Midvalley suffering through doctor drought
July 5, 2005
An exodus of general physicians and pediatricians from the midvalley is putting pressure on those who remain and forcing families to travel farther for general medical care.Doctors are saying there is a need for more general practitioners in the midvalley, which has been growing at a healthy clip, but the economics of health care remain a barrier.”We are essentially maximally busy,” said Dr. Gary Knaus, of Roaring Fork Family Physicians, which has offices in Carbondale and El Jebel. The practice recently had a physician leave. In addition to looking for a replacement, the doctors at Roaring Fork Family Physicians hope to expand business in the El Jebel office, which is open four days a week.”We’re looking to expand but probably … can’t take care of the bulk of patients in the midvalley,” Knaus said. That’s due in part to the midvalley clinic closures such as Aspen-Basalt Care, a clinic that was designed to care for indigent patients. Aspen-Basalt Care received a significant amount of support from Aspen Valley Hospital; when the hospital withdrew that support in 2003, the clinic was forced to close.
Aspen Valley Pediatrics has also lost more than half its staff. Dr. Madeline Simonet left at the beginning of 2005, Dr. Liz Gremillion left in early 2004, and Dr. Caudia Nelson left in the summer of 2004.That leaves doctors Harvey Fahey and Bill Mitchell, the latter having been here for more than 30 years. They split their time between Aspen and Basalt. Mitchell said there are no immediate plans to hire new pediatricians because of “economics.” “I think at some point we’ll bring on more help,” Mitchell said, but not now, although he said his workload is “crazy.”The shortage concerns some valley residents. A group of parents wrote a joint letter to The Aspen Times last year, asking the question, “How will Aspen Valley Pediatrics (and their employer, Aspen Valley Hospital) continue to meet the medical needs of our kids – especially those of the midvalley?”There’s a drought in the mental health arena as well. Lowell Stratton, head psychiatrist at Colorado West, is moving his office to Grand Junction full time in November. Aspen child psychiatrist Dr. Jerome Karasic has also left his Aspen practice to work in Denver.”I definitely had to reduce my cost of living,” Karasic said.
Karasic was surprised to learn that Stratton had left.”I know Dr. Stratton was terribly busy; the waiting list was up to six weeks for him,” he said. Karasic added that it’s “very aggravating” that there isn’t enough treatment for children in the Roaring Fork Valley. “It doesn’t seem to be important to Pitkin County.” The departures of Stratton and Karasic mean that downvalley patients receiving counseling who need prescriptions are out of luck, unless they make the commute up to AVH’s house psychiatrist. There are private psychiatrists still available in the midvalley, but they are few and far between. Only two are listed in the midvalley area.Knaus suggested that the cost of running an office is partly at fault.
“When rent is $30 a square foot, it’s hard to do business. Even from Carbondale to El Jebel is more expensive to operate.”And Mitchell said the lack of medical help for those on Medicaid and the indigent is another large part of the problem, saying it congests the workday for many doctors and inhibits the ability of doctors to stay afloat.”Medicaid gives us $11 out every $100 we make,” Mitchell said. “It kills us; we can’t afford it.” Mitchell admitted he is stumped for a solution, but he suggested the community look within itself.”Our community wants to pay maids $20 an hour during the Christmas season, and it’s not enough money to pay for health-care benefits. The same goes for part-time workers,” Mitchell said. “Our community lives on the backs of these people.”I consider myself a failure at helping the indigent, and I can’t blame AVH either. So I don’t know – who is going to pick up the burden?”