2006-q3-fall-wellaware

SurvivorJenn Lyon Comes Home for Cancer Care

New DirectionsMCMC Meets Industry Challenges Head On

MID-COLUMBIA MEDICAL CENTER Fa l l 2 0 0 6w w w. m c m c . n e t

SurvivorJenn Lyon Comes Home for Cancer Care

New DirectionsMCMC Meets Industry Challenges Head On

Well Aware Fall 06 8/23/06 12:46 PM

Ihave been in healthcare my entire professional life, and I have seen in this industry my share of

passing trends and fundamental shifts in the wayhospitals conduct their business. And I know the difference between the two.

For several months our hospital, our community,and you, the people we serve at Mid-ColumbiaMedical Center, have been experiencing the symptoms of the latter phenomenon. The healthcaremodel we have grown used to over the last severaldecades is changing rapidly and forever.

Time was, when you brought a new primary care doctor to town, you could count on him or her settling in and helping manage the healthcare needs of area families for a long time,often through more than one generation of a family. That’s not the case any more.

I am not suggesting we will never again see a new doctor come to town and complete anentire career here; however, I am saying that will likely be the exception,not the norm. This is not a trend that will soon pass.

Young doctors entering the medical profession generally don’t have the same goals as previous generations of physicians. They look at the long hours primary care physicians put inand the other lifestyle sacrifices required, and they often decide to pursue other specialties.That’s not a judgment; it’s their personal choice. But it has created a shortage of primary care physicians that is dramatically changing the healthcare landscape nationwide.

You will read in this issue of Well Aware the extent to which this is now happening and how it is reshaping the way healthcare is delivered in communities across America. Or atleast it is in progressive communities, whose hospitals and healthcare providers recognize thedifference between a trend and an unalterable reality.

I hope that as you read the following articles pertaining to MCMC’s “New Directions for Changing Times” you will come to understand that the healthcare providers who serve your community have recognized this fundamental change in our industry. I also hope you feelreassured knowing we are addressing these issues with innovative solutions that will ensure youcontinue to have access to the high-quality primary care to which you have grown accustomed.

At MCMC we are very excited about our New Directions; once you read about them yourself,I believe you will share our enthusiasm.

Sincerely,

Duane FrancisPresident/CEO

Dear Neighbor

On the Cover: Jenn LyonPhoto by Jim Semlor


Inside ScoopIt is Our Mission. . .

To lead and act as a catalyst in promoting health for all people.

To recognize the individual as a wholehuman being with different needs that

must be enthusiastically met.

To communicate a vision of health, art,education, technology and create a center for healing which will continually upgrade the quality of life in the community and

environment in which we live.

To empower people to become partners in their health care.

Mid-Columbia Medical Center is a not-for-profithealthcare organization offering comprehensive

services to the Mid-Columbia Region, and is governed by a volunteer Board of Trustees:

Robert L.R. BaileyJorge BarragánPamela ClausenDuane Francis

Gretchen KimseyRobert A. Staver, M.D.

Wallace Wolf, Jr., D.V.M.

Well Aware is published byMid-Columbia Medical Center

1700 East 19th Street The Dalles, OR 97058

(541) 296-7545

All rights reserved. No information may be reprinted without the written consent of MCMC.

(ON THE COVER)

SurvivorJenn Lyon thought competing on Survivor was tough until a cancerdiagnosis drove home the difference between reality TV and reality.

Fall 2006

Photo Credits:Cover, pages 4, 6, 8, 10, 14, 16 & 17 photos by Jim Semlor

Pages 2 & 18 photos by Susan Crowley

New DirectionsInnovative measures are helping MCMC assure access to high-quality care in a dramatically changing medicalenvironment.

Getting ConnectedMedical records go high tech.

Direct HitRepeat MCMC patient, and former footballer,John "David" Johnson gives hospitalist teamcredit for getting him back in the game.

Care When You Need ItIf your doctor can’t see you today, theConvenience Care Clinic staff can.

The Doc FinderTurning up the heat on physician recruitment.

LifeWorks’ New Medical Director

MCHF ‘Chips In’ For Comfort

Mind MattersThe Center for Mind & Body Medicine celebrates adecade of helping people care for themselves.

Just For WomenColumbia River Women’s Clinic welcomes new doctor.

Fall 2006 Lecture Series

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4

Jenn Lyon

thought competing

on Survivor was

tough until a cancer

diagnosis reminded

her of the difference

between reality TV

and reality.

SurJenn Lyon

thought competing

on Survivor was

tough until a cancer

diagnosis reminded

her of the difference

between reality TV

and reality.


5

Stranded on a remote island in the Pacific for 37days, Jennifer Lyon endured all manner of abuse

to her system, her senses and her sensibilities.She lived on rice and whatever could be coaxed

from the sea with crude fishing gear. At night she slepton a makeshift bed, soft as a picnic table, under aprimitive lean-to. She fought through a series of challenges that tested her physical abilities and mentalwill, and she lived in constant fear of being stabbed inthe back by a fellow castaway.

Had someone told “Jenn” that, even after survivingall of that and more, an even bigger challenge soonawaited her, she would have bet an Immunity Idol thatsomeone was off their rocker.

And then there she was last October, back home inThe Dalles, starting chemotherapy at Celilo CancerCenter. Just one year earlier Jenn had been depositedon the island of Palau for the filming of CBS TV’s realityshow phenomenon, Survivor. By the end ofher stay, after she had outwitted, outplayed

and outlasted all but three of her island mates, Jennfound it impossible to imagine going through anythingmore difficult. Now she could.

