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Cardwell working to bring specialists to Powell Valley Healthcare

Paul Cardwell has a vision for Powell Valley Healthcare’s future, and he has set it in motion.

Under Cardwell’s direction, the organization is recruiting for two obstetrician/gynecologists, a second full-time orthopedic surgeon, a three-day-per-week cardiologist and another family practice physician.

In addition, he said he plans to restart radiation oncology and chemotherapy services at the hospital, and he is working to bring more specialists to Powell as visiting physicians.

“I’d like to bring eight to 10 new physicians to town in the next six months,” he said. “We’re already well on the way. I think it is absolutely going to happen.”

Cardwell took over as chief executive officer for Powell Valley Healthcare on March 7. He said he has spent much of his time since then meeting with physicians, administrators, medical staff and employees about their roles and their views of the organization.

“One thing that is really obvious, after visiting with the medical staff and the hospital board, is that a lot of citizens in Park County were needing to drive to Billings for provision of services,” he said. “My main function these last three weeks has been to find a way to find specialists to come here.”

In addition to allowing patients to receive more care at home without traveling to Billings, Cardwell said recruiting more specialists will improve the hospital’s revenue.

Gross monthly revenue at Powell Valley Healthcare has stood consistently around $4.5 million for the past four years or so, while costs and unreimbursed services have increased, leading to a lower bottom line, he said.

“We have seen an increase of people without insurance,” he said. “Unlike most businesses, we take all comers,” he said, including people who don’t have insurance and can’t pay for their care. “It’s really not the single visit that hurts. It’s coming in for the catastrophic thing — such as coming into the emergency room, followed by surgery and intensive care, generating a $40,000 to $50,000 bill. We still have to pay the physicians and the nurses and the rest, but we receive no reimbursement. It puts a great deal of pressure on the hospital.”

Cost-cutting measures have been necessary, one of the most recent being temporarily curtailing contributions to employees’ 401K retirement accounts. That decision was made before Cardwell arrived, and he said he would like to reinstate those contributions.

“With the support of the staff and physicians, we will be able to return to that in fairly short order,” he said.

Cardwell said he believes bringing in new physicians as planned should increase the hospital’s gross monthly revenue to between $5.5 million and $6 million. And if that is successful, it would allow the hospital to provide still more needed services, such as dialysis.

“Dialysis is extremely expensive,” he said. “We need revenue from those other physicians to pay for a service that doesn’t necessarily pay for itself.”

Cardwell said increasing the number of physicians at Powell Valley Healthcare increases the number of veterans who receive health care through the organization’s contract with the U.S. Veterans Affairs Administration. That, in turn, allows Powell Valley Healthcare to increase its services to the community.

Currently, PVHC doctors care for 1,300 VA patients through that contract, he said.

Cardwell said part of the answer to recruiting physicians and providing more health care services is working more cooperatively with West Park Hospital to recruit specialists who would serve both Powell and Cody.

“I think there’s a whole host of services we can partner with and provide services to the Big Horn Basin,” he said. “Oftentimes, we’re both just a little too small to provide some services, but when we combine the two, we will be able to roll those services out.

“I don’t think most people realize how closely we’re already tied,” he added. “Some of our physicians provide services there, and some of theirs provide services here.”

But, he added, “Powell Valley Healthcare has always been pretty independent, and we plan to maintain that independent status.”

One thing that will work in his favor as he recruits new physicians, Cardwell said, is the close-knit, cooperative group of providers already here.

“We have an outstanding key group of physicians who are fiercely loyal to the hospital and the community,” he said. “That makes my job much easier.”

Bringing in more physicians will benefit the community in other ways as well, he said.

“I would estimate 10 additional physicians here in Powell would bring at least an additional 30 employees to the hospital,” he said, “and that’s going to be good for the community.”

But it isn’t without challenges, one of the biggest of which will be finding sufficient office space for them.

“Fortunately for us, there is some unfinished space in the hospital and the (new) clinic,” he said. “The clinic’s whole second floor and the entire basement are empty.”

Cardwell said he will make a recommendation to the board on Monday regarding the proposals received from five firms for updating Powell Valley Healthcare’s master facilities plan.

“We will retain an architectural firm, then that architectural firm will make recommendations on how to get all our doctors and support staff there,” he said. “Everything’s off the back burner and onto the front burner.”

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