Summer in Steamboat Springs


Yampa ValleyI had the good fortune of spending two beautiful summer days meeting with the governance and medical staff of Yampa Valley Medical Center as they contemplate their role in a future characterized by delivering population health. They  recognize that they’re practicing in a state that is, generally speaking, quite healthy.  Picture a cloudless sky, 85°F temperature, with zero humidity.  This is the bucolic setting for a special hospital nestled in the community of Steamboat Springs, Colorado.  People move to Steamboat to take advantage of the spectacular weather, the amazing skiing, and all of the natural beauty in the landscape.

Despite the enviable geography and weather, the health needs of their community still require attention. I stuck to my stump speech and encouraged them to continue to engage with the community at large, and lay the groundwork for the transition from volume to value.  I challenged members of the medical staff to work together and begin the difficult process of self-evaluation, measurement, closure of the feedback loop, and to “practice” before the arrival of bundled payment, and potentially even global capitation.  In very frank discussions with their board of trustees and medical staff leaders, they were receptive to this message.

Kudos to Yampa Valley Medical Center, as they recognize the status quo may not be sustainable beyond another 2-3 year time horizon.  Change management is a lot easier when the platform you’re standing on is in flames.  Change management in beautiful Steamboat Springs, Colorado, with a cloudless sky, and no humidity (despite recording-breaking heat back at home in Philadelphia), is not nearly as easy.  I’m looking forward to possibly returning to Yampa Valley one year from now to gauge their acceptance of the tenets of population health and to assess how much further along in the journey they really are.  I have confidence in their leadership, like CEO, Frank May, and CMO, Dr. Lisa Kettering. In the end, physicians can run far away, but they cannot ultimately hide from the tsunami of change.


  • August 27, 2016

    Your presentation here was timely and well done, Dr. Nash, and yet, a physician board member, when faced with the question of whether or not the board should ask its’ CEO to inform the board, on an annual basis, of whether or not we practice evidence-based medicine(and if so, how, or if not, why not), informed the members that as a rural hospital, we are different and this was not something we should ask of our CEO. How would you advise the board to proceed?

  • September 4, 2016

    It is the responsibility of the organized medical staff to address the issue of quality care and patient safety which is directly related to the practice of eviidence-based medicine (when there is evidence to inform care). Medical staff committees that include credentialling, quality, peer-review, and executive all should cross over to the issues of the practice of evidence-based medicine. The medical staff should not divest themselves of this responsibilty to their colleagues, patients, and the community they serve. The administrative team including the CEO have a role in implementing the policies and procedures devised by the medical staff and providing the support staff to assure implementation. The Board should support the primacy of the organized medical staff in assuring the practice of evidence-based medicine in order that quality and safety of care remains the most important oversight that they provide.
    Richard P. Porreco, M.D.

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