RURAL MEDICINE, CONT. Kevin Johnston, MD, sits for an on-camera interview about the challenges and opportunities of rural medicine, as part of a special OMA sponsored video planned for the OMA General Membership meeting Saturday, April 25, 2015. Learn more at www.theOMA.org/AnnualMeeting. practice were covered by the Medicaid program (now the CCOs), the state would incur greater cost in complicated deliveries, air ambulance services, and neonatal intensive care services. It was not a hard argument to make: Spend more money and have worse outcomes; no one would suggest that should be the goal. To their credit, the legislature seemed to hear that message,” Johnston said. Johnston recently switched from private practice to hospital-based employment so his practice could fulfill its vision of building a patient-centered medical home. It wasn’t an easy decision for the independent physician, but he says the small private practice didn’t have the resources to make it happen. Still he believes the greater focus on primary care access and managing entire community health will pay off with better outcomes and lower costs over time. Commitment to Patient Centered Medical Homes “It costs more to run these primary care homes,” says Johnston. “We have more frontline nursing staff, case managers, things that allow us to provide care outside the traditional ‘you walk in and you see me for 20 minutes, and I write out a bill kind of model,’ but it has to be funded differently; and the coordinated care organizations are recognizing this and saying ‘we’ll pay the clinic a per-patient per-month fee, so you’ll manage their care beyond that patient-centered visit.’” Johnston hopes the OMA will take a leading role in lobbying lawmakers for funding needed to expand development of patient centered medical homes around the state, but he knows payers will also need to commit to the concept. “That’s where I think the OMA would be a huge partner with us in saying we recognize this is the way we can take care of more people, do it in a more fiscally responsible manner and improve the services we give—the triple aim that we talk about. My own opinion is this is the model that has the greatest chance of succeeding, but it will only succeed if we can really get payers to buy in,” said Johnston. The Rural Connection Growing up outside Glide, Oregon, near Roseburg, Johnston developed an affinity for the agriculture-based community and the special people who make a living off the land. And, after a six-week medical school rotation in Burns, he knew this was the type of place he wanted to practice and raise his family. “My own bias is that the people who are tied to the land have a different work ethic, a different perspective on life than those of us reliant on our professions,” said Johnston. “More importantly and why I wanted my kids to grow up here: In a community as isolated as this, you are responsible for your behavior 100% of the time because there is absolutely no anonymity. That can be intimidating for some. In my mind, that lack of anonymity means that you have to ‘BE’ the person that you want others to perceive you to be. There is very little room for self deception.” For more information, please contact: Kevin Johnston, MD Family Practice Physician Harney District Hospital Burns, Oregon (541) 573-2074 kjohnston@HarneyDH.com 10 Medicine in Oregon www.theOMA.org
OMA Winter 2015 Magazine
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