Interdisciplinary Approach Is Necessity in Remote Region of Colorado

"You end up being a lot of things to a lot of people." That's how Martin Neubert, PA, describes his service in rural Dove Creek, Colorado—one of the three most isolated areas in the continental United States.

Neubert, a National Health Service Corps (NHSC) clinician, works at the Dolores County Health Association's Community Health Clinic, which serves about 1,500 people in a county of more than 1,000 square miles. While the community's isolation is a challenge, last year the clinic treated an impressive 86 percent of the residents, providing them with comprehensive care ranging from emergency services to mental health counseling.

Neubert applies an interdisciplinary approach to health care by necessity. He coordinates the work he does with that of other medical specialists (some of whom travel from as far as 100 miles away to examine patients at the clinic) and also refers patients to facilities outside the area when necessary.

The clinic accepts patients of all income levels and offers a sliding fee scale for the uninsured. It offers comprehensive primary health care and many internal medicine emergency care services. Health professionals who come to the clinic on a regular basis include a urologist, an orthopedic surgeon, a physical therapist, and a chiropractor. Others, including an audiologist, a dietician, a diabetes educator, and a cardiologist have expressed a desire to begin regular visits to the facility as well.

As the clinic's primary full-time clinician, Neubert says, "I switch hats a lot." To ensure consistent, quality patient care in this environment, Neubert stresses using an extensive referral network ("Our referral book is now 54 pages and growing," he says). Spending "a lot of time on the telephone is a prerequisite to the job."

Dolores County is a poor county, says Neubert. It has suffered from drought conditions for the past 10 years. The ability to sustain a living in this environment is difficult under the best of circumstances. The clinic's ability to provide so many diverse health care services to this isolated community is due to the community's overwhelming support of the facility. It is also successful due to the clinic staff's willingness to be "priest, confessor, optometrist, dentist, and doctor and just about anything else we need," as one of Neubert's patients put it.

Learn about other NHSC success stories.