Jenn wasn’t born in The Dalles — Larry and JaneLyon moved Jenn and her brother Mark here fromNevada when she was 11 — but this was home from thetime she entered fifth grade at Dry Hollow ElementarySchool to the day she left for Portland State University.

Before graduating from The Dalles High School in1990, Jenn made her mark as a three-sport athlete,playing basketball, track and soccer (continuing the lat-ter in college). She went from PSU to Western Oregon,then on to Oregon State, where she earned her degreein food and nutrition.

The plan was to start doing some nutritional counseling and eventually get to work on a master’sdegree. But that got waylaid when Jenn was offered ajob as a nanny for an American family living in London.

In high school, she had spent a year in Spain as aforeign exchange student, and she jumped at the opportunity to return to Europe.

Two years later she was back in the states,settling in the Los Angeles area.

“After growing up in a small town, I decided to go to the big city,” Jenn says. “So I was living in Venice Beach and doing some nutrition counseling.My cousin is a wedding photographer, and I love photography, so I assisted her for a while.”

She also got some work as an extra on film sets,and was even cast in a music video. But Jenn stillaspired to a career in the nutrition industry. In fact,she had returned to school and was working on hermaster’s degree when the talent scout walked up toher during a workout in a local gym.

“He was actually casting for The Amazing Race(another CBS reality show), but they already had theirblonde,” Jenn says smiling. “He suggested I try out forSurvivor instead.”

And so it was that, after putting off the secondyear of her graduate work; after sitting through severalinterviews and photo sessions; after making the finalcut of 50 and being sequestered for a week in an L.A.hotel while the show’s producers watched and madenotes of her actions and interactions with other candidates; after being told, “Sorry we’re going another direction,” then being told, “No wait, that’s a mistake, you made it;” after enduring all that,now Jenn was being told that a sweat suit wasn’tgoing to work for the boat ride.

“They gave us a list of suggested clothing to packfor the show, but they told us how they wanted us todress for the flight and the boat trip to the island,”Jenn says. “They told us to wear whatever we’d mostlikely have on at work or on a regular daily basis. Theywanted viewers to get an idea who we were.”

(For the uninitiated, the first episode of the seasonfeatures cast members traveling by boat to their

rvivorby Dick Baltus

(Continued on page 6)


6

unknown destination, dressed in streetattire. The competition begins with the cast diving off the boatand swimming to shore, fully clothed.)

When Jenn told the producers she’d most likely befound in sweats, they decided the show didn’t need tobe that realistic. “They said they’d rather I wear amini-skirt,” Jenn says.

Jenn, her wet mini-skirt and small bag of personalitems landed on Palau on Oct. 27, 2004. Shortly beforeshe left, Jenn had felt something strange in her rightbreast. It didn’t feel normal, but neither did it feel likethe small pea she had heard could be the early sign ofcancer. It felt more like “several small rocks strungtogether.” After doing an Internet search Jenn con-vinced herself it was scar tissue that had developedafter she got saline implants several years earlier.Uninsured at the time, Jenn elected not to follow upimmediately with a physician.

Feeling healthy as ever, Jenn landed on Palaueager to enjoy what, in many ways, would be one ofthe worst experiences of her life — one she says shewould repeat in a heartbeat.

“I would absolutely do it again,” she says.“It was really hard, but it was the best, most excitingadventure I have ever had. Not knowing what wasgoing to happen from one minute to the next; gettingto know people and trying to figure out the beststrategies to stay alive; testing your limits physically and mentally…it was very tough to get through, but I loved living life that way.”

Jenn’s game plan was to lie low and not draw too much attention to herself in the early going,befriending as many people as possible and trying notto alienate anyone. It was a sound strategy that kept heron the island all the way to the final four, but kept her off

the TV screen for much of the early part of the show.But as one after another cast member met their

fate at Tribal Council, Jenn, who performed well at thephysical challenges and managed not to make anenemy, emerged as a threat to go all the way. Herdemise finally came two days from the end of filming,when she lost a tiebreaking fire-starting contest.

The show was filmed between October andDecember 2004, and Jenn couldn’t tell a soul what shehad been up to until “Survivor Palau” began airing inFebruary 2005. When the final episode aired in May,with Tom, the firefighter from New York, claiming the $1 million first prize, Jenn and her fellow castmembers performed a tribal tradition that dates backto the start of the series.

“Once the finale happens, everyone runs out andgets an agent,” she says. “Because you’re only goingto be hot for a short period of time.”

Jenn accepted a few small offers — like a specialfor the E network — and turned down a major one —an invitation from Playboy magazine — before gettingready to settle back into her former life. That’s aboutthe time she felt another lump in her breast, a yearafter she had discovered the first.

“This time I felt one lump right in the center of my breast, and another in my right armpit,” sheremembers.

Jenn visited an L.A. surgeon who rather unceremoniously announced she was almost certainthe lumps were breast cancer. A mammogram,ultrasound and biopsy confirmed Jenn’s worst fears —stage III breast cancer.

She had a modified, radical bilateral mastectomyon Aug. 29 at Cedars-Sinai Medical Center in L.A. But,for her follow-up chemotherapy and radiation therapy,Jenn was coming home.

“The acupuncturist helped me deal

with hot flashes and other symptoms of

radiation treatment. I got massages while

I was waiting for my treatment. It all

helped immensely. Considering how

stressful a cancer diagnosis is, Celilo made

the whole experience pretty relaxing.”

