The value of rural healthcare

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I’ve spent over three decades engaged in almost every conceivable aspect of healthcare. Since the late 1980s, I’ve been involved in the business, finance, recruitment and general operations of hospitals all around the United States. I’m no stranger to waxed floors and white lab coats. I know from firsthand experience that having a local clinic or hospital extends far beyond having medical services within reach. A hospital is a foundational institution that marks the growth, stability, and vitality of a community. The presence of a medical facility means an established community placing a strong value on health and wellness. My experiences do give me an interesting perspective on the value of rural healthcare.

In my career, I’ve had the opportunity to open or expand exceptional facilities that would go on to be public fixtures for better living, but I’ve closed facilities as well. I want to share some personal experiences regarding opening and closing, hoping they will reinforce the value of rural healthcare, especially in smaller communities.

Opening and maintaining

In 1990, I assisted in reestablishing a community hospital in Nevada that was on the verge of closing down. Almost immediately, I could see this facility’s value for the surrounding community. Luckily, the management company I worked for at the time helped the community set up a new not-for-profit corporation. A board was organized, and we negotiated separation from the regional health care system that was planning to close the facility. We helped secure financing for operating capital and recruited new leadership to officially reopen the facility.

Today they are a thriving small community health system much like Tri-County Health Care. The takeaway from this situation is that avenues do exist to maintain a healthcare system. Opening a new facility is tough, but so is closing one. A community rallying together to maintain a hospital is necessary, so my advice is to foster deep relationships with the community. Remember that we serve our neighbors, friends and families. We all have the same goal in the end.

Closing down

A year after the Nevada facility noted earlier, I shifted my focus to another small community. Unfortunately, I wasn’t called upon to reorganize and reopen but to close a small community-owned hospital in North Dakota. We spent approximately three months in our analysis and managing the facility to help stabilize the situation. Unfortunately, our analysis did not prove to offer much of a solution; it was the beginning of the end. We couldn’t do much due to a challenging rural health financial environment and receiving the call several months too late.

Shutting down a hospital or clinic is a very methodical and tiring process because a hospital is ingrained in every aspect of the community. The amount of financial and legal hurdles that need clearing in even a small facility can be staggering. The process included a review of staffing, financial considerations, market considerations and community perception issues. Considering all of this, circumstances dictated the decisions, not by anyone’s expectations or resolve to make it better. We guided the shutdown process along with a bankruptcy attorney and trustee. We would finish one project, only to reveal ten more. Informing the community and organizing transition plans proved to be the most gut-wrenching.

Aftermath

Impact on the community was, of course, difficult. The loss of services meant that most community members had to travel 15 miles or more to receive care. The local economy also suffered; the hospital had provided over 70 jobs. When you close down an organization like this, you not only lose jobs, but also the commerce invested in the community. Such a closure also brings unforeseen circumstances like the local nursing home having to find another medical partner for various services like lab work.

This isn’t discussed in board rooms or bank offices, but the loss of community pride is inherently noticeable. It isn’t like a coffee shop or hotel shutting down; you can’t just start a new hospital down the street. If a community can’t even protect its own well-being, are they a community at all? Something to think about.

The new building

Another aspect I have much experience with is the construction of new facilities. The key steps to successful projects are identifying the needs, evaluating various options, performing financial feasibility studies, and planning the project with input from the individuals closest to the work. Engaging a solid team of planners, architects, engineers, and contractors is important to bring about a new vision. I don’t know everything, and I know when it’s time to lean on others.

I want to touch on something that doesn’t often get brought up, which is moving day. Setting up a new hospital isn’t as simple as cutting a ribbon and ushering staff and patients through the door. Setting up a proper, efficient hospital requires working with internal leaders and external advisors to orient the new space. This step is critical to ensure a smooth transition. Methodical move-in practices combined with specialized training should be paramount before operations start or resume. The worst thing is having a beautiful new hospital, but it’s filled with staff who can’t find the supplies and equipment they need. A well-organized and choreographed move-in is first and foremost about patient safety.

