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Celebrating 26 Years of the AHEC Program and OHSU Family Medicine Rural Rotation in Enterprise, OR

Tuesday, July 18, 2017   (0 Comments)
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Meg Bowen, Quality Director, Winding Waters Clinic

 

Nestled on the slopes of the Wallowa Mountains in far Northeast Oregon, Winding Waters is one of the newest Federally Qualified Health Centers in the region. The original clinic opened its doors on January 29, 1975 and has served Wallowa County for over 40 years. In a frontier county with a population that hovers around 7,000 people, Winding Waters has been dedicated to meeting the complete primary care needs of Wallowa County residents and visitors. The number of staff has doubled since becoming an FQHC in August 2015, as we work to provide wraparound services to our community. In addition to high-quality inpatient, outpatient, and emergency department medical care, we provide fully integrated mental and behavioral health services, primary dental care, clinical pharmacy services, community health and care coordination services, and access to telemedicine. We rely on open-access scheduling and our main clinic is open 64 hours per week to better meet the needs of our community. 

In 1990, Wallowa County was in trouble. Only two Winding Waters physicians, Dr. Scott Siebe and Dr. Lowell Euhus, provided care for the roughly seven thousand residents in this wild and remote corner of the state. Dr. Siebe surveyed physicians across Oregon and found similar stories in rural communities: physicians were leaving or retiring from practice in rural areas, and there was no pipeline of physicians to replace them. Dr. Euhus took the survey findings to the state legislature with a strong call to action. The legislators listened, and created Oregon’s Area Health Education Center (AHEC) and a mandate to Oregon Health & Science University (OHSU) to train and retain primary care providers across the state of Oregon.


This month marks the 26th anniversary of both the AHEC program and the OHSU Family Medicine rural rotation in Enterprise at Winding Waters Medical Clinic. These programs together have touched Wallowa County in countless ways. The AHEC has brought programs like MedQuest and Girls in Science that have trained and mentored rural youth to pursue health-focused careers. The AHEC Rural Community Health Clerkship and Oregon Rural Scholars rotations in Enterprise, and the OHSU Family Medicine Residency programs in both Portland and Klamath Falls, have brought four practicing physicians to Wallowa County – Dr. Kirsten Caine and Dr. Emily Sheehan, with Mountain View Medical Group, and Dr. Keith DeYoung and Dr. Elizabeth Powers with Winding Waters. The provider pipeline is working.

OHSU Family Medicine residents come to Winding Waters with responsibility for the resident panel of patients (i.e. those patients who have selected the “resident” as their PCP). Resident physicians have a medical assistant who serves as their at-the-elbow support for navigating our busy locations. Additionally, our main clinic was designed for a team-based model of care – medical assistants, community health workers, nurses, providers and learners all share space in one of two “pods” where conversations flow and teaching occurs organically. The care team, which tackles referrals, care coordination, prescription refills, labs and imaging, sits in an open area directly connected to the pods, encouraging interaction, shared learning and seamless process and workflow development. All twelve 2nd year OHSU Portland residents rotate through Winding Waters, providing care in Wallowa County for six to eight weeks at a time. Additionally, as the newest site in OHSU’s Campus for Rural Health (and currently the only site in Eastern Oregon), Winding Waters also hosts OHSU PA, NP and MD students. We also have a strong relationship with Pacific University, supporting a rural rotation for PA students . 

In cooperation with the OHSU Campus for Rural Health, the Oregon Rural Scholars Program combines primary care training, rural medicine and care continuity for students with a particular interest in rural practice. This is one way for an OHSU student to demonstrate their intent to practice in a rural community, which among other things, makes them eligible for various grants, scholarships and loan repayment programs. Peter Engdall, an OHSU medical student and Rural Scholar, spent three months at Winding Waters in late 2016. Peter recently wrote about his experience for the Spring edition of the OAFP’s Family Physicians of Oregon magazine. 

“Prior to trekking out to the Wallowa’s, I anticipated working with highly respected health care providers dedicated to improving the health and welfare of the people living in rural communities. I was excited to follow patients for an extended period of time. I was prepared to work hard, learn medicine, and see firsthand how rural communities do more with less. While there, I hoped to integrate into the life of the community itself. I am happy to say that I underestimated the impact this experience would ultimately have on my education, my future career, and dare I say my soul.”

Winding Waters became Oregon’s first 5-STAR Patient Centered Primary Care Home (PCPCH) in March of 2017. The Oregon Health Authority created this distinction to recognize clinics that have implemented deeply transformative processes using evidence-based best practices and the PCPCH framework. Some of these processes include expanding access, establishing a Patient and Family Advisory Council to guide operations from the patient perspective, full integration of mental and behavioral health services, and tracking and promoting quality improvement activities, just to name a few. 

The current crop of learners at Winding Waters (see photo below) includes Kevin Vandenheuvel, an OHSU PA student, Kristen Otto MD, an OHSU resident, and Elke Neuenschwander, an OHSU Rural Scholar. Kevin recently accepted a position at Winding Waters and will join our staff full-time in October. After all these years, Dr. Siebe’s and Dr. Euhus’s call to action continues to bring highly talented and qualified medical professionals to Wallowa County and to all of rural Oregon.

 

 

Winding Waters Clinic

L to R: Kevin Vandenheuvel OHSU PA Student, Tiffany Zollman MA, Savannah Wilhelm MA, Kristen Otto MD, OHSU Resident, Elke Neuenschwander OHSU Rural Scholar

 

 

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