Survivor (Continued from page 5)


7

“Around this same time, my brother Mark’s wifeJamie was being treated at Celilo for brain cancer,”Jenn says. “I’d visited her there and knew what a wonderful place it was. I thought it was amazing tohave all those resources in a single place, and in mysmall hometown. It was so progressive. There are certainly lots of cancer resources in the L.A. area, butthey’re spread out all over the place.”

Jenn started chemotherapy in October 2005;Coby Archa, the Texas hairdresser who was part of herSurvivor tribe, accompanied her to Celilo the day of herfirst treatment. Chemo treatment ended last January;radiation therapy followed from February to April.

During her repeated visits to Celilo Jenn availedherself of the center’s complete array of complementarytherapies, which include massage therapy, acupuncture,yoga, stress management classes and t’ai chi. “I think Iused everything,” she says. “The acupuncturist helpedme deal with hot flashes and other symptoms of radia-tion treatment. I got massages while I was waiting formy treatment. It all helped immensely. Considering howstressful a cancer diagnosis is, Celilo made the wholeexperience pretty relaxing.”

Prior to coming back to The Dalles, Jenn hadtalked by phone with Keith Stelzer, M.D., Ph.D., Celilo’s

medical director of radiation oncology. “He wanted toknow everything that I was concerned about, and bythe time I got up there he had pulled together a wholepacket of information for me to read. I was reallyimpressed by how knowledgeable and thoughtful thephysicians are.”

Jenn says she still has name and face recognitionfrom Survivor and she has been hard at work usingthat as a platform to spread a message about cancerawareness. “I’m taking advantage of every opportunityI get to speak to women about this disease,” she says.

There were times during treatment when Jennwondered if she would ever return to her old selfagain. But, she says, she’s back now. All the way.

“I feel like I’m ready to go back on Survivor again. In a weird way I feel sort of lucky to have gotten cancer at such a young age. It’s hard to explain,and I certainly wouldn’t wish it on anyone. But inmany ways it has been an amazing experience. Itmakes you value every day, and it sure makes youappreciate the people in your life and the thingsyou’ve always taken for granted. You emerge at theend feeling truly changed, but changed for the better,and that’s a gift.”

Though one in seven women will develop breast cancer, survival ratesincrease dramatically when the disease is detected in its earliest stages.

That alone should provide enough incentive to encourage you to make sureyou have regular mammograms, but if you need a little extra motivation,here it is. Every woman who has a mammogram at MCMC throughNovember 24 will be eligible to win a free KitchenAide® mixer. It's justour way of rewarding you for taking the time to do something really important for yourself.

The National Cancer Institute, the American Cancer Society and the AmericanCollege of Radiology all recommend annual mammograms for women over 40.

Schedule your mammogram today by calling Mammography Services: 541.298.4000

are you due for a mammogram?

October is Breast Cancer Awareness Month


As in communities all over the United States, the Mid-Columbia region is struggling to attract and keep

enough doctors to provide the first line of care to a growingpopulation of patients.

“The United States is in the midst of a healthcare crisisthat is expected to worsen over the next several years,” accordingto a report this spring by the American College of Physicians.

The facts are startling:• 21 percent of doctors who were certified to practice

internal medicine in the early 1990s have left the practice.

• Only 20 percent of physicians in the last year of medicalresidency programs say they plan to practice internalmedicine, a decline of 63 percent in the last seven years.

• The Council on Graduate Medical Education forecasts ashortage of at least 65,000 physicians — and possibly asmany as 150,000 — by the year 2020.

• By 2020, internal medicine doctors will spend 25 percentmore time — about 40 percent of total time — withpatients age 65 and above.People in The Dalles aren’t immune to the effects of these

changes.

“We’ve lost five internists in the last eight months,” saysTom Nichol, M.D. “People moved on for various reasons.”

Lifestyle choices drove several of those departures. In particular, physicians want predictable, regular hours. Many are even choosing to work part time, so they can have moretime for other personal interests.

Under the traditional model of care, a physician would see patients in the office, and also when they went into thehospital. Typically, a doctor would respond to urgent needs oftheir hospitalized patients during the day. After hours, however,they would share that duty with other doctors. The greater thepool of doctors, the less frequent any individual doctor wouldhave to wear a beeper that might yank them out of bed at 3 a.m. to attend to a patient in the hospital.

All that is changing. A dwindling pool of internists hasincreased the frequency of “call” duty for those who remain,and that has boosted disruptions to office hours and personaltime. More disruptions equals higher stress equals greater pressure to consider professional change.

“No way they’re taking call every other night,” is howlocal internist Gretchen Blair, M.D., summed up the attitude of an increasing number of physicians.

In response to this situation, Mid-Columbia Medical Center

New DirectionsInnovative measures are helping MCMC assure access to high-quality care in a dramatically changing medical environment.

8

by StuWatson

Gretchen Blair, M.D., (left)

is one of MCMC’s new

hospital-based physicians.


NEW

FOR CHANGING

Medical records are like a road map to a foreign country. Without them,doctors wouldn’t know where the patient had been, where their health

currently stood, and where they might go next to reach a healthy destination.Providing quick and universal access to the most current information about a

patient is a key component to Mid-Columbia Medical Center’s continuing efforts toimprove efficiency — and patient care.

Electronic records are the solution, and MCMC is on track to link all its caregivers — inside and outside the hospital — to the same electronic files.

