Doctor shortage causing pain

It seems that nearly everybody in Sisters Country knows somebody first- or second-hand who has had delays in getting medical care. Most often, the anecdotes go, it’s a patient waiting for a joint repair or replacement. The shortage of orthopedic surgeons is at near crisis levels, nationally and locally.

The largest provider of such services is The Center in Bend, well-known to folks in Sisters. In a letter to patients, The Center said: “Thank you for entrusting your care to The Center. Our community is facing an unexpected shortage of orthopedic providers that has created a higher demand for our services.”

They continued: “What This Means for You. Longer wait times during your visits. Delays in scheduling appointments and procedures. Slower response times for routine questions from our medical staff…

“We understand that waiting for medical care can be a frustrating experience, especially when you’re dealing with pain or discomfort. Please know that we are doing everything within our power to minimize these delays. We are actively recruiting additional staff.

“Be Kind to Our Staff: They are the backbone of our practice, working tirelessly under challenging circumstances. Any delays are beyond their control, and your kindness and understanding are greatly appreciated.”

Amid the crisis, St. Charles Health System (SCHS) is considering purchasing some or all The Center’s operations, announcing last week that the two healthcare organizations would “expand” their relationship. But what exactly that means for The Center is unclear. CEO Brett Hazlett says the full legal transaction hasn’t yet been defined.

“Whatever form that takes, the end result is that the majority of the employees will become employees of St. Charles,” he said.

The Center is the region’s main provider of orthopedic and neurosurgical services, as well as offering physical and rehabilitation medicine.

However last Thursday the Oregon Health Authority denied a request by SCHS to fast-track the acquisition. St. Charles has filed for an “emergency exemption” to a new state regulatory review process, saying the chain, known as “The Center,” was in danger of going under due to an exodus of doctors, and declining payments from insurance.

The Center has 200 employees, and St. Charles executives had said they would employ “a substantial number” of them following the deal’s conclusion.

The Nugget interviewed Isaac Harris and Paige McAndrews both in the front of recruiting at St. Charles, Harris for doctors and specialists, and McAndrews whose work is to keep the hospital and clinics fully staffed with nurses. The four-hospital system currently lists openings for 289 positions among them 14 physicians and 42 nursing professionals and eight advanced practice providers.

There are no openings for orthopedic surgeons. Both say that St. Charles is competitive in salary and benefits. The primary challenge is nearly always geographic based. Candidates have many options and those looking at Central Oregon are often swayed to larger cities like Denver, Boise, Seattle, and Portland.

It’s easier to recruit for Bend and Sisters than Prineville or Madras, Harris said.

Housing costs are an obstacle both say. McAndrews recalled that it was only a few years ago that candidates from Portland would find it cost advantageous to transfer to Bend. No longer is that the case, as Bend and Sisters housing costs often exceed those of Portland.

Bend’s median age is 39.5 according to World Population Review. In Sisters it’s 49.4. Per capita, Sisters uses more health services especially in orthopedics.

Debi Lancaster in Sisters is typical of those who have been waiting for more than six months for a knee replacement.

“I’m on hold with no firm date and I don’t know if it’s a shortage of doctors or facilities,” she told The Nugget.

St. Charles is hoping to meet more of its talent needs locally. The Three Sisters Rural Track Program is the first Graduate Medical Education Program and Rural Track Program in Central Oregon. As a 1-2 program, this residency will recruit up to six residents per class.

Residents will spend their first year in Portland, followed by two years in Central Oregon at their Madras hospital and Family Care Clinic. In partnership with Oregon Health & Science University, this program aims to bring together educational teams within various clinical models to help meet rural needs.

Harris is hopeful that they can “grow” more local talent reducing the need for long-distance hiring.

A year ago, St. Charles was experiencing a high vacancy rate exacerbated by workforce shortages related to the pandemic and a nationwide shortage of nurses. To meet patient care needs, SCHS brought in many expensive temporary nurses to cover key positions.

Today, St. Charles’ labor shortage is all but erased and the vacancy rate for acute care nurses is down to 6 percent (from a high of more than 20 percent in early 2023). One key factor in this turnaround is traveling nurses, like Teeters, opting to apply for permanent positions with St. Charles.

These conversions used to be extremely rare, but not anymore. In 2022, St. Charles hired four traveling into permanent positions. In 2023, that ballooned to 58 travelers into permanent positions and so far, this year 18 travelers have already been hired into permanent spots.