Longtime Spokane physician Bob Hustrulid knows it’s rare for a doctor’s office to be based inside a retirement community, but the approach makes sense to him – and he’s done it before.
In his long career, Hustrulid has worked at group practices and veteran hospitals. A U-turn happened when he opened a private practice in 1999 at the Waterford, now Touchmark on the South Hill, where his elderly parents then lived. He stayed until about 2007 and cared for residents and patients from outside the center. As an internist, he then received an invitation to join Spokane Internal Medicine.
But in the past two years, Hustrulid, 78, grew frustrated with modern medicine’s pace and administrative changes after a buyout. So a few months ago, he made a cold call that received a warm reception. This time, Hustrulid is set again to open a solo practice inside Evergreen Fountains Senior Living Community in Spokane Valley.
With no plans to retire , he wants to spend more time with each patient during office hours three days a week.
“I’m moving on, back to the future,” Hustrulid said. “I’m doing the retirement home thing again.
“Those are the best years of my medical career when I was at the Waterford. The way I practice medicine is somewhat different than what’s typically done. It’s the way medicine used to be practiced.”
Medicine is thought of today as mostly a business, he said, and it’s a concept that doesn’t fit with his view of doctors helping people.
Instead, he thinks of that role as a privilege and one that requires long conversations with patients. He never went into the field to get rich.
Hustrulid followed a family member into medicine and trained at the University of Minnesota, then moved west to join his uncle, the late Dr. Roy Pearson. In Spokane, he started seeing patients in 1971. He learned what’s important is to both listen and watch a patient.
“Actually, in the scheme of things, most people aren’t very sick when they come to see you,” he said. “They’re frightened, or there are things going on in their world that make them feel less than well. Sometimes, just talking to them is all you need to do.”
He hears from friends and patients about appointments today when doctors don’t look at them in the exam room, instead focused on typing on computers to gather data. Hustrulid doesn’t care much for computers.
“That doesn’t work for me. Most of what I learn about somebody is just watching them. When I’m in the exam room with a patient, I’m looking at the patient, and I’m talking to them and looking at their responses to the questions. That’s how I’ve always practiced medicine.
“It doesn’t generate a lot of money doing it that way. But to me, that’s the only way you can effectively take care of people.”
Another preference doesn’t fit with modern practices, especially when schedulers work remotely.
Hustrulid said he typically sees about 20 people a day but starts with only 10 patients who have booked visits to allow for people to call in if they need last-minute appointments. That hasn’t gone well the past two years, so he ended up handing out his cellphone number to many regular patients.
“Before, my staff would say, ‘Come on in,’ so I’d see them that day or the next rather than the next available time is a month from now, which is typical in today’s world. If you wanted to see your doctor today, the chances are virtually zero, but not with me.”
Near that 1999 timeframe, he and his parents visited Evergreen Fountains, and Hustrulid strongly considered the community for his dad Andrew, then 93, and mom, Anni, who was 88 when they moved here from Oregon. Construction noise, however, impacted the Evergreen site. After moving to the Waterford, his dad died about four years later. His mom remained until her death at age 94.
While at the Waterford where he could visit with them regularly, he saw patients sometimes in their living quarters. He carried around a black leather doctor’s bag with instruments received during medical school. The facility also offered ample parking and a welcoming environment to see patients.
“When I left the VA and moved to the Waterford, at that point I didn’t have a practice as such, so most of the people I first started seeing were really patients who were there,” Hustrulid said. “After all was said and done, eventually most of the patients I saw day in and day out actually came from the community. That worked very well.
“A lot of people, patients from the outside, ended up moving to the Waterford for their retirement needs. From the cure standpoint of the people living there, they’d come and see me for an office call in their pajamas, and I could make house calls. I would just walk down the hall. People didn’t need to go out.”
Hustrulid’s last day at Spokane Internal Medicine was Nov. 13. He said Evergreen Fountains co-owner Prokey Arger responded favorably to his cold call to open a practice there and met with him within two days. Hustrulid said he plans to lease the space and is paying for renovations.
Launching the practice has required administrative reworking, but Hustrulid expects it to be on track by year’s end. Remodeling includes prepping two exam rooms, an office and storage areas. He hopes to have a medical assistant he’s worked with before join him.
There’s also been complications because of COVID-19, so he plans at first to see patients who live outside the Evergreen center inside an RV that he purchased and will have parked at Evergreen Fountains.
When Hustrulid left Touchmark, he said a nurse who became a nurse practitioner then took over the space while seeing only Touchmark residents. Hustrulid said he’s not aware of any doctor private practices at other retirement communities in Spokane, but he hopes to help expand that option eventually.
In the meantime, Hustrulid plans a focus that benefits patients at Evergreen Fountains.
“Being there as a doctor, at least people can have generally most health care needs met without ever having to go out, and that’s a real positive,” he said. “For old people, there is a lot of fear. When you’re 25 and you get a stomachache, you think it’s probably the flu. When you’re 85, you’re afraid it’s cancer; it’s still usually the flu. It’s just a different way of seeing the world, so just a reassurance is quite often what people need.”
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