Current status

The first portion of construction on our new building just drew to a close. The walls went up relatively quickly, and we now have a fully enclosed structure. Seeing its development step by step has been a beautifully enlightening process. New buildings are great, but the new building is only as good as the staff you put in it. I’m fortunate to have a wonderful group of professionals working with me at all times. The staff combined with this new facility will bring a new era of wellness to the City of Wadena and, in many ways, the entire central part of the state.

Thank you for reading and please try to remember the value of rural healthcare.

Joel Beiswenger understands the value of rural heatlhcare.

About Joel

Joel received his Bachelor in Business Administration degree from the University of North Dakota in 1986, and his Master of Health Care Administration degree from the University of Minnesota in 2010. He is also a Certified Public Accountant. He has been in the health care management field since 1986. Joel has been a part of the Tri-County Health Care family since 1998. Joel is passionate about conveying the value of rural healthcare while giving back to the community.

 


2021: A new year, a new you!

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2021 is a new year for growth and reflection. 2020 is drawing to a close and many are looking back on how much our society has changed in just one year. 2020 was a time of division and turmoil while a pandemic ravaged the world. We have to look forward and continue to live our lives but maybe 2021 can be a little safer. Let’s use the struggles of the previous year as a catalyst of change.

The vaccine is here

After months of Netflix binging and Zoom calls, we have a glimmer of hope. Just before the end of 2020, a vaccine arrived. Some people are scared of the vaccine; some are indifferent and some are fighting to be first in line. The medical community is in agreement; the best way out of the pandemic is the vaccine. Taking the vaccine is a personal choice but statistically and scientifically, a vaccine is the best way to safeguard yourself from COVID-19. As the vaccine becomes available to the general public, please educate yourself and make the best decision, but remember your choice could affect countless others.

Ring in the new year with a healthier routine

Cleanliness and caring

Months ago, the lady wiping her shopping cart with alcohol wipes may have seemed a bit odd. Still, now it’s routine to spray them with an antibacterial solution before carefully toweling them down. Things have changed, and it might seem like we’re living in a bizarre alternate dimension dominated by hand sanitizer and colorful cloth masks, but perhaps some changes are for the best. Disease is no joke. Germs are everywhere and no amount of cleaning supplies will ever change that.

However, taking a stronger stance on reducing virus transmission could help society and the health care industry. When the day comes that COVID-19 has been defeated, we shouldn’t go back to openly coughing on each other. We should use this opportunity to educate ourselves and keep some COVID era changes, like washing our hands regularly. Something as simple as washing your hands could stop the spread of an infectious disease. 2021 should be a new year of cleanliness and kindness.

Embracing technology

The COVID-19 pandemic has changed the way we communicate. The last several months have shown the world that technology is a gift that shouldn’t be taken for granted. During past pandemics, people didn’t have a smartphone loaded with instant messaging software and video chat. They were left alone, isolated from others. We live in an unprecedented time where a person can speak to a small crowd without ever leaving the comfort of their living room. Every day we are surrounded by smart TVs, smartphones, computers and the internet. We often take these things for granted. Let’s appreciate the technology that has enhanced our life and use it to its fullest extent. When this pandemic is done and over, remember that our friends and family are only a few button presses away.

New year health goals

It isn’t uncommon to hear others exclaim how this will be the year they drop that pesky 20 pounds. Unfortunately, that doesn’t tend to happen. Many start strong, going to the gym, eating fruit smoothies and running in the morning, but it never sticks. This year, try setting attainable goals. Attainable goals are devised with reasonable expectations. They set you up for success instead of disappointment. Grand goals often seem too big and intimidating. They are so insurmountable that it discourages even attempting to meet them. This year, try not placing numeric values on weight loss or going to the gym. Set bite-sized goals and try to meet them in a reasonable time frame. When you meet those goals, make more. Instead of losing 20 pounds in a year, challenge yourself to go for a walk every other day. Minor lifestyle changes can lead to massive improvements in time.

Use the new year of 2021 as a launchpad of success. Reflect, learn and grow. Tri-County Health Care is dedicated to your health and wellbeing. For more information about COVID-19, please visit our information page.


TriWadena: No Spandex Necessary!

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By: David Kloss, MD, FACS

A triathlon is a fun way to stay active and meet people.  It can be a great excuse to travel places you might never go to otherwise, and it gives you an excuse to eat a little bit healthier, to get more sleep at night (a definite health bonus!) and to stay active!

