CU medical students study rural living in RGC

MONTE VISTA—Students from the University of Colorado Anschutz Medical Campus visited Rio Grande County last week for Rural Immersion Week. The week is designed for medical, physician assistant, pharmacy, advanced practice nursing and veterinary students to better understand what practicing medicine and living in such an area will be like. Students enrolled in the Rural Track will practice medicine in a rural area upon completion of medical school. The 2017 Rural Immersion week was sponsored by the University of Colorado Anschutz Medical Campus, in conjunction with the Colorado Area Health Education Center program office. Rio Grande Hospital also assisted in the program.
Twenty-three students attended the program from June 5-9 as well as Director of the Rural Track program Dr. Mark Deutchman. Some of the students stated they were from rural areas and one stated he grew up in Alamosa, but the majority of the students were from urban areas and were surprised by their findings about local life. On Friday, the students presented slideshows about what they learned at Smokin’ Johnny’s BBQ. The students were divided into presentation groups based on topics: business, economy/economic development and local government; natural resources, agriculture, environment, wildlife and tourism; education, community life, arts, culture and faith-based organizations and healthcare, human services, public safety and law enforcement.
The business, economy/economic development and local government group, consisting of first and second year medical and pharmacy students, told presentation attendees that they toured and met with several local business owners and managers including Three Barrel Brewing Company, Proximity Malt, The Windsor Hotel, Java Dave’s and Kristi Mountain Sports. They also met with Rio Grande Savings and Loan CEO Kathy Rogers and Colorado House District 62 Representative Donald Valdez.
The students were very impressed to see how many local businesses were willing to help others, in both similar and different industries. They used the example of Three Barrel Brewing Company providing assistance to Square Peg Brewerks in Alamosa and giving their leftover malt to local pig farmers, “It’s very beautiful to see everyone work together for economic development. “The students also praised the efforts of Del Norte’s town board and business owners for finding an identity for the town, “filling niches the community doesn’t know is there.” They also praised Will Kreutzer for envisioning that Del Norte should be more like Salida. Areas the students saw for improvement included connecting business owners with more resources, such as the City of Monte Vista website which provides step-by-step instructions for business owners, more assistance with helping businesses apply for grants, finding an identity for South Fork and Monte Vista like Del Norte has and creating a plan for more affordable housing. The students cited Valdez for not having a plan to intervene in what they saw as a lack of homes for sale and expensive housing as a detriment and stated “we walked by a realty office that had some houses up in the windows” as evidence for this claim.
The healthcare, human services, public safety and law enforcement presentation was presented by first and second year medical students, a Bachelor of Science in Nursing sophomore and the spouse of a medical student. These presenters were excited to learn what rural practicing and life was like in their chosen field, meeting with Clarissa Woodworth and Mary Lambert from San Luis Valley Behavioral Health, Dr. Kelsey Hurley-Walker of Rio Grande Hospital, Monte Vista Police Chief Evan Lopez, Director of Rio Grande County Public Health Emily Brown, South Fork Fire Chief Tyler Off and other members of the South Fork Fire Department, Karen Martinez of the River Valley Inn and Jodi Kern with Rio Grande County Department of Social Services. The students learned how various resources network within Rio Grande County and the Valley in general and learned the history of Rio Grande Hospital. The students were also impressed to find out that Lopez is not only chief of police but also an EMT with the ambulance service and volunteers with other community organizations.
“The challenges or areas of improvement as I like to call them” stated the presenter, that these students took away from their immersion project included substance abuse, lack of resources/gaps in services, generational poverty, cultural differences in health education and difficulty in developing a work/life balance. The positive takeaways included how welcomed they felt by all of the healthcare professionals , the “incredible collaboration” between agencies, creativity in resource use in grant writing, community involvement with “nobody ever saying ‘that’s not my job’” and consistency in continuity of care. Brown asked the spouse what he took away from the immersion week. “I’m not going to be just this or just that,” he said, acknowledging that professionals wear many hats in the community, before joking that the South Fork Fire Department had already tried to recruit him. An audience question about specialists also led to high praise for Arlene Harms and Rio Grande Hospital’s business model of hiring family physicians that also can practice in the ER, to provide a strong primary care base. Deutchman explained “you don’t need a rheumatologist or cardiologist here,” adding “small hospitals break the bank trying to keep specialists you don’t need,” stating rural areas need a strong primary care system to be the most effective and people can travel to cities and larger health networks for specialists.
