I'm walking the halls of Ashley County Medical Center in Crossett with Phillip Gilmore and thinking this is a story that needs to be told.
Crossett was in the news in June when Georgia-Pacific Corp. announced plans to close its bleached board operations, costing 555 people their jobs. In 2011, the company shut down its plywood and stud operations at Crossett, and 700 people lost their jobs. That's 1,255 jobs that have disappeared in this decade in a town that has seen its population fall from 6,471 residents in 1990's census to 4,900 people these days.
Lest you think there's nothing but bad news in Crossett, spend some time with Gilmore, the hospital's chief executive officer. At a hospital located just a few miles north of the Louisiana border in one of the most remote parts of Arkansas, he has developed a model of what a rural hospital should be.
It was announced earlier this month that CARTI, the nonprofit cancer care provider headquartered in Little Rock, is opening its newest clinic at Ashley County Medical Center with medical oncologist Bilal Malik offering infusion services that include chemotherapy.
As I drive up to the facility on the edge of town, I notice a banner proclaiming there's also an alliance with Arkansas Children's Hospital. Gilmore tells me about yet another alliance with the University of Arkansas for Medical Sciences for stroke treatment and prevention.The 25-bed hospital serves one of the largest counties geographically in the state. Ashley County covers 940 square miles.
"This hospital has been around for 111 years," Gilmore says. "Since this was a timber town, it was the last wooden hospital in the state. Now, we have some of the best equipment in Arkansas. We offer 3-D mammography, for instance. Otherwise, patients would have to go to Pine Bluff or Monroe, La., for those services.
"We have one of seven concussion specialists in the state. We have three pharmacists on staff. We have a surgical suite and a six-bed intensive care unit. We operate a fitness center downtown. We just ordered new furniture and beds for our rooms."
Gilmore continues to list the hospital's assets, but I'm thinking about two discussions I had earlier in the summer.
One was with employees of Mid-Delta Health Systems at Clarendon on the lower White River in east Arkansas.
The other discussion was with Dr. Cam Patterson, UAMS chancellor, over lunch at Cathead's Diner in the emerging East Village neighborhood of Little Rock.
I'm also thinking about the rapid urbanization of Arkansas, a subject I've written about a great deal during the past year. A majority of Arkansas counties are now losing population as we transform into two states within a state--an urbanized (think northwest Arkansas, central Arkansas and the Jonesboro area) state of "haves" and a rural state of "have nots."
Among the biggest challenges in what I call "the new Arkansas" will be providing quality health care to those who continue to live in rural areas. For smaller Arkansas cities with hospitals, Crossett can serve as a model. For even smaller Arkansas towns with no hospital, Clarendon can be a model.
In the middle of it all, UAMS must try to put the pieces together to ensure that no Arkansans are left behind. Patterson, a renowned cardiologist who came to Arkansas a year ago from New York, understands that. He has spent the past year getting to know the state better while plotting a course for the future.
"In many ways, that's the central challenge we face here," Patterson tells me when I ask him about the urbanization of Arkansas. "We have areas that continue to lose population. One Delta town has a hospital with almost 150 beds and an average patient count of 17. That's not a sustainable model. I have to ask myself what UAMS can do to support health services in a place like that.
"That's not to say our challenges are confined to rural areas. We have people in the growth areas who have to leave the state for certain specialty services. We have to find ways to address both ends of the spectrum."
I mention the recent closure of the hospital at De Queen, near the Oklahoma border in southwest Arkansas.
"We're seeing hospitals close in rural areas across the country," Patterson says. "Here in Arkansas, we must get out ahead of this and come up with a solution before one hospital closure turns into 10 or 12."
UAMS has employees in 73 of the state's 75 counties. Sixty percent of Arkansas' doctors and 70 percent of its pharmacists are UAMS graduates. There are eight regional campuses. The chancellor realizes that UAMS has a statewide mission.
"I wouldn't be able to understand Arkansas unless I was getting out in the state on a regular basis," Patterson says. "I love getting to know the health-care providers who have devoted their careers to making life better for people. I get inspired when I visit with them."
Gilmore, who serves as president of the Arkansas Rural Health Partnership, praises Patterson for his outreach. The ARHP is a nonprofit network governed by the CEOs of hospitals in Arkansas, Ashley, Bradley, Columbia, Chicot, Dallas, Desha, Drew, and Jefferson counties in east and south Arkansas. The administrators typically meet on the first Friday of each month.
According to the organization's annual report: "Even while our small rural hospital partners have struggled financially, they have not stopped paying their membership dues. Instead, they are looking to cut costs by engaging with network partners in new cost-saving initiatives.
"The partnership is doing a great job in our region, especially when it comes to things like addressing the opioid crisis, the mental health crisis and the diabetes crisis," Gilmore says.
He points out that his hospital has been in the black for nine of the past 10 years despite being in a county that's losing population. It's supported by a quarter-cent countywide sales tax.
Monroe County, the home of Mid-Delta Health Systems, has been losing population even faster than Ashley County. In fact, Monroe County lost a higher percentage of its population (21 percent) than any other county between the 2000 and 2010 census. Yet the community health center operates out of a state-of-the-art facility in downtown Clarendon (one of the few modern buildings in town) constructed in 2012.
The clinic offers the services of both a physician and a dentist along with visiting pediatricians and gynecologists. There are exam rooms, a laboratory and a community room where civic clubs meet. The clinic employs about 30 people.
In Crossett, meanwhile, the Ashley County Medical Center has more than 300 employees. Still, Gilmore says his employees "wear a lot of hats. For example, I don't have a chief financial officer on staff."
Of the state's 75 counties, 23 don't have a community hospital. Another 39 counties are served by only one hospital.
Gilmore views partnerships with organizations such as UAMS, CARTI and Arkansas Children's Hospital as the wave of the future.
"Cam has a heart for rural health," he says of the UAMS chancellor. "He sees that we're saving lives in places such as Crossett. The reason we go into this field is to do the kinds of things we're doing at this hospital. With the focus that Cam has, we have the opportunity to do much more for rural health in Arkansas in the years ahead."
------------v------------
Rex Nelson is a senior editor at the Arkansas Democrat-Gazette.
Editorial on 08/18/2019