Where Patients Bloom

"I've always considered us a different type of practice," says Pam Born, RN, practice manager of River Rose Obstetrics & Gynecology. That's why no plain-Jane name would do when the practice, once part of a university, went out on its own in 2003. The name River Rose stemmed from the practice's location near the Hocking River and from the custom of delivering a single red rose to each patient following surgery.

In the Appalachian region of southeastern Ohio where the practice is located, the median household income is $17,122 and 45 percent of patients are on Medicaid. "We don't turn anyone away," says Born, noting that the practice recently opened a second location in nearby Meigs County, an even poorer area than Athens. River Rose offers a sliding fee scale and payment plans for patients who are under- and uninsured, and often gives out gas vouchers and lunch coupons. These patient-friendly touches have helped increase volume from 200 patients a week to 350 to 400 a week.

"Practicing in a region of low economics, we have adapted our office and practice schedules to allow us to maximize physician time, office space, and staff resources while containing overhead," Born says. For instance, the four physicians and office staff have staggered schedules, and office space is designed so that several physicians can work at the same time without getting in each other's way. The practice opens at 6:30 a.m. three days a week to accommodate people who are self-employed or work the night shift. Time is allotted each day for acute patients. And the practice has added a maternal-fetal medicine physician to help manage high-risk pregnancies and interpret ultrasound reports - patients no longer have to make the two-hour trek to Columbus or Dayton for these services.

Community Matters

River Rose also taps into local resources. For instance, the Department of Community Services and Ohio University College of Osteopathic Medicine provide a grant-funded nurse who offers prenatal education for uninsured and high-risk patients and helps them get enrolled in any assistance programs they qualify for. The practice also collaborates with the Athens County Department of Job and Family Services to provide smoking cessation education to prenatal patients.

The physicians regularly provide free Pap clinics to the community, and also work with the local medical school and adult education center to help train medical assistant students. Often, the physicians dip into their own pockets to help patients with money for gas or medication - or even a much-needed night on the town. "You have to be a certain type of doctor to work here," says Born.

Seeing low-income patients means seeing more patients, and River Rose rewards staff for long hours and hard work. "You have to be resourceful [with staff incentives] because we don't have tons and tons of money," says Born. A favorite perk is closing the office early so the staff can attend the annual Athens County Fair together. One of the physicians has a condo at a nearby ski resort, which he makes available to each employee for a weekend away. The result? Virtually no turnover - except for one employee who left to spend more time with her baby.

Of course, "Our patients are wonderful. They truly appreciate everything you do for them," says Born. The practice has a "Wall of Fame" featuring photos of families with the doctor at their first post-natal appointment - a tradition that patients love. But perhaps the highest compliment of all: "Recently we have noted the popular trend of patients using 'Rose' as the baby's middle name" in tribute to our practice, Born says. 

- Abigail Green

This article originally appeared in the November/December 2005 issue of Physicians Practice.