JRMC makes plans to replace OB-GYN doctor
Jamestown Regional Medical Center is working to get a plan in place for OB-GYN care following the early departure of its only OB-GYN doctor, whose last day was earlier this week, said Michael “Mike” Delfs, CEO of JRMC.
Dr. Bailey Runkles started at JRMC in August 2017 and, since then, had served as the facility’s only doctor specializing in obstetrics and gynecology. In December 2018, she notified JRMC that she had accepted a new position in Louisiana.
“She had notified us that she was going to be done in June, but she has the opportunity to go early,” Delfs said. “I’m happy for her, I think the organization is happy for her. On the other hand, we’re scrambling a little bit.”
Delfs, who moved to Jamestown and started as JRMC’s new CEO just five weeks ago, said JRMC is working on short-term and long-term plans to continue to provide OB-GYN services to the community. On Wednesday, he hoped to have the short-term plan finalized by the end of the week.
“Right now, we’re still making phone calls and contacting doctors but the intent is we’re going to make sure that patients get what they need on the clinic side,” Delfs said.
The short-term plan for patients may include returning to their primary care doctors or, where possible, pushing scheduled appointments and procedures back until JRMC has the necessary coverage, he said.
One goal is to limit situations where patients will need to travel outside of Jamestown to receive specialized care.
“If a patient needs a procedure done, we want to make sure that we can accommodate that because, generally speaking, people do not like to travel for their health care ,” Delfs said. “They just don’t.”
JRMC’s non-specialty family medicine doctors, who have received “some pretty extensive training in birth and obstetrics,” will continue to deliver babies, Delfs said. Most non-specialty family medicine doctors can deliver babies on their own but will call in an OB-GYN specialist if they encounter a complicated pregnancy or delivery, he said.
“We deliver babies, we perform C-sections,” Delfs said. “We do all of those things that occur within the birthing experience. What we’re missing as of today is a true OB-GYN who can enhance all of that.”
JRMC’s long-term goal is to hire and retain at least one OB-GYN doctor.
“We’re recruiting to make sure that we have OB-GYN,” Delfs said. “It’s really clear that the community wants that, and it’s really clear that it’s a need in the community.
“It is not unusual to have a mom in town who says, ‘I now know that I’m pregnant, I want an OB-GYN,’ so that option being available is really important.”
While JRMC intends to fill the OB-GYN position, it could be six months or more before one is hired and ready to start seeing patients in Jamestown.
“Once you start recruiting a doctor, from the time they visit until they can actually start practice, usually an aggressive timeline is four to six months, but it can be a little longer,” Delfs said. “As you might imagine, doctors are not necessarily a quick recruit.
“Some people are in contracts where it might be two or three months until they can get here. Some people are saying, ‘Based on the time of year and when my kids can get into school, here’s really when I would want to move …’ so it’s really dependent upon the candidate.”
In general, recruiting specialty doctors to work in rural North Dakota has become increasingly difficult, said Brad Gibbens, deputy director of the Center for Rural Health at the University of North Dakota.
“It’s not easy,” Gibbens said. “A lot of times they’re concerned about the quality of care, they’re concerned about the technology … and they can be very, very nervous about being the only (specialist) in that town.
“That isolation is a huge factor in terms of recruiting and retaining.”
Plus, you have to find a specialist who is interested in living in a rural community.
“I love rural North Dakota, but not everyone is cut out for living in rural North Dakota,” Gibbens said.
In 2015, the UND School of Medicine & Health Sciences reported that there were 63 OB-GYN doctors in North Dakota - 47 in urban areas and just 16 in rural communities, Gibbens said.
Delfs recognizes that, as a whole, rural communities in North Dakota are facing a “huge problem” with recruiting and retaining specialty doctors.
“Health care and shopping patterns follow each other,” Delfs said explaining that patients who travel to larger cities for health care will often do some shopping while they are there. “So this is not just bad for health care, it’s bad economically for small communities as well, and the two are so closely tied together. It is a real problem.”
Fortunately for Jamestown, JRMC already has several applicants for the OB-GYN position, Delfs said.
“I can tell you that we’ve had conversations with multiple candidates,” he said. “What I don’t want people to believe is that it’s so hard to get an OB-GYN in Jamestown that the first one who comes along is just what you’re stuck with, because it’s not that at all.
“We’re really careful about making sure we vet doctors who come in. We want to make sure that they’re a good fit all around.”