Doctors looking to build practices, support SCMC into the future
MORRIS, Minn. -- When Dr. Toby Christie-Perkins and Dr. Brent Barnstuble began work at Stevens Community Medical Center last summer, one of their goals was to deliver more babies here in town.
Coincidentally, on the days I stopped by SCMC to interview each of them about their first year in the community, both were busy monitoring mothers in labor just upstairs from their clinic offices.
As the two newest doctors at SCMC, Perkins and Barnstuble have spent the year building their practices in the model of an old-fashioned family doctor, developing relationships with patients and their families that could last a lifetime.
Perkins grew up just south of Morris in Dawson. He attended the University of Minnesota, Morris and earned degrees in biology and chemistry before going to nursing school at South Dakota State University in Brookings.
After working for a year in Sioux Falls, Perkins moved to Kirksville, M.O., to attend medical school at A.T. Still University of Health Sciences. The private university specializes in osteopathic or "whole person" medicine, which Perkins describes as doing "all of medicine, plus."
"[Doctors of osteopathy] have a little bit more of a whole patient approach," said Perkins. "I'm in no way a holistic doctor, but I do try and take a look at the whole patient -- everything that is going on with that person -- instead of just simply the disease process."
Perkins did his clinical studies and residency at the St.Cloud Hospital Family Medicine Program in St. Cloud before coming to SCMC last summer.
Compared to life in St. Cloud, Perkins said the pace at SCMC is slower, but far more focused on every patient -- "They're less of a number or a diagnosis in that room. ... I've really appreciated that."
"Every time you start a new practice -- and this is the first new practice I've had or ever will have -- there is a learning curving and figuring out how to be a physician in practice rather than a physician in training," said Perkins. "It's been a great experience -- I think I've grown a lot."
Perkins said he also appreciates working with Barnstuble, who did some teaching before coming to SCMC. Both often bounce ideas off each other and ask for advice.
"He's very receptive and used to teaching, so it's been nice to have that," said Perkins.
Barnstuble also grew up in the area, Alexandria, before moving to Fargo. He graduated from the University of Minnesota, Twin Cities and stayed there for a masters in biomedical engineering before going to medical school at the University of North Dakota.
He completed his residency at the University of Nebraska before joining the Air Force in 2007. During that time Barnstuble served as a teaching faculty member for family medicine at the University of Nebraska and served overseas as part of Operation Enduring Freedom.
When he returned from Afghanistan, he completed a one year obstetric fellowship at Altru Hospital in Grand Forks before joining the staff at SCMC in 2012.
After a year at SCMC, Barnstuble said he is pleased with his decision to come to the facility. Barnstuble praised SCMC CEO John Rau for giving doctors flexibility to run their practices the way they choose.
"He doesn't push you to see a thousand patients a day so you can actually spend time with folks," said Barnstuble.
Jodi Strickler, the nurse who partners with Barnstuble to see patients, said she appreciates Barnstuble's approach of not over-prescribing treatments for patients.
"If he doesn't believe you need to have something done, he won't push it," said Strickler.
"A lot of people love him because he's like a big kid -- people aren't scared to talk to him," she added.
One of the challenges for a new doctor, especially moving to a new community, is finding patients to build their practice into the future.
"In other facilities, new doctors struggle to get enough patients and to build their practice -- we're just not having that struggle," said Perkins.
He speculated that one reason may be that the physician population at SCMC is beginning to undergo a transition.
"Some people are starting to look for a new family doc that they can have for a long, long time," said Perkins. "They've loved their doctors that they've had for a long time -- they all say that and feel guilty sometimes when they're switching -- but they also know it's a transition period in our facility."
Barnstuble said it has been a challenge to familiarize other staff and members of the community with the extent of the work a family physician is trained to do -- everything from cesarean sections to vasectomies to screening colonoscopies to basic dermatology.
"We're broad generalists, but each have our specialties," said Barnstuble. "A good family physician should be able to handle 80 to 90 percent of things."
Perkins, for example, is trained in manipulative medicine, a practice similar to chiropractors that addresses acute and chronic pain as part of regular or specialized office visits.
"I can incorporate that into an office visit or see patients just for that," he said. "It's really a great service and kind of an interesting thing I can do."
Another task for the new doctors is looking to the future. One project both are involved in is researching a system for electronic medical records.
"We are trying to take a nice slow, thoughtful approach to this to find the one that works well for our facility, doesn't make things worse and doesn't cost us money that we shouldn't have spent," said Perkins.
Barnstuble is also working to convert one of his three exam rooms to a "kid room" with a tv, video games, board games and a couch -- a more comfortable place to do exams for children or a place for kids to wait while their parents are meeting with a doctor.
"My hope is that it'll be easier on moms and dads -- when they're talking they can actually talk and the kid can play," said Barnstuble.
As he settles in, Perkins said he is excited to help promote SCMC and help the clinic remain vibrant, independent and up-to-date with where medicine is going.
"In most facilities, it's rare to get young doctors that are interested in coming to a small town and staying in a small town forever," said Perkins.