The offices of internal medicine doctors are the first to get the new NextGenelectronic medical records system.

Kathy Johnson, director of business services for MCMC, says the system will be installed and introduced to the offices of family practice physicians this fall.

“Once all the doctors are on it, we’ll be implementing it in the hospital,”Johnson says. “We want to give physicians electronic records that can be accessedfrom the hospital. That way, if one of their patients shows up in the Emergency Room,for example, the physician would have their medications list, and would know whattook place at their last office visit.”

The goal is to eliminate paper charts, and speed communication.When a doctor orders lab tests, to offer another illustration, the order will be

communicated electronically, and the results will come back the same way.Doctors who now have the system in their offices can enter or access

information at desktop personal computers, or by using a portable wireless tablet. Thetablet now is the only way for a physician making hospital rounds to access recordselectronically.

“The tablet is about the same dimensions as a sheet of paper,” Johnson says. “The doctors can enter material in writing, type it in or use templates.”

Hospital officials expect the system, once fully installed, to reduce errors, improvephysician efficiency and ensure that a patient’s treatment continues on course fromthe off-site office through the hospital stay.

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and its affiliated physician practiceshave adopted several innovationsintended to ensure that everyonegets the care they need (see pages 9-13 for more information):

• Creation of hospitalist teams to provide all hospital care topatients admitted by internalmedicine doctors. This freesinternal medicine doctors fromworking on call, and lets themfocus on patients in the officesetting.

• Creation of a “ConvenienceCare Clinic” to serve pressingcare needs of patients whohave no regular doctor, or whocan’t find time on their doctor’sschedule.

• Hiring of a full-time physicianrecruiter to focus on hiringphysicians both for the hospitalistteams, and to assume care ofpatients in the office setting.

• Adoption of an advanced electronic medical records system that, when fully implemented, will link everyoneproviding care — in the doctor’soffice or in the hospital — to full and current informationabout each patient.“This is an effort to minimize

turnover,” says Tom Hodge, M.D.,medical director of the Mid-Columbia Medical Group, which provides business services to themajority of internal medicine andfamily practice physicians in TheDalles. “We’re being responsive toa changing healthcare model.”

GettingConnectedMCMC’s new electronic medical records system provides an important and efficient link between providers and the patients in their care.


Battling offensive linemen for legendary University ofAlabama football coach Bear Bryant was nothing

compared to John “David” Johnson’s 21-year battle against a host of serious medical issues.

Given his druthers, Johnson would prefer to trade helmetshots for the days and weeks he has spent in hospital care fora ruptured appendix, Crohn’s disease, pancreatitis, gall bladdersurgery, kidney stones, colon cancer and six bowel resections.

Johnson, 47, of The Dalles, sees huge parallels betweenplaying on two national championship football teams in the1970s, and working with the team at Mid-Columbia MedicalCenter.

“Thank God for the doctors and medical professionals,”he says. “They keep me in the game.”

These days, the “game” includes coaching junior and senior high school football and basketball, plus the AmericanLegion Hustlers.

For the game of life, Johnson credits the medical teamwith pulling his bacon out of the fire on numerous occasions,particularly last March after a Crohn’s episode forced admission to the hospital.

“I honestly think Dr. (Tom) Nichol saved my life,”Johnson says.

Johnson knows something about healthcare, from bothsides of the bed. A late uncle was chief of staff at theUniversity of Utah hospital, and Johnson’s stepfather is a pediatrician. Johnson trained as a medic in the Army, andworked as a certified nurse’s aide after the service.

“It gave me a lot more empathy,” he says. “If you’ve beenin a hospital bed for two or three months, it’s easier to relate.”

After his appendix blew during his junior year at Alabama,he spent six months in the hospital. Years later, after a move to Phoenix, a trip to the emergency room led to the diagnosisof his Crohn’s disease, a chronic condition that leads to inflammation of the digestive tract and other complications.

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Repeat MCMC patient, and formerfootballer, John "David" Johnsongives hospitalist team credit forgetting him back in the game.

by Stu Watson

Direct HitDirect HitWell Aware Fall 06 8/23/06 12:47 PM

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He says his physical conditioning and medicalknowledge helped him defy predictions that he wouldn’tlive beyond five years. It also helped him find goodphysicians in Phoenix and in The Dalles after movingnorth with his wife, Kami, and six children in 1995.

Johnson’s experience mirrors that of many internalmedicine patients in the Mid-Columbia community.He has seen doctors come and doctors go. The recentdeparture of several internal medicine doctors has putthe squeeze on those who remain.

After his last physician left, Johnson found himselfwithout a doctor — for about five months.

A trip to the hospital introduced him to his currentinternist, Kimya Nguyen, M.D., who helped provide treatment as part of the hospital’s trial during the lastyear of the hospitalist staffing model.

Hospitalists are internal medicine doctors who provide care to patients in the hospital. During the trial,local internal medicine doctors would spend a week at a time working primarily with hospital patients.

“The first time I met Dr. Nguyen, I was in the hospitalfor an infection in my face,” Johnson recalls. “She wasvery friendly, very knowledgeable, and I felt good aboutthat fact that she was the doctor caring for me.”

Johnson understands why, effective Sept. 1,Mid-Columbia Medical Center will shift all care of internal medicine admissions to a team of six hospitalists. Longtime local internists Tom Nichol, M.D.,and Gretchen Blair, M.D., will head the team.