Signing up for any race, whether it is a local charity fundraiser, a three-mile run on the far side of Minnesota, or perhaps Grandma’s marathon in Duluth, all are a great motivator. The very act of plunking down 15 dollars (or more?) is a great motivator to train for your event; it motivates you to eat a little bit healthier, to go to bed a little bit earlier and to actually GO TO THE GYM, rather than just talk about going to the gym!

This is the 2nd year for “TRIWADENA, no spandex necessary”, the little local beginner’s triathlon.  This could be just the ticket for you to get motivated! It is a FUN way to participate in a sport you may never have heard of before!  As our advertisement says: “no spandex necessary”. You do not need expensive exercise clothes, no funny looking skin tight bike shorts, and certainly no $3000 bicycles!  Our race is geared for the person who can barely swim, but who IS interested in becoming a BETTER swimmer.

Last year we organized our race at the Maslowski Wellness Center. It was a spectacular day for our 22 competitors. All of them were first time triathletes!  The youngest was 17 and the oldest was 72. We had 25 volunteers who also had fun cheering on the racers and also keeping them safe while riding and running the course around Wadena.  You had to swim (or walk) eight lengths of the pool, bike 12 miles around Wadena, and run 2 miles around St. John’s Lutheran church.  Don’t think you can do it? Train a little bit and TRY IT!!!  Register for the race at the Maslowski Wellness Center and you can come to our three training seminars!

Jeremy Moonen was our first male finisher and Dr. Laura DuChene was our first female finisher.  But “best time” and

Dr. DuChene

winning were not primary; finishing, having fun, and just the act of training for the race…….those were REAL goals.  Each participant had to spend some extra time at the gym practicing each of the three events: swim, bike, and run.  And actually two other areas of the triathlon race get ignored by beginners: the TRANSITION.

The TRANSITION is the process of getting out of the swimming pool and then hopping on the bike while you are still a little bit winded.  This is Transition one.

TRANSITION two is harder: getting off the bike and running. Your legs are tired and they rebel! This takes training and practice to condition your muscles to change gears and to run!  Don’t make a rookie mistake! Practice this transition!

The other part of triathlon and indeed any event, is the discipline to TURN OFF THE TV and actually go to the gym regularly.

The training, the extra time spent at the gym instead of on the couch, the practice in the swimming pool, the time spent with your friends running around the track is REALLY what our race is about.  Our race doesn’t have a large cash prize, there is no huge trophy!  Our race is about having fun and staying motivated to stick with your New Year’s Eve resolutions!

So come on! Try something new! Call the MAS and register! We’ll help get you ready for this mini-triathlon!  Your family will be impressed! They’ll come cheer you on! And you do get a REALLY cool athletic shirt!!!  If you can’t swim or you have bad knees and can’t run, you can still participate: we have a RELAY TEAM division!!! Get three friends to participate with you!

And to help motivate the adults even more, we’ve added a kid’s race (10-14 years old) on Friday evening at 6PM. The kids can swim one length of the pool (with life jacket if needed), ride their bike around the MAS, and run around the high school! Come cheer on the future Olympians!!!

See you at 0800 on the starting line, Saturday, May 20!

To learn more about TriWadena click here: www.TriWadena.org.

About the Author: David Kloss, MD, FACS, has worked at TCHC for five years. He completed the Iron Man Madison race in 2014 in 14 hours 27 minutes. He’s completed many full marathons across the country, in Paris, France and Dublin, Ireland. He loves to be active and stay in shape for ski season and canoe season in the Boundary Waters! He has two grandchildren who add even more motivation to stay in shape!


Holiday Wellness Guide – 5 Tips for Surviving the Bulge

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By: Shelby Hunke, RD, LD

I know that a lot of people get concerned about holiday weight gain. Here are my 5 tips for managing your health during the busy holiday season:

  1. Don’t Drink Your Caloriesholidaydrinks
  • Alcoholic drinks really add up! It’s easy to drink 500-1000 calories.
  • Other caloric holiday drinks:
    • Hot chocolate
    • Eggnog
    • Punch
    • Cider

Work on limiting your intake of these items. Hot chocolate or specialty coffee drinks that are out this time of year can be really high in calories. They usually contain 2 percent or whole milk and whipped cream on top! Ask for skim milk, sugar free flavoring, and/or no whipped cream!

