Local healthcare officials discuss physician changes at clinic, hospital

Doctors will be present in the emergency room at the only hospital in Cook County this summer, but the extent of a physician’s role in the local healthcare facility on a daily basis remains unknown.

“The emergency room is not changing,” said Kimber Wraalstad, the administrator at North Shore Health.

Beyond that, the role of doctors at the Grand Marais hospital is unclear. This uncertainty about the availability of doctors at the hospital comes as Sawtooth Mountain Clinic and North Shore Health announced earlier this month changes to physician services for both facilities.

Physicians at Sawtooth Mountain Clinic have traditionally provided care to patients at North Shore Health, in addition to seeing patients at the clinic. However, according to the April 6 announcement, due to “physician shortages,” doctors at the clinic will no longer provide certain services at the hospital. Prior to the changes taking place, the hospital “is working to secure alternatives so that patients can continue to be admitted to observation, acute and swing bed services.” The changes take effect July 1.

According to local healthcare officials, Sawtooth Mountain Clinic has struggled to find doctors to replace physicians who are retiring, relocating, or reducing their workload. Among those leaving is Dr. Kurt Farchmin, a well-known local physician who appeared regularly on WTIP during the peak of the COVID-19 pandemic. With news of Farchmin leaving and other physicians looking to reduce their workload, the clinic hired a recruitment firm and pursued a variety of other recruitment initiatives to no avail, according to Kate Surbaugh, the CEO of Sawtooth Mountain Clinic.

Surbaugh attributes the challenges in finding physicians at Sawtooth Mountain Clinic to a variety of factors, including a nationwide physician shortage.

“It’s particularly acute for family-practice physicians, which are the type of doctors who work here,” Surbaugh said during an interview with WTIP this week.

In addition to the nationwide shortage, Surbaugh said there’s always the issue of recruiting to a rural area, which many in the local business community understand are also experiencing when it comes to the struggle to find workers.

Surbaugh also referenced changes in recent years in medicine, both hospital work and clinic work. Adding to the challenge is trying to find someone who would be interested in working at both the hospital and the clinic in Grand Marais, according to Surbaugh.

“Those residents who are in training these days, most of them are expecting to go into either clinic work or hospital work,” she said. “It’s a very small pool of candidates who are training to do both and who are interested in doing both. And so that’s where we start from, with that small pool of candidates.”

These changes to the role local doctors play in the two healthcare facilities “will certainly change how patients are cared for while in the hospital,” according to Wraalstad.

Wraalstad said that with the changes to local physicians and the role they play at the hospital “multiple avenues of care are being explored.” Among the options being considered are virtual services where physicians talk with patients via telehealth in the hospital.

“We are starting to look for the alternatives,” Wraalstad said. “And I know people want the answers, but we probably don’t even have all the alternatives yet.”

Meanwhile, local physicians will continue to admit patients to home care, residents to the care center, and provide colonoscopies, among other procedures, according to the hospital administrator.

“Patients are still going to be able to come to North Shore Health and get their labs, get their X-rays, get their cardiac rehab, get their physical and occupational therapy,” Wraalstad said. “That’s what a lot of people do here. And they can continue to do that.”

When asked if nurse practitioners or physician assistants could play a role in filling the gap created by doctors leaving the local healthcare facility, Surbaugh said it could be an avenue to explore. Sawtooth Mountain Clinic currently employs two full-time nurse practitioners, and the upcoming policy change that ends the agreement with the hospital where doctors had a dual role of sorts does open the door to a variety of candidates, according to Surbaugh. Candidates could be physicians, as well as nurse practitioners or physician assistants, the clinic CEO explained.

“This offers us a lot of opportunities to change the model and continue to preserve the same level of access to primary care,” Surbaugh said.

The audio below is the full interview with WTIP’s Joe Friedrichs, Surbaugh and Wraalstad. WTIP will continue to follow this situation and provide updates on the airwaves and on this website.

Meanwhile, officials from both local healthcare organizations remain adamant that, despite the changes, quality healthcare in the community remains the primary focus moving forward.

“We are committed to working together to ensure a smooth transition and the continuation of high-quality health care services to our patients and community,” Surbaugh said. “It is our hope that this transformation will ultimately be a positive change for all involved.”

Joe Friedrichs April 13, 2023