The natural resources, agriculture, environment, wildlife and tourism group included first and second year medical students and one veterinary student. This group spoke with several farmers, business leaders and government leaders, including the owners of Three Guys Farms, Aspen Potato, Jim Ehrlich with the Colorado Potato Administrative Committee, Rio Grande County Commissioner Karla Shriver and Shaun Noonan with the Bureau of Land Management (BLM). This group was the most eager to learn from the Valley natives who took them on facility, farm and public lands tours, telling attendees about how government regulations affects potato growers, how water quality and air quality are affected by local and distance pollutants, how solar plants are expanding in the Valley and how the Forest Service, Fish and Wildlife Service, National Parks Service and BLM each operate and cooperate to expand tourism. The students talked about the impact of technology in farming, beginning with SNOTEL tracking snowpack, to magneto-thermodynamics making watering more efficient, to aircraft thermal imaging and phone apps for farmers to track their fields to mechanized packaging reducing the risk of injuries and maximizing the efficiency of potato storage without costing many jobs. The presenters included many quotes to summarize what they learned including Ehrlich’s statement “nobody has ever died from eating a potato,” when discussing the necessity of government regulation but the frustration that CPAC and farmers have with meeting new and constant changes. They also cited how the community works together on water bill advocacy, wetland conservation easements, and soil conservation, including a quote by Shriver, “if you don’t have water rights, you don’t have anything.”
The positive aspects the students took away from their research was the collaboration of multiple agencies and the proactive culture shared when addressing potential problems. They noted that there is some resistance to change in the culture as well, which they said was a challenge, but overall they felt they learned an immense amount, joking, “especially about potatoes.” They concluded with another quote from Ehrlich, “Farming is part art and part science.”
The final presentation, education, community life, arts, culture and faith-based organizations tackled each topic by presenting positive points and challenges on each subject. They spoke with Superintendent Robert Webb of the Monte Vista School District and talked with representatives of the Colorado State University Extension, the Del Norte Headstart and Father Derrick Scott of the San Juan Catholic Community. Throughout the presentation the students emphasized what other groups had said, collaboration between agencies and groups is unprecedented and largely for the greater good of the community. However, the group found that some of the collaboration wasn’t spread equally, with the Del Norte School District citing a very positive, proactive relationship with DSS for example, while Webb stated that the Monte Vista School District has found their intervention to be only reactive after something has gone wrong. Father Derrick also stated that there is not much collaboration with faith organizations and despite the efforts of the clergy to maximize their involvement, with two priests performing eight services a week in three different churches, other community organizations do not return the favor and they often find church meeting times and events being in conflict with local sporting events. The students also cited a “lack of diversity” in faith-based groups as a potential downside to Rio Grande County, with the vast majority being Christian.
The students were also impressed with how interested the communities are in local events, describing their surprise that employees at a quilt store had high praise for the Hot Rod Dirt Drags events and the respect that each town has for events like the Potato Festival, Covered Wagon Days and Stampede. There were both positives and negatives to their education research, with opportunities for interns at all levels of education beginning at the high school level with the CSU Extension offices’ projects being listed as a positive along with several forward-thinking programs being implemented in Monte Vista Schools. However, they also stated that about 50 percent of MVHS graduates attend college, with half of those students dropping out after the first year, which they attributed to both economic and academic struggles. They also noted that homelessness is a problem that is not as easily seen as it is in urban areas, because often homeless people and families will be sleeping in cars or staying temporarily with friends and family instead of prominently in encampments. The students in this group were told repeatedly, “it takes time but it’s worth it” regarding adjusting to rural life.
Johnny Ward, owner of Smokin’ Johnny’s BBQ and whose wife is also a local doctor, encouraged the students to stay dedicated to their rural track program and their goals, but to expect challenges along the way. He discussed his experiences moving from a very populated area of “about a half million people” in Texas to Demopolis, Ala., home to about 7,000 people. Ward stated that he was told by a local “If you embrace Demopolis, it will embrace you,” which he assured the students was true of many rural areas, including the San Luis Valley.

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