According to the American College of Physicians,the number of new physicians choosing to specialize ininternal medicine has declined by 67 percent over thelast seven years. At the same time, the number of newphysicians choosing to work as hospitalists hasincreased by 200 percent.

“The hospitalist is doing shift work,” says TomHodge, M.D., Mid-Columbia Medical Group medicaldirector. “We’re better able to recruit to that.”

Translation: Hospitalists work fixed hours, and donot have to wear a beeper or serve on-call one or moredays (and nights) a week. So far, MCMC has found iteasier to recruit hospitalists than internal medicine physicians for its outpatient clinics.

MCMC has hired three hospitalists to join the team.Two other physicians have both expressed strong interest in the last hospitalist position.

By staffing MCMC 24/7 with hospitalists, Dr. Nicholsays, outpatient internal medicine doctors will no longerhave to share on-call duties. That should aid recruitingefforts. After the change, those doctors can focus onoffice patients, without interruptions.

“To provide good care, we need office-based doctors to be in the office every day and not be overburdened,” Dr. Nichol says. “I’m convinced that this is going to lead to better care.”

Dr. Nguyen has seen the benefit of the hospitalistmodel to her outpatient practice. “When I have a sickpatient in the (critical care) unit, I can spend hours in thehospital,” she says. “Having hospitalists is very helpful; Idon’t have to leave my practice to take care of patientsin the hospital, because the hospitalists can do that.”

For patients, going from their own doctor into thecare of a hospitalist can be a little disconcerting.Johnson recalls wishing his internist had been able tocontinue his care in the hospital. “If you feel good aboutthe doctor, and they know you, you don’t question thecare,” he says.

But Dr. Nguyen and others serving as hospitalistsput his concerns to rest. “As a patient, I felt all my needswere met,” Johnson says. “At no time did I have to waitfor things to happen. Everything was done in a timelyand professional manner.”

Johnson appreciated the speed with which an on-site physician could respond to his needs, adjustmedication, communicate with staff. “I had a goodsense that things were moving smoothly from one doctor to another,” he says.

Dr. Nguyen, who had been hired as a hospitalist,chose late last year to set up her own practice.Based on what Johnson had seen of her care, he waseager to have Nguyen take him on as a patient.

“I would tell anyone that being in the careof a hospitalist is a good experience,” Johnson says.“If not for the hospitalist program, I would never have met Dr. Nguyen.”

NEW

FOR CHANGING

“I would tell anyone that being in the care of a hospitalist is a good experience.”


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When you need a physician — whether you’ve got a doctor,or not — we’ve got you covered.

As Mid-Columbia Medical Center and its affiliated clinicsrespond to changing times, the organization remains committed toproviding quality care, when you need it.

If you or a family member is feeling sick or needs help with achronic condition, you’ve got a couple options.

First, if you have a regular doctor, call their office. If you don’thave a regular doctor, call us at 541-296-9151 and we’ll findsomeone who can see you.

If your own doctor can’t see you, we’ll try to get you in to seeanother doctor in the same practice.

If that’s not possible, we’ll refer you to the Convenience CareClinic at 1815 E. 19th St. in The Dalles.

MCMC set up the clinic in February to handle pressing needsthat don’t require a visit to the Emergency Room at MCMC.

Two physicians and a nurse practitioner share the care ofpatients at the Convenience Care Clinic. Sonia Schuemann, M.D.trained in family practice, sees patients two days a week.Stephanie O’Connor, a nurse practitioner, also works two days.Stephen McLennon, M.D., a family practice physician, staffs theclinic on Fridays.

If you are referred to the clinic, you will be advised to show up between 10 a.m. and 2 p.m., or 3 and 6 p.m.

“The important thing to remember is that you’ll need to call one of our offices first,” says Kim Boothe, director of familypractice for the Mid-Columbia Medical Group. “You can’t just walk in to the clinic; you need to be referred, so they know you’recoming.”

But Boothe says the clinic ensures that if you need to see adoctor that day, you’ll see a doctor … that day.

“It’s been working awesome,” she says. “Concerns aboutaccess to care have definitely declined.”

CareWhen

You Need It

If your doctor

can’t see you today,

the Convenience

Care Clinic staff can.

NEW

FOR CHANGING


Everybody thinks their job is tough, but Mary Weerts

may have one of the toughest inmedicine these days. Since joiningMid-Columbia Medical Center inFebruary, she has lived front andcenter in the middle of the intensenational battle to find and hire internal medicine physicians.

“It’s getting very difficult to findinternal medicine doctors and familypractitioners, all over the country”says Weerts.

The American College ofPhysicians, which represents 119,000internists, annually surveys third-yearmedical school residents about theircareer plans. Since 1998, responseshave shown a 63 percent decline inthe number of physicians who planto practice internal medicine. At thesame time, the U.S. Census predictsan increase in the number of peopleover age 65 from 38 million today to55 million in the year 2020.

Do the math: 17 million morepatients, fewer physicians. The ACPcalls it a “crisis.”

In the old days, a physicianwould set up a practice, then shareresponsibility with other internistsfor care of patients who had beenadmitted to the hospital. The stressof trying to manage care for patientsin an office, and in a hospital, hastaken its toll. More than one-fifth ofboard-certified internal medicinephysicians have left the field sincethe early 1990s.

At the same time, new physi-cians are choosing other specialties.

Money is one reason; the averagestudent debt for new physiciansexceeds $100,000.

Lifestyle choices also drive decisions.

New physicians want to workflexible schedules, or part-time.

New physicians want fixed hours and normal family lives,minus the disruption and stress of“call” rotations.

