Doug Miller runs a family health clinic in Rocky Ford, a town of fewer than 4,000 residents in Colorado’s Lower Arkansas Valley. And “runs” perfectly describes his work.
“There are days I pray for a no-show,” he says, laughing. Miller, a nurse practitioner, has owned the Rocky Ford Family Health Center since 2003 but has worked there since 1998.
For many years, Miller was the sole provider at the clinic, seeing as many as 125 patients a week as part of a total patient population of more than 2,000. That’s a heavy caseload for any family care provider. It’s one Miller describes as unsustainable.
But Rocky Ford has been home for nearly 20 years and he didn’t want to leave. Instead, he brought on another full-time nurse practitioner. The clinic is now open 11 hours a day most weekdays. But even with longer hours, two care providers and a declining population — the number of Rocky Ford residents has dropped by about 400 since 2000 — Miller still finds it difficult to keep up with his town’s health care needs.
Though it’s a private clinic, nearly three of four patients are Medicaid clients, not surprising in a town with a median income of about $26,000, more than $33,000 below the statewide median income. Only 75 percent of residents have a high school diploma compared with 90 percent statewide.
And many patients experience health challenges such as diabetes, hypertension and depression, a reflection of those socioeconomic factors. Still, skipped appointments are not uncommon in Rocky Ford. “You know, life gets in the way for so many people,” says Miller. “And the lower you are on the economic scale, the easier it is for life to get in the way of appointments.”
Miller, already a bit of a pioneer with his nurse practitioner-owned practice, is experimenting with new ways to better care for his patients. He won a State Innovation Model (SIM) grant to integrate behavioral health care into his clinic. A counselor from Southeast Health Group now sees patients during their primary care visits. While this partnership just began last month, Miller has a simple goal.
“My hope is that people would just be able to deal with life better.” SIM and other projects offer exciting opportunities for the Rocky Ford Family Health Center.
But at the end of the day, it’s Miller’s deep commitment to his community, his understanding of challenges outside of health care and his can-do spirit that is moving the needle.