Dr. Robert Epstein: Improving Health in Washington
Dr. Robert Epstein, a family medicine physician with Family Medicine Port Angeles, a rural health clinic located in Washington. Dr. Epstein is also an Assistant Clinical Professor at the University of Washington, and uses 3RNet to easily help find physicians who are a good match for his practice.
We connected with Dr. Epstein to learn more about how our 3RNet Washington member, Jawana Cain, helps him with his recruitment efforts and quickly discovered that not only is he a great advocate of 3RNet’s—he is a great voice for rural health!
He’s passionate about family medicine
I went to medical school pretty late. I was a nurse practitioner for 10 years. I woke up one morning and said I wanted to be a doctor. My wife and I worked on the Navajo reservation for Indian Health Service and eventually came out here.
My wife and I always intended to live in a rural area. We always worked in rural areas as nurses and ended up in Port Angeles because it was a good fit for both our family and myself. It’s bigger than we thought we’d end up in (it’s about 20,000 people) but it’s been great.
He’s starting an FQHC to better his practice, and health care
We’re in the process of converting our private rural health clinic into a Federally Qualified Community Health Center (FQHC). That’s part of the progression of all the things we’ve been doing. We’re going from Family Medicine Port Angeles to North Olympic Health Care Network starting September 1. We received a grant from the federal Health Resources and Services Administration (HRSA) to help facilitate this transition.
We’ve been a rural health clinic since about 2001 and now we’ll be an FQHC. One of the reasons we did that was to give us a bit more stability. We’re hoping it will facilitate starting a Rural Training Track and maybe even becoming a training center at some point.
He’s helping tackle the physician shortage
It became really evident that if we were going to be able to deal with our chronic primary care physician shortage, the best way to do it would be through graduate medical education. I realized this quite a while ago and started to look at it pretty seriously.
My group has been involved in undergraduate medical education since about 2002. We’ve been a site for third year students for quite a while now and we have visiting residents. It became really evident that when you look at where people end up when they’re in residency—that exposure to small, well running communities prompts people to stay in rural communities. Rural Training Tracks (RTTs) have a very consistent level of success: about half of training physicians who participate in an RTT stay near where they did that RTT; the other half ends up in rural or underserved areas.
We have a great relationship with a hospital in Seattle, and I proposed the idea of starting up an RTT to them. Residents will spend first year in Seattle, second and third out here. There are a lot of barriers to starting an RTT, but we’re still hoping that we can have residents start in Seattle in 2017 and be out here in 2018. We’re very actively trying to figure that out.
He’s working smarter (using 3RNet!) to successfully recruit
I met Jawana and Renee [Renee works with Jawana and is also part of the 3RNet] probably five years ago, when we were just starting to think about the RTT.
They send prospective people who might be interested in our area. They helped with the state loan repayment program when it was funded in the past, which helped us get some nurse practitioner and physician assistants. We were a National Health Service Corps loan repayment site, and we’re working on reactivating our site now that we’re becoming an FQHC, and they’re a huge help with that process as well.
They’re our connection to the state and federal level of so much of this.
We’ve had an incredible recruiting year. We have five new physicians starting at our clinic this year. 3RNet is part of that. Two of these physicians actually came to us through 3RNet and Jawana [3RNet’s member in Washington]. One of the things that we’ve been able to attract recruits on is this whole idea of being involved with an RTT, medical education, starting an FQHC, and we’ve been able to attract these incredible people.
It would be hard to do all of these things: recruiting, National Health Service Corps, state loan repayment, and even interacting with others interested in rural health care. Jawana and Renee can point me in the right direction.
There’s a lot of good things going on.