New physicians willingly relocateto pursue new career opportunities.

After the departures of severalinternists in the last couple of years,MCMC knew it needed to put a full-court press on the physician-hiringfront. Enter Mary Weerts.

Weerts is cheerfully optimisticabout the community’s ability to lurenew internists.

“MCMC and Celilo have specialand unique niches,” she says.“It’s a beautiful area, with a greatlifestyle. We have progressive technology.

“Once recruits get to visit the hospital and meet the physicians,they want to work here.”

Finding interested prospects is the challenge. “It’s like finding a needle in a haystack,” she says.“They’re in such demand throughout the country.”

Weerts says physicians often fallinto two major groups: Big-city docs,and small-town docs. The physicianmay be interested, but also has toconvince their spouse that a move to The Dalles will fit their needs — personally and professionally.

“As far as incentives and pay,we’re on target and higher in somecases, and living is very affordablehere. They can afford a home fortheir family, and still have money topay back their student loans.”

Weerts has helped hire threenew internists to work in MCMC’shospitalist program.

“They could have gone anywhere in the country, and theychose to come here,” she says.

And she has two key candidateswho could join the community bythe end of the year, or early 2007.

In the mean time, the hospital isemploying what are called “locumtenens” — temporary doctors — to help see patients in the officesmanaged by the Mid-ColumbiaMedical Group.

The Doc FinderNew physician recruiter tackles the increasingly tough job of finding internists wanting to practice in small communities like The Dalles.

13

by Stu Watson


14

New Medical DirectorLifeWorks Comfort Care Team Welcomes

William Hamilton, M.D., hasassumed the role of medical

director of LifeWorks Comfort Care,a palliative care program at Mid-Columbia Medical Center. Dr. Hamiltonopened his practice, Mid-ColumbiaSurgical Specialists, in The Dalles in1987.

“Dr. Hamilton has played an integral role in The Dalles medicalcommunity for many years. Therespect and compassion he brings to this position will truly elevate this program to the next level,” says Annie Soper, R.N., LifeWorks director.

LifeWorks is a palliative care program designed to support anyonewith a non-curative condition as theystrive to live the best quality of lifethrough all their remaining days.Palliative care is defined as “relievingor soothing the symptoms of a diseaseor disorder without effecting a cure.”

“LifeWorks is such an importantprogram for this community,” says Dr.Hamilton.“It is vital that we have systemsin place to care for our families andloved ones when someone is diagnosedwith a condition that is not curable.”

LifeWorks is a team approach to working with patients and theirfamilies, under the direction of theirprimary care physician, to personalize,humanize and demystify the processesinvolved in symptom managementand complex end-of-life issues. TheLifeWorks team considers the wholeperson and addresses their emotional,psychological, spiritual and socialneeds in addition to their physicalneeds when mutually determining acare plan.

“We need to be able to educateour patients and their families to allthe resources and services that areavailable to them and provide themstraightforward access to theseresources.” adds Dr. Hamilton. “I want patients and their families tofeel empowered to make their own choices regarding how they choose to live and remain comfortablethroughout all their days.”

For more information about theLifeWorks Comfort Care program atMid-Columbia Medical Center, pleasecall 541-298-7925 or visitwww.mcmc.net.

“It is vital

that we have

systems in

place to care

for our families

and loved ones

when someone

is diagnosed

with a condition

that is not

curable.”

by Karen Knoll


15

Mid-Columbia Health Foundation

‘Chips In’ For Comfort

The sun was just peeking over the horizon as thefirst wave of golfers arrived at The Dalles Country

Club on the morning of Tuesday, June 13 for the 21stAnnual Mid-Columbia Health Foundation Golf Benefit.

“Mother Nature had comfort in mind when sheblessed us with this glorious day,” said Anne Copper,project coordinator for the Foundation. “We are sopleased to be able to support the LifeWorks ComfortCare program, once again, through this fun event.”

Throughout the day, 36 teams, 144 golfers, over 40businesses from throughout Oregon and SW Washingtonand more than 40 volunteers all pitched, putted anddrove toward the same goal, to raise funds for theLifeWorks Comfort Care program at Mid-ColumbiaMedical Center.

LifeWorks began as a vision in 2004, came tofruition in April 2005 and continues today to providecomfort for so many throughout the Mid-Columbiaregion. LifeWorks is a palliative care program designed to support anyone with a non-curative condition as theystrive to live the best quality of life through all their

remaining days. The LifeWorks program was developedby Mid-Columbia Medical Center as the next logical step in the healing process beyond the services that have previously been available in this region.

“Through the generosity of everyone here today,”said Celeste Hill-Thomas, executive director, “The Mid-Columbia Health Foundation will be able to give morethan $27,000 to help the LifeWorks team continue to dothe amazing things they do for so many members of ourcommunity who need their services.”

Although the first place award went to the Oil CanHenry’s team, the real winners of this tournament arethe patients of LifeWorks.

Thank you to all who made this tournament a success!

For more information on how you can partner withthe Mid-Columbia Health Foundation to “make a healthydifference” in our community, please call 541-296-7275or visit us at www.mcmc.net.


16

Like ripe fruit hanging from a tree, the treasure ofgood health draws nutrients from deep and

diverse roots, broad and soaring branches.As The Center for Mind & Body Medicine turns the

corner into its second decade, its directors hope toexpand public awareness of the many paths that lead tothe singular destination of optimal health.

