WILLMAR -- Sen. Amy Klobuchar had good things to say Monday about Rice Memorial Hospital's new facility and about the apparent teamwork among local health providers.
"I'm just really impressed by the work you're doing," the Minnesota Democrat told some 20 providers during a half-hour briefing that was followed by a tour.
"We're very proud of it," responded Lorry Massa, CEO of the city-owned hospital. "We think we practice big-time medicine out here in a beautiful rural environment."
It's an environment under intense pressure, however, as local providers then proceeded to explain.
Klobuchar, who was visiting Willmar on a tour of the region that also took her to Granite Falls and New Ulm, listened intently.
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Dr. Michael Morris, a partner in Family Practice Medical Center of Willmar, is concerned about the future supply of primary care doctors.
As the cost of medical school rises, many students are graduating with $150,000 to $200,000 worth of loans and can't afford to work in lower-paid specialties such as family medicine, Morris said.
"We've had increasing difficulties encouraging young physicians to get involved in primary care," he said. "They say the numbers just can't work."
As current physicians retire, it's going to be harder to replace them -- and the situation likely will be worse in rural areas, said Terry Tone, administrator of Affiliated Community Medical Centers.
"There's just not enough doctors coming out of training now," he said. "It's going to be a lot worse in five years."
Others spoke of shortages for certain specialties, such as psychiatry, and the need to ensure adequate training programs for future health care professionals at all levels.
Reimbursement formulas for Medicare and Medicaid put rural hospitals and clinics at a disadvantage by paying them less, the providers told Klobuchar.
"Comprehensive reform would be something we would like to see happen," Massa said. "The Band-Aid approach leaves everyone in the lurch."
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Jay Kieft, director of Kandiyohi County Family Services, described "huge gaps" in access and services for the poor.
If the rural health infrastructure begins to falter, "it just has a really immense impact for us," he said. "Social justice is about making sure people have what they need to live."
He urged Klobuchar to be vigilant of these needs, especially as health care reform proposals emerge for debate in Congress.
"There's a push towards privatization and we need people to watch closely how efficient this really is," he said.
The providers also had some accomplishments they wanted to share.
For instance, there's the dental training site and clinic, a joint venture between Rice Hospital and the University of Minnesota that's scheduled to open this fall.
It will offer hands-on training in a rural setting and help fill some of the gaps in dental access for low-income and uninsured people, said Dr. Patrick Lloyd, dean of the university's School of Dentistry.
"We were able to raise $2.5 million in 20 months. It's federal. It's local. It's state dollars. It's private money," he said. "I think it's one of a kind in the country."
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Nurses described how simulated training is helping Ridgewater College teach valuable critical-thinking skills to student nurses.
Local providers also told Klobuchar how they're working to be at the forefront of health care quality and reporting.
Klobuchar said she wants to co-author some health care bills to begin addressing some of the areas of greatest need.
"I think we at least have to get some legislation started," she said.
Although major reform is unlikely to happen until after the 2008 election, "it doesn't mean we can't do little things. We should have some of the things we want on the table," she said. "If we don't get it started, we're not going to have it on the table."
