By Mike Christopherson

They had in-person access to her for one full hour this morning, so local healthcare representatives and other officials and dignitaries didn't waste their opportunity when Minnesota Sen. Amy Klobuchar came to town to discuss rural healthcare issues.

During her roundtable discussion in the University of Minnesota, Crookston Student Center, Klobuchar heard about a variety of ways that the federal government could help rural healthcare providers standardize procedures, boost technology, increase reimbursement rates and - the most popular concern - recruit and retain healthcare professionals.

"I'm going to remember that surgeon story, believe me," Klobuchar said, after RiverView Health President/CEO Deb Boardman told her that RiverView has been trying to find a second general surgeon for more than two years, without success. With their lone general surgeon in his 60s and pondering retirement at some point, Boardman said it's critical that a surgeon be found.

"If we don't have a general surgeon to perform C-sections, we can't provide maternity care," she told Klobuchar.

The Minnesota Rural Healthcare Association, with an office at UMC led by Judy Neppel, hosted Klobuchar's visit. Barb Muesing, spouse of UMC Chancellor Chuck Casey, is also the president of the MRHA board of directors and attended this morning's discussion.

The freshman senator made Crookston her first stop today as she continues her "Main Street Tour" through various Minnesota cities.

Lots of issues

Boardman and others stressed that quality, successful rural healthcare providers transcend their industry. Boardman, who also serves on the Crookston Housing and Economic Development Authority Board, said she wears "two hats" because rural healthcare and economic vitality are so closely intertwined.

Piggy-backing on her surgeon story, Boardman suggested loan help and/or forgiveness for physicians who shy away from taking jobs in rural areas because the salary simply won't keep up with their tremendous debt-load.
On other issues, she said that standardized, uniform practices spurred by the federal government in areas like billing would cut a tremendous amount of time spent "paper pushing," where one missed code can throw a giant monkey wrench in all the red tape. The same goes for the push for electronic medical records, Boardman said. If the government would standardize the system, there wouldn't be so many private technology companies trying to get in while the getting is good.

"Unless some of these things are government-driven, there are too many self interests determined to see that we never get there," she said.

RiverView is a non-profit, as are many other rural healthcare providers, Boardman told Klobuchar. But the Internal Revenue Service is cracking down more than ever before to make sure that providers are living up to their non-profit, tax-exempt status by giving back to the community.

"It would be devastating" to a rural healthcare provider to lose its tax-exempt status in an IRS audit, Boardman said, adding that she knows of one provider recently subjected to an audit by the IRS of its 2005 records. Auditors spent nine months on-site going through every document, she said.

Roundtable participants stressed the need for continued support of Area Health Education Centers, one of which opened in Crookston in 2007 through a partnership with RiverView, UMC and the University of Minnesota Academic Health Center. Joan Porraz, executive director of the Crookston AHEC, works to introduce more students to the benefits of a variety of careers in the healthcare industry.

By 2020, said Jean Tate, Riverview's human resources director, it's estimated that there will be a shortage nationwide of 100,000 to 200,000 healthcare professionals, a problem compounded tremendously by the elderly population that's expected to double by 2030.
Klobuchar said at her many stops to talk issues with citizens, healthcare concerns "seem to come up over and over and over." She said healthcare will be a huge issue in the presidential campaign, and because of that, she said she doesn't expect any major healthcare-related legislation to be approved by Congress until 2009.

"But that doesn't mean we're just going to wait and year and do nothing," she stressed. "We're working on these issues."