Prineville gets family physician
Published: October 31. 2005 4:00AM PST
PRINEVILLE - In his first three weeks on the job, Dr. David Cleveland said he's been busier than expected.
His new family medicine practice in Prineville is already nearly 80 percent full, and Cleveland hasn't had time yet to unpack his boxes or put pictures up on his bare office walls. The 30-year-old physician moved here from Denver, where he completed a residency in family medicine in an inner-city setting.
Cleveland and his wife, he said, are ready for a small-town environment.
"This is a small enough community that family doctors can still do obstetrics and ... a full breadth of family practice," Cleveland said.
"When I came to visit, I noticed the people here were very friendly."
Members of the Prineville medical community are happy to have the help of a new family physician, said Leslie Thornton, a spokeswoman for Pioneer Memorial Hospital. Cleveland's practice is privately owned, but is housed within Pioneer Healthcare Associates of Oregon, a clinic attached to the hospital.
Attracting primary care physicians into rural practice has been a challenge for many years, said Dr. Michael Knower, a family practice physician in Prineville. Because family medicine doctors tend to make less money than specialists, and because the price of medical school continues to increase, many young doctors can't afford to choose family medicine as a career.
That argument is especially true in rural areas, where reimbursement rates tend to be lower than in cities.
"Recruiting students into family medicine, recruiting graduating residents into rural areas, continues to be an uphill battle," Knower said. "(It's) always nice to at least see occasional small victories."
Cleveland said the medical school he attended, Quillen College of Medicine at East Tennessee State University, was designed at a time in the 1970s when another nationwide shortage of primary care physicians was taking place.
"Their goal was always to not necessarily push people that way, but to show students what primary care was like in a good learning environment," Cleveland said. "I went into family practice because I think I would be bored if I was doing one specialty all day."
Plus, he said, by attending a state school, his education costs were about half what they would have been at a private university, making it easier for him to set up shop. Cleveland is contracting with a management company to handle the business aspects of his medical practice, including determining how many Medicare and Medicaid patients he can afford to treat.
Low reimbursement rates often lead to physicians limiting the number of Medicare and Medicaid patients they take on in Central Oregon. Cleveland said he is well aware of the challenges of running a medical practice with too many patients on government-subsidized payment plans.
In the past, Knower has said, at least one new family physician in Prineville was overrun with Medicare patients and eventually closed his practice.
"From what I have gathered, David saw the usual influx of Medicare and Oregon Health Plan patients from his first day in practice," Knower said. "(I) would anticipate that his practice manager will be monitoring his numbers fairly closely."
Seeing how much money the nation spends on health care and how poor the outcomes are of that spending is frustrating, Cleveland said.
"I know (the health care system is) broken," he said. "I don't know how to fix it."
For now, Cleveland is looking forward to getting to know his patients and to becoming a part of the community. His favorite part of family practice is delivering babies and treating them as they grow.
And, Cleveland said, he's already impressed by the longevity of Central Oregonians.
"One thing that amazes me is the older patients here that are still working on the ranch," Cleveland said. "They are 80-something-years old and still going strong."
Kayley Mendenhall can be reached at 541-383-0375 or at kmendenhall@bendbulletin. com.
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