Wednesday, March 19, 2014

Ketchum clinic may represent medicine’s future

‘Mid-level’ practitioners are replacing general practitioners

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By GREG MOORE
Express Staff Writer

Nanette Ford, right, and Kristen Allen are partners in a Ketchum medical clinic that strives to provide personalized health care. Photo by Willy Cook

As “mid-level” medical practitioners, Nanette Ford—a physician assistant—and Kristen Allen—a nurse practitioner—say they are able to provide physician-quality care to most patients at less cost. And since they’re not part of a corporation, no administrator is telling them how much time they can spend with each patient.
    The two women are partners in a medical clinic in Ketchum. Ford, 58, has worked in the Wood River Valley for 26 years, and won the Best Medical Provider award five years in a row in the Sun Valley Guide’s Best of the Valley. Allen, 51, joined the enterprise two months ago after having worked as a registered nurse in California for 24 years. She recently upgraded her status to nurse practitioner by completing a two-year-long master’s program.
     Though they arrived at their credentials through different routes, both have about the same legal capabilities to practice medicine. In Idaho, they can diagnose patients, treat them and write drug prescriptions.
    They said that with medical-school costs skyrocketing, graduates can no longer afford to be general practitioners, and are forced by financial circumstances to become specialists. In many areas, the void is being filled by physician assistants and nurse practitioners.
    According to the U.S. Bureau of Labor Statistics, employment of physician assistants is projected to grow 38 percent in the next 10 years, much faster than the average for all occupations.
    “The lines have really blurred,” Ford said. “We do about 80 percent of what a physician would do.”
    The clinic’s emphasis on wellness rather than sickness is reflected by a décor with a somewhat Eastern and Buddhist theme that promotes relaxation.
    “My goal when I started this business was to have it as nonmedical-looking as possible,” Ford said.
    Ford and Allen said they offer “integrative” and “personalized” medicine.
    They describe the “integrative” part as involving mind, body and spirit—a bridge between Western and Eastern medicine, with some herbal remedies and advice on lifestyle changes. Those changes, Ford said, can require a lot of education and counseling.
    They say that many of their patients are wary of the potential side effects from prescription drugs, and in their office, herbal remedies are often offered as an initial tactic when appropriate. Ford said they are usually safer and can often achieve the same results—but only when they’re pharmaceutical-grade supplements with standardized ingredients. She said some companies only sell herbal medicines of that quality through medical offices.
    Allen said conditions treatable with herbal remedies include high cholesterol, immune-system deficiency, joint problems and menopause, among other things.
    But the women don’t shy away from prescribing traditional drugs when they’re needed. Sometimes that’s after other attempts don’t work, and sometimes when it’s obvious that they’re needed immediately—a bacterial infection, for example.
    “I’m not anti-drug company,” Ford said. “They’ve saved millions of lives. But I want to offer choices.”
    Ford said the choices she offers patients have not resulted in a single malpractice suit over her 26 years of practice.
    “I know my limits, I know my boundaries, I know what’s safe,” she said.
    The “personalized” part of their practice, they said, involves taking enough time to analyze all of the potential mind-body-spirit connections.
    “What’s happened with the big corporations is that they’ve lost the personalized medicine,” Ford said. “None of the head-to-toe, the spiritual part of being a patient, and that’s what we’re able to do here. I think what people are looking for is to be listened to. We’ll spend the time listening to what’s going on.”
    That approach seems particularly appreciated by women, who make up about 65 percent of the clinic’s patients. But Allen said the integrative approach is effective with “male menopause” issues such as fatigue, and for athletes who want to improve their performance. Ford said it’s common for women to be so pleased with the treatment they received from Ford that they refer their husbands to her. The clinic also treats children over 4.
    “We’re a family practice,” Ford said. “We get multiple generations of families.”

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