In a nutshell, the center brings an array of comple-mentary disciplines to the treatment and prevention ofhealth problems. Those therapies include nutrition andfitness education, acupuncture, breath work, massage,

meditation, aromatherapy, support groups, t'ai chi and yoga.

Founded 10 years ago, the center reflected a vision tooffer “integrative type therapies to take care of the wholeperson,” says Barbara Robison, director of the center.

Since then, the center has become a valued partner to the community’s traditional and integrativemedical care.

“When people finally get to us, they’re sick and tiredof being sick and tired,” Robison says. “They’ve hadsome big wakeup call, and they want to change things.”

Mindatters

The Center for Mind & Body Medicine celebrates a decade of helping people care for themselves.

by Stu Watson


The center’s staff works to treat more than just the immediate physical problem. It works to lift the emotional, spiritual, intellectual and attitudinal barriersthat can impede someone from taking a more active role in their own recovery and wellness.

Jeanette Paysse, M.D., an internal medicine physicianand medical director at the center, brings a personal passion and sweeping view of health care to her work.She loves to ski and bike. She studies yoga. She has modified her own diet to eliminate meat, refined sugarand processed food.

“When I take care of myself, I’m healthier all around,emotionally and physically,” Dr. Paysse says. “So when Itell patients, ‘Watch what you eat; take care of your anxietywithout medications,’ I’m speaking from experience.”

During a previous solo practice in Steamboat Springs,Colo., she made friends with a naturopathic physician.The two often shared patients, and privately Dr. Paysselearned a lot about nutrition, and natural supplementsthat help tackle the underlying causes of chronic diseases.

“It had an amazing and profound effect on the way I looked at medicine,” she says.

The experience energized her passion for healing inthe broadest sense of the word. Trained in traditional

western medicine — what is also called allopathic medicine — Dr. Paysse brought to her medical practiceand work with the center a desire to help people “makebetter choices to make themselves healthier.”

She says allopathic medicine focuses on diagnosisand medications. “Allopathic medicine doesn’t alwaysemphasize the importance of taking personal responsibilityfor ones own health,” she says. That’s why she finds timewith each of her patients to educate them a bit aboutnutrition, stress reduction and exercise.

She understands, however, that many physicianshave less time to provide such counsel than they mightlike. It’s why she appreciates the complementary value of The Center for Mind & Body Medicine.

“The center is a resource, absolutely,” she says.“I refer patients over here for so many things.”

A patient’s success with a first toe-dip into a center program, such as cardio-pulmonary rehabilitation,often stimulates a desire to learn more, and engageother disciplines.

"When people contact us they often say they arefatigued, have challenges with daily activities and motivation and they find it difficult to change theirlifestyle," says Robison. "It's exciting to see people getinvolved in our programs, take control of their health and feel better. That is a testament to health and we feelprivileged to be a part of that."

That patient satisfaction, Dr. Paysse says, is the center’s greatest accomplishment.

“What we do here is astounding work,” Paysse says. “The staff has a lot of compassion and empathy,and patients come out saying they want more.”

In the near future, Dr. Paysse and Robison both say they would like to expand awareness and use of

the center, among the physicians in the community,and among the broader public.

“The mind’s ability to heal is just as important asany pills,” Dr. Paysse says. “If the physician doesn’taddress the mind’s role in healing, it will be a majorcomponent of healing that will be lost.”

“Bringing people to optimal health is our goal,”Robison says. “It takes work. At the center, we’re focused on helping people make healthy changes thatare enjoyable, obtainable and lifelong.”

17


18

I think that the relationship

between doctor and patient

should be a collaborative

one where both are working

together for the best interest

of the patient.— Analene Pentopoulos, M.D.

“

”


The opportunity to develop long-term relationshipswith women and their children has led Analene

Pentopoulos, M.D., to join the Columbia River Women’sClinic in The Dalles.

Dr. Pentopoulos, an obstetrics and gynecology specialist, joins the practice of Drs. David Mack and James Faherty.

“Dr. Pentopoulos is brilliant,” said Dr. Faherty.“We’re very much looking forward to her joining our practice.”

Dr. Pentopoulos will fill a position left vacant for the last 16 months after the departure of Dr. Diane Ellis, who followed her husband to England so he could pursue a fellowship.

Dr. Faherty said recruiting someone of Dr.Pentopoulos’ caliber takes awhile, for a variety of reasons. For one thing, many new physicians prefer part-time work, he said.

For another, few new physicians want to work on-call as part of a small practice. In the case of theWomen’s Clinic, that means responding to urgentpatient needs once every third night. In a larger practice,the frequency of working call can be as little as onceevery 10 days.

“One thing that attracted her to us and us to her isthat we do a full range of obstetrics — incontinencework, cancer surgery, gynecologic urology, obstetric andgynecologic ultrasound,” Dr. Faherty said.

“In a bigger city, a patient usually goes to someonewho does only one thing. Dr. Pentopoulos has told meshe wanted to practice where she saw a lot of diversityof cases, more complexity, than a general ob/gyn wouldsee in a city.”

Dr. Pentopoulos followed a path to The Dalles some-what similar to the path that led Dr. Faherty to town 10years ago — through New Zealand. Dr. Faherty hadspent a year of his residency at the University of Otago inDunedin, New Zealand. Dr. Pentopoulos wanted to spenda year in New Zealand as well, learned of Dr. Faherty,and contacted him. He put her in touch with the manager

of the residency program at the New Zealand school.When she returned, Dr. Pentopoulos began

discussions about a possible practice with the Women’sClinic. She signed a contract in the fall of 2005, midwaythrough her final year of residency.

