates.

While the hospital's conversion to electronic medical records on Aug. 26 wasn't a main factor in the change, Rudd said that it created a timeline for them. "It didn't make sense for the Warm Springs physicians to go through all the training," he said.

The Warm Springs clinic has been using an electronic records system since 2004, Rudd said, adding that there was a "learning curve."

By cutting out the travel time to St. Charles Madras, as well as the time actually at the hospital, he anticipates that the clinic doctors will be able to provide more care to more Warm Springs patients.

"In a given day, typically, we'll have 60 or patients come for care," said Rudd. "We actually have more patients wanting appointments than we have appointments to give them."