Christmas Table Arrangement

  1. Moderation is Key
  • The holidays only happen once per year and that mean some foods you only get one time a year!
  • So go ahead and have it – but be mindful of how much you have.
  • Everyone has that one item that they look forward to every holiday. Start out small though, you will be still be satisfied without stuffing yourself. My item is my Grandma’s fudge.
  1. How to Avoid Overeating
  • Don’t go to a holiday party or family gathering starving.
  • Don’t make it your only meal of the day.
  • Drink plenty of water.
  • Fill up on fiber.

If your family gathering or parties are like mine – there is always too much food! To avoid overeating – I just dish up a little bit (couple bites) of everything I want to try.  This way I can have it all without overdoing it. The items that I don’t limit my intake on are the vegetable tray, salads, and fresh fruit. These items help fill me up and keep my meal well balanced. I also try to avoid the bread or buns. If I don’t put it on my plate I usually forget about it and don’t even miss it!

Fruit Christmas tree with different berries, fruits and mint.

Fruit Christmas tree with different berries, fruits and mint.

I don’t add extra butter or gravy to my meal items. Remember that moderation is key and while I ALWAYS have vegetables on my plate, I also never skip dessert – because it’s my favorite part!

  1. Beat the Bloat
  • Drink plenty of water!
  • Exercise
  • Watch your sodium intake
  • Mixed nuts
  • Stay away from the relish tray (olives, pickles, dips, etc.).
  • Ham
  • Sugary Drinks
  • Snack mixes

It’s important to still drink water on the holidays. Often times when we’re out of our normal routines, we drink less water. This along with a food hangover can leave you feeling pretty awful the next day. So, remember to sip on water all day long!

Family Ice-Skating on Pond

 

  1. Exercise
  • It will burn calories and help with bloating.
  • Boost your mood (endorphins).
  • Think outside the box:
  • Build a snowman
  • Shoveling
    • 125 lb person, ½ hour – 180 calories
    • 155 lb person, ½ hour – 223 calories
  • Skiing
  • Snowshoeing
    • 130 lb person, 1 hour – 472 calories
    • 180 lb person, 1 hour – 650 calories
  • Sledding
  • Ice Skating
    • 130 lb person, 1 hour – 325 calories
    • 180 lb person, 1 hour – 450 calories
  • Cross Country Skiing
    • 130 lb person, 1 hour – 413-472 calories
    • 180 lb person, 1 hour – 572-654 calories

I know that a lot of people get concerned about holiday weight gain. Although the average person only gains about a pound during the holidays, this accumulates over the years. If you don’t change your lifestyle the weight will just keep going up. Make a commitment to your health, and decide to make small steps towards your best self, prior to the New Year!

Shelby and her family.

Shelby and her family.

About the Author: Shelby Hunke is a Registered Dietitian working at Tri-County Health Care in the hospital and clinic. She has a degree in Exercise Science and Dietetics with a passion for helping patients live a healthy lifestyle. She lives in Wadena with her husband Paul and two kids, Madison and Jackson. In her spare time she enjoys family time, running with her dog Bela and cooking!

 

Try out this great recipe to bring to any holiday party!


It’s not a DIET! Top 5 Tips for Changing Your Lifestyle

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By: Shelby Hunke, Registered Dietician

1.Energize your liferunning

 

Your greatest wealth is your health. Having an attitude for gratitude and focusing on the positive things in life is the resiliency you need for when things get tough. Try writing down a few things you are thankful for in your life, and use those as motivators for improving your health and changing your lifestyle.

Whether you are a mother, father, daughter, son, grandma or grandpa – you are a role model to someone in your life. Be a positive one and show others around you that eating healthy and being physically active is part of life – an energized life!

 

bike2. Get moving

 

Physical activity is a key component to a healthy lifestyle. Remember its physical activity, not exercise. You don’t need a gym membership or equipment at home either. Start with a goal of at least 10 minutes of physical activity a day and gradually build up to 150 minutes per week. Brisk walking is an ideal choice for many because it’s relatively easy and can be done almost anywhere!

