Board says new medical center needed

By Katie Klingsporn
Published: Friday, June 23, 2006 11:37 AM CDT
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Telluride needs a new medical center.

But because of unusual factors such as the altitude, remoteness and constitution of the community, Telluride doesn't necessarily need a slew of specialized services in the medical center that would address the gamut of medical issues.

These conclusions were reached at a meeting of the Telluride Hospital District Board on Wednesday, when the board, members of the medical community, public officials and the public gathered to discuss the results of an assessment of the region's medical services that was released in May.

The report, which was commissioned by the Hospital District to serve as the second part of a three-phase plan to implement a new strategic plan for the region's medical services, was put together by Stroudwater Associates, a nationally renowned health care consultant.

While it gave Telluride's medical center high marks on location, quality of emergency and primary care and quality of providers, it also contended that many aspects of health care in the region are lacking. The report recommended bolstering aspects such as available services, hours of operation, range of specialist services and transparency of billing as well as building an entirely new medical center to create more capacity for a growing population.

And as most in attendance on Wednesday were in accord that a top priority for the district should be securing a site for a new medical center, they also deemed several of the recommendations impractical or just not feasible.

Telluride, it was agreed, is a community of a unique constitution. It has its own yearly flux of visitors and part-time residents, and its full-time populace is comprised of a better than average chunk of young, active and athletic individuals. Add to this the high elevation - which makes some medical services difficult if not impossible - and the remote location, and you have a town that, many at the meeting agreed, may not be suitable for the levels of bolstered services the report recommends.

“We live in a rural place, we will always live in a rural place, and I think there will always be things that will be difficult to do here,” said Dr. Sharon Grundy, an internal medicine doctor.

The report, which based much of its data and conclusions on national data, may have been more effective if it tailored itself to Telluride's population of part-time residents and younger, more active individuals as well as taken into account the limitations placed on it as a high-altitude and remote location, the board concluded.

The report recommended that the medical center should encourage adding procedure-oriented specialties such as orthopedic surgery, plastic surgery, podiatry and gynecologic surgery. It recommends the medical center pursues an MRI service, examines the possibility of doing ambulatory surgery, and considers becoming a Critical Access Hospital - which would enable it to add amenities such as a four- to six-bed inpatient unit that would care for patients for up to four days.

But when the board asked members of the medical field in attendance about the practicality of these types of expansions on Wednesday, the reception was largely dubious.

Nurses and doctors said these services would require a costly bolstering of staffing, equipment and space, and may not end up being utilized that much.

“The staffing issue, it's huge,” Grundy said. “For a CAH, we'd have to double, at least at the minimum, the staffing.”

They also concurred that the numbers of surgeries that was projected by the report is unrealistically big, the limitations caused by the altitude make some procedures - like laser eye surgery or delivering babies - ill-advised or prone to liability and the affluent character of the community makes people more likely to seek the surgery options in major cities, which would render them moot in Telluride.

Dr. Allen Soloman, who sits on the board, summed up what he believed to be the consensus.

“A critical care hospital designation would benefit a small number of people and may not be financially possible,” he said.

One finding that wasn't contended was that a new medical center is going to be necessary.

Because the district does not own the site of the current medical center, the report recommended, it would be unwise to make major additions to it. Plus, it said, the population is on a growing trend, which will create a bigger capacity for a facility that is already short on space.

“A new medical center will be needed,” said board president Bill Grun, adding that the actual realization of such a facility is at a minimum, five years out.

“The critical thing is finding that site,” said Mountain Village Town Council member Rube Felicelli. “The regional governments are committed to helping the hospital district in finding a new facility.”

Felicelli said providing affordable housing for employees will go hand in hand with the new facility. He said governments will be working on this, but it should be explored in the private realm as well.

The report said that funding the building will likely rely heavily on philanthropy.

Many also expressed a need to buff up the image of Telluride's medical center to communicate to the community that the despite the diminutive staff and limited services, what is available is excellent.

Kim Hewson, who served at the medical center for five years, said the community needs to be educated about the reality of the medical center; it's staffed by highly-qualified individuals who don't get paid well compared with others in their field but live and work in Telluride because they love it.

“We need an image of a high quality facility,” he said.

Reporter Katie Klingsporn can be reached at katie@telluridenews.com