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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

VA center hits wall in recruiting ER doctors

Recruiting emergency room doctors remains a challenge for the Mann-Grandstaff VA Medical Center, which hasn’t made any progress since December in filling vacant positions.

The VA is working with a national recruiter and advertising in outdoor magazines in an effort to entice ER doctors to Spokane, said Ron Johnson, the medical center’s interim director. In the meantime, the VA will continue to offer an urgent care clinic from 8 a.m. to 6 p.m. daily, staffed with contract physicians.

The clinic offers most of the same services as an ER, though it doesn’t accept emergency ambulance transfers, said Dr. Kimberley Morris, the VA’s former chief of medicine, who now works with geriatric services. Patient visits have remained fairly steady since the 24-hour staffing was cut back in December. The ER had about 1,445 patient visits monthly in 2014; the urgent care clinic is averaging about 1,313 visits monthly.

The VA has a 36-bed hospital and outpatient services, providing care to more than 32,000 veterans in Central and Eastern Washington, North Idaho and northwest Montana.

Many of the patients who visit the urgent care clinic have health issues that could be addressed by a primary care provider, Morris said. But the VA is mandated to provide an ER, and many of the veterans in the Spokane area want that service restored, Johnson said.

To fully staff an ER, the medical center needs to recruit seven doctors and one half-time physician, he said. The ER could also operate with a combination of staff and contract doctors.

The hospital’s small size is a disadvantage in recruitment efforts, Johnson said.

“We don’t have a lot of services that lend themselves to bringing complex patients in,” he said. “If you’ve trained as an ER doctor, you want to see trauma patients, or cardiac patients or stroke patients.”

The VA has made gains in hiring other staff over the past 16 months, adding 21 doctors and 45 nurses, he said. But the medical center has about 52 positions that remain open, including difficult-to-fill specialties such as doctors who treat gastrointestinal issues, lung disease and rheumatoid arthritis.

If the VA can’t provide the service, the medical center connects veterans with private-sector doctors, Johnson said.