In the end, the closing of the Affiliated Community Medical Centers clinic in Atwater came down to an insurmountable challenge: Fewer primary care doctors are interested in rural practice, and even less are willing to go solo.
ACMC officials searched for various solutions that would allow the clinic to stay open after Dr. Stephen Olsen retires this spring, but none were workable, said Terry Tone, ACMC administrator at the Willmar offices.
"We looked at a lot of things. Quite frankly, the biggest issue for us was recruitment," he said. "We just couldn't find someone."
With around 1,500 patients, the clinic is one of the smallest in ACMC's regional health network.
Olsen has been the clinic's lone physician for more than 20 years.
He was a "hometown doctor" who was popular with patients, Tone said.
"A lot of the people really liked Steve and that was a big draw in and of itself," he said. "He had a lot of patients from Willmar too... He's just a great guy."
ACMC got a preview of how hard it might be to replace Olsen when he took a sabbatical in 2001. No full-time physician could be found, so Affiliated ended up bringing in a mid-level practitioner to help see patients at the Atwater clinic until Olsen's return.
Since then, the challenge of finding doctors to work in a rural practice has only gotten harder, Tone said.
A study last year in the Academic Medicine journal found that only 3 percent of the 17,000 students who graduate each year from medical school plan to live and work in a rural area. Overall, about 20 percent of the American population lives in the rural U.S., but fewer than 10 percent of doctors are located in rural communities.
Most medical schools and residency programs are in urban areas, and doctors and their families often adopt an urban-oriented lifestyle that they're reluctant to exchange for life in a rural community, Tone said.
A solo practice is an even tougher sell, he said.
"That is by and large the biggest problem. We're fighting the numbers," he said. "We just couldn't find someone."
ACMC had hoped to keep the Atwater clinic open as long as possible, he said. But when Olsen decided to retire, "I think that changed a lot of things."
Letters went out last month to patients, notifying them that the clinic will officially close May 1.
Patients have the option of switching to ACMC in Willmar, New London-Spicer or Litchfield, or going somewhere else. If they stay with Affiliated, their medical record will follow them, Tone said. "They really don't have to do anything to see an ACMC doctor, other than make an appointment."
The clinic's four employees are being reassigned to Affiliated's flagship clinic in Willmar.
The clinic building in Atwater was rented and the lease agreement will be terminated, Tone said.
He said he knows the Atwater community is disappointed at the loss of Olsen and the clinic.
"It's tough for the folks over there because it is a bit more of a drive to go somewhere else," he said. "We had a really good staff there. Most of them have been there as long as he has. It's kind of tough to see him retire."