Benefits of physical activity:

  • It will help you feel and look better by: helping you lose weight and keep it off, improve your self-esteem, help you sleep better and reduce stress and give you more energy.
  • It will improve your physical fitness by: improving muscle tone and reducing body fat, making your joints more flexible, strengthening your heart, lungs and bones.
  • It will improve your health by: lowering your risk of heart disease and some kinds of cancer, raise your HDL cholesterol (“good” cholesterol), and lower blood pressure.

3. Lose weightfruit

 

Did you know that only a 7% weight loss will show a drastic improvement in your health? For example, a 200 pound individual would need to lose only 14 pounds to see benefits in their overall health. Recommended safe, healthy and long term weight loss is 1-2 pounds per week.

Ways to help you get started on your weight loss goals is to begin making healthy choices. Start by keeping track of everything you eat and drink to see:

-What food you are eating?

-How much you are eating?

-What time of day you are eating?

-What types of beverages you are consuming?

Keeping track of what you are eating and drinking is the first step in learning how to change your behavior and making healthy lifestyle choices.

Some important tips to remember:

  • Don’t skip meals
  • Don’t drink sugary beverages (soda, juice or flavored milk)
  • Don’t binge eat
  • Do eat slowly and enjoy your food
  • Do allow wiggle room for special occasions to splurge (birthdays, etc.) without feeling guilty
  • Do be mindful of what, when and how you are eating

4. Cut your risk for developing chronic diseases such as type 2 diabetes and heart diseasemeasuringtape

 

Chronic diseases such as type 2 diabetes and heart disease can be prevented or delayed in at risk populations. Granted there are uncontrollable risk factors in these diseases that we cannot prevent, such as our age, race, gender and genetics. But you can control your lifestyle choices (eating habits, physical activity) – which research has shown will drastically cut your risk of these diseases.

Almost 26 million Americans have type 2 diabetes and according to the Center for Disease Control (CDC) almost 79 million Americans have pre-diabetes. Prevention is key, so catching those Americans with pre-diabetes and having them change their lifestyle can delay or prevent the onset of type 2 diabetes.

5. Improve problem solving and coping skills

 

weightsProblem solving is a process. Do not give up when you cannot come up with a solution immediately. Do not give up when your first plan to solve the problem does not work. It often takes many tries to find a solution. Problems are inevitable, but most problems related to eating less and being more active can be solved.

Follow this problem solving process:

-Describe the problem (“I am busy at work, skip lunch then come home and eat a whole box of cookies”)

-Brainstorm your options for solving the problem

-Keep healthy snacks in my office or car

-Don’t buy cookies to have at home

-Keep fresh fruit accessible at home

-Quit my job

-Go for a walk when getting home

-Pick one option to try

-Don’t buy cookies to have at home

-Make a positive action plan to put the chose option into effect

-Instead of buying cookies I will have fresh bananas and apples at home

-When feeling stressed will go for a 10 minute walk to unwind

-Keep a box of healthy granola bars in my car to have a snack on the drive home

Just try it!

icanpreventdiabetesThese lifestyle tips and so many others will be part of our next I CAN Prevent Diabetes class. This 16-session program begins on Tuesday, October 11 and will meet from 5 – 6 p.m. at the TCHC Wadena Clinic. This class that I’ll be teaching is part of the National Diabetes Prevention Program. It’s a community-based, lifestyle change program that offers diabetes prevention education and support for people with pre-diabetes and those at a high risk for pre-diabetes. There is no cost to participants. People who’ve done this program have cut their risk for developing type 2 diabetes by 58 percent!

You can register by calling 218-632-7115, or e-mailing me at shelby.hunke@tchc.org.

 

Shelby with her family after she finished the 5K Sunnybrook Stomp!

Shelby with her family after she finished the 5K Sunnybrook Stomp!

About the Author: Shelby Hunke is a Registered Dietitian working at Tri-County Health Care in the hospital and clinic. She has a degree in Exercise Science and a passion for helping patients live a healthy lifestyle. She lives in Wadena with her husband Paul and two kids, Madison and Jackson. In her spare time she enjoys family time, running with her dog Bela and cooking!