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Internists rare at the hospital

John Colson

One year ago, there were eight internal medicine specialists in active practice at the Aspen Valley Hospital.

Today, there are technically two internists at AVH, although one is not admitting patients these days and is expecting his contract with the hospital to expire at the end of September.

That means there are only two on the active on-call list at the hospital, two doctors who are certified to perform complicated medical procedures in what one doctor called “urgent care” situations that are not critical enough for the emergency room.

What all this means, according to doctors unhappy about the situation, is that for the medical needs of patients that fall somewhere between the generalized abilities of a family practice doctor and the critical skills of the emergency room specialist, there are not many options in the upper Roaring Fork Valley.

But, according to the chief of the medical staff at AVH, as well as a board member and the hospital’s chief administrator, it is not really as bad a problem as it may seem.

And, according to the board member, things will be better soon.

Good medical care

The hospital is being buffeted by internal strife these days, according to many employees who have contacted The Aspen Times on condition of anonymity to complain about a variety of management issues.

But one thing that most agree on is that the quality of the medical care at AVH is very high.

“The medical end of our hospital is terrific,” said one critic of the hospital administration who asked not to be named.

Some internists, however, have complained that over the past year they have been pushed too hard to be on call too much of the time as the roster of internists has shrunk.

“I resigned when it became three [available internists], and I was expected to be available 24 hours a day, every third day,” said internist Susan Zimet. “I had no choice.”

She explained that the pressures of being on call posed a threat to her private practice and conflicted with her responsibilities as a mother and a wife.

Other internists have resigned, in effect, for a variety of reasons, ranging from simply having been an on-call internist for decades to clashes with the hospital administration and board over policy disputes.

Doctors Barry Mink and Carl Schiller, for example, resigned their “active” contracts some time ago and have been put on special “emeritus” status.

Board takes action

But the hospital board, according to board member Chuck Torinus, realized months ago that it was heading into a shortage of internists and started the search for replacements for those who have resigned.

Torinus said the board hired a “headhunter” who has come up with four candidates for the two or three internist spots the board believes must be filled, and that those candidates will be arriving with a month or so for interviews.

In addition, he said, the hospital revamped its policies and procedures to allow family practice doctors greater privileges at the hospital to take up the slack left by the declining number of internists.

Calling it a “medicine-department call,” Torinus said local citizens should not be worried about the quality of medical care because “we’re practicing excellent medicine at that hospital.”

Specialists, he said, “are readily available when we run into an acute medical situation.”

According to Zimet, under the new arrangement, seven family practitioners are rotating on-call and other duties with the sole official internist, and the result has been promising.

“I am most likely going to get back on staff,” she said.

For his part, Torinus said, he believes the community’s health care needs can be met under this arrangement.

“We have emergent situations taken care of,” he said.

And for those who feel more comfortable dealing with internists than with family practitioners, he said, the board is working on it.

“It is good to have a balance between an appropriate number of internists and an appropriate number of medical doctors,” he said, and the board is seeking to re-establish that balance.


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