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| Doug Miller, FNP |
I need to start this column by saying I am so grateful for my job. I am a nurse practitioner in Rocky Ford. I own my own medical practice. I am honored to be a part of the lives of my patients, their parents and grandparents, and sometimes even their great grandparents.
I needed to start out with that positive statement, because a clinic in rural Colorado often feels to its owner like a small ship in a big ocean, an ocean with some pretty nasty waves.
I'll start with the challenge of getting help. Not only is it hard to attract medical professionals to rural spots like ours, finding enough funds to pay them competitive salaries is difficult too. The Colorado Rural Health Center (CRHC) has done much to help on this front; the two physician medical directors I've recruited since opening the practice in 2003 have come due to CRHC recruitment.
Part of our challenge out here is getting the government and insurance companies to really understand that care in rural areas is often delivered via advanced practice nurses like me.
I'll close with a word about health care reform. While much debated and criticized, much in the health care reform law approved by Congress is good, especially when it comes to pre-existing conditions and allowing parents to continue to insure their children to age 26. The issue that worries me about reform is the number of newly covered patients it creates. Don't get me wrong; more covered people is definitely a good thing, I just worry about my, and our, capacity to care for significant numbers of new patients. Also, I worry about how the state, which is required to pay for half of all Medicaid charges, is going to find the funds to accommodate the increased cost of thousands of new patients?
Since I started on a positive note, I'll end on one. We're an innovative and generous state and country. I'm confident we can address these challenges, but also appreciate the time to get to work on them is now!
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