After graduating Magna Cum Laude with a bachelorof science degree in microbiology from the University of California at San Diego, Dr. Pentopoulos completedmedical studies in 2002 at Yale University MedicalSchool. This summer she finished four years of internshipand residency in obstetrics and gynecology at OregonHealth & Sciences University in Portland. During heryears at OHSU, Dr. Pentopoulos attended to the deliveryof more than 500 babies.

By its nature, her medical training required her to workdifferent shifts and focus on different aspects of medicine.It didn’t foster many close relationships with patients.

Dr. Pentopoulos said she is eager to practice in aclinical setting, and definitely looks forward to getting to know her patients in The Dalles and provide for theircare as long as they need.

“I think that the relationship between doctor andpatient should be a collaborative one where both areworking together for the best interest of the patient,”Dr. Pentopoulos said.

Dr. Pentopoulos brings a world view to her profession. Born in the United States to parents whohad grown up in Zimbabwe, she spent the first six yearsof her life in South Africa. She spent the balance of herformative years in Walnut Creek, Calif., then a muchsmaller town than it is now. She wants to return to thelife of a smaller community.

“Here's someone who basically came to me, andwhen talking about business stuff, she said ‘I'm not worried about that; I trust your reputation’,” Dr. Fahertyrecalls. “The only commitment she wanted from me wasthat I wouldn’t be leaving the community. She bought ahouse before signing her contract.”

For more information, or to schedule an appoint-ment with Dr. Pentopoulos, please call 541-296-5657.

19

Women’s ClinicWelcomes Doctor

by Stu Watson


NON-PROFITU.S. Postage

P A I DMID-COLUMBIA

MEDICAL CENTERPermit #161

CURRENT RESIDENT

1700 E. 19th St., The Dalles, OR 97058

TUESDAY, SEPT. 19

Pressing for Pain Relief Acupuncture and acupressure are ancient therapiesthat offer new solutions to effective pain management.If you suffer from acute or chronic pain and are lookingfor relief, this program is for you. Carola Stepper, RN,LAc, explains the science behind acupuncture, when itis appropriate to use and the value of adding it to yourcare. Simple instructions on using Acupressure pointsto ease pain will also be shared.

TUESDAY, SEPT. 26

Blues Clues: Living with DepressionDepression changes how you view the world. It’s notjust feeling sad or down, it is a serious illness of themind. We all get the blues, so how do you recognizedepression? Does social isolation contribute to depres-sion? What works best in treating it? Joella Anglin,Clinical Social Worker with Lifeworks Comfort Care,Mid-Columbia Medical Center, sheds some light ondepression. She’ll offer tips on how to cope as well asskills family or friends can use to support a loved onewith depression.

Blues Clues (Pistas de Blue, título de popular programa televisivo para niños que tiene doble sentidode “indicios de la depresión):Viviendo con la DepresiónLa depresión cambia la manera en que consideramos elmundo. No sólo se trata de sentirse triste o decaído,sino que es una enfermedad mental grave. Todos nossentimos decaídos de vez en cuando, ¿pero cómoreconocer cuando se trata de la depresión? ¿Contribuyeel aislamiento social a la depresión? ¿Qué funcionamejor en cuanto al tratamiento? Joella Anglin,Trabajadora Social del Lifeworks Comfort Care, Mid-Columbia Medical Center, arroja luz sobre la depresión,

ofreciendo consejos prácticos de cómo enfrentarse a ladepresión, así como técnicas que los familiares y ami-gos pueden usar para apoyar a un querido que padecede depresión.

Nota: Esta conferencia es gratis y abierta al público.Se celebrará de las 7:00 PM a las 8:30 PM el 26 deSeptiembre en el salón de conferencias del edificio deconsultorios (Medical Center Office Plaza ConferenceRoom) del Mid-Columbia Medical Center, 1810 E. 19th St.,The Dalles.

TUESDAY, OCT. 3

Fire in the Hole: GERDDo you suffer from GERD, or gastroesophageal reflux?GERD is ‘heartburn’ that occurs two or more times perweek. If so, join Jeanette Paysse, M.D. as she helps youput out the fire! Dr. Paysse will explain the causes ofGERD and share information about natural and preven-tive approaches to minimizing it through nutrition andstress reduction. She will also explain the risks & bene-fits of medications from proton pump inhibitors toantacids used to treat GERD.

TUESDAY, OCT. 10

The Startled Brain:Understanding Stroke“A chief event of life is the day in which we have encountered a mind that startled us.”

Ralph Waldo Emerson

Paul Cardosi, M.D., medical director of mPower, MCMC’sAcute Rehabilitation Program, talks about recognizingthe signs of stroke, the different types of stroke and thedegrees of disability that follow one depending uponwhich part of the brain is injured. Who’s at risk forstroke and important tips on how to prevent stroke willalso be shared. Please join us for this important program.

FALL 2006Planetree Health Resource CenterHealth Lecture SeriesInformative Discussions on Your Good Health — All lectures are free and open to the public. Lectures are held in theMedical Center Office Plaza Conference Room at Mid-Columbia Medical Center, 1810 E. 19th St., The Dalles. All programsare from 7 to 8:30 p.m. Your on-time arrival is appreciated. Phone 541-296-8444 to pre-register. You may also register onour web site: www.mcmc.net (click on Planetree Resource Library, then Lecture Series). We look forward to seeing you.


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