Hospital Partners With New Providers
Jasper Memorial Hospital (JMH) obtained a new partner, Rural Physicians Group (RPG), in its mission to provide care for the Jasper County community at JMH, starting June 18.
JMH has signed a contract with RPG to manage its Emergency Room (ER) services. Like many rural hospitals throughout Georgia and the United States, JMH partners with an ER management company to provide emergency room care for its community.
These partnerships exist for a variety of reasons and primarily revolve around the issues of the expense of hiring and managing hospital based ER doctors and the struggle of trying to find physicians dedicated to working in rural area hospitals. These partnerships work to help keep rural hospitals like JMH alive.
After a long standing, and not always perfect partnership with the same management company for the last 25 years, though the company had several different names and owners, JMH began its partnership with RPG this June. As Robert Cumbie, the Chief Executive Officer (CEO), of JMH stated, “We’re excited to partner with them [RPG]. It is a new opportunity to provide continuity of care for our community and to keep our local patients local.” In fact, RPG proudly states, “We keep local patients local.”
Rural Physicians Group (RPG) as its name implies, specializes in working with rural hospitals and is not new to working with rural hospitals. It currently serves 42 rural hospitals across the country, offering full-time on-site providers to provide critical care coverage in rural hospital emergency rooms. In short, the mission and vision of RPG is to bring rural hospitals and providers together to help rural hospitals better meet the needs of their community by providing access and continuity to high quality care.
According to Cameron Byers, Vice President of Clinical Services at RPG, all of the administrators at RPG, Byers included, are familiar with and have a background in the medical field. They understand the importance rural health care plays in a community and are emphatic that rural communities get the best medical care available. Their combined bios read like a “Who’s Who” among the medical field.
The CEO at RPG has served as both a CEO and Chief Financial Operator at two separate rural hospitals, the Chief Medical Officer has worked over the past decade in both urban and rural hospitals, their Chief of Staff has over 23 years experience in internal medicine, their Vice President of Hospital Solutions and Operations is a Registered Nurse (RN) with over 20 years experience as an Emergency Department Nurse and Byers himself is a Physician Assistant (PA) with over two decades of varied patient care experience. By design RPG is run by a group of physicians that are passionate about serving small communities.
The only change to staffing through this new partnership with RPG is in the chief clinical provider at the ER. The majority of ER staff, including the RNs and Technicians (Techs) remain in place and are full time or part time JMH employees.
RPG offers a staffing model that includes a 24 hour on-site full time medical professional (not unlike fire stations are housed) in the form of a rotation system using Nurse Practitioners (NP) and PAs with a 10 on 20 days off system. The NP or PA on duty has 24 hour oversight through JMH’s long standing ER Medical Director, Dr. Laura Moore, for consultation and medical chart review. In addition, RPG also offers a tier of physicians available for oversight and consultation also available 24 hours a day, seven days a week.
The PAs and NPs assigned to JMH are here by choice. RPG conducted a nationwide search and interview process for its hospitals, in which Byers offered nearly 60-70 percent of applicants are often rejected due to RPG’s desire to hire only the highest quality applicants, a matter of particular importance to RPG. As explained by Byers, since rural communities often have little to no access to specialists like cardiologists, pulmonologists and neurologists, rural communities need a high level of competence in their ER staffing to make their rural.partnership programs work. JMH then conducted its own interviews of the selected candidates and had the final sayso on its hires. JMH also maintains the right, should it be necessary, to terminate anyone who for whatever reason, doesn’t meet the needs of JMH, a caveat not available to JMH in its previous ER management company partnerships.
The four medical professionals hired include Cyndi Houtrouw, NP from Nevada; David Cain, PA from California; Jake Arnold, PA from Texas and Kyle Rountree, NP from Alabama. Each of the four have various specialities and expertise that make them the right fit for JMH.
The first person on board is NP Cyndi Houtrouw. An ER nurse for over 10 years and an NP since 2016, she has worked under hospitalists and cardiologists and is trained in working in emergency room practices, cardiology, and primary care. Hailing from Las Vegas, Houtrouw has worked at the Las Vegas Hospital ER, and with RPG as a substitute in South Dakota on a tribal reservation and in various locations in the surrounding Nevada area.
Her decision to work with RPG as a permanent clinical provider at a rural location rather than as a substitute came to her while stuck in traffic in an hour and a half commute from Las Vegas to a rural location she was assigned. She decided on the spot she wanted to be based at the rural location rather than be stuck in traffic on a long commute (something many in Monticello can relate to who have worked in Atlanta on a daily basis!).
“RPG is big on continuity of care,” Houtrouw shared, with follow up on a patient, whether admitted to the hospital or not, a huge priority. “We schedule appointments with necessary specialists for the patient,” she said, “and make sure they get the care they need.” This includes being the primary care contact for anyone who is admitted through the ER into JMH. She and the other RPG primary clinical care providers follow the patient into the hospital as their primary providers, remaining the primary medical care contact until the patient’s discharge, including ensuring the patient has a follow up appointment within seven days after discharge.
“We care. We want to make a difference,” Houtrouw assured. She is excited to be in Monticello and offered that she has had an “amazing, super reception here,” from the others at JMH and in the ER.
RN Jim Strickland, the ER Nursing Manager at the ER and one of four full time RNs on staff at the ER concurs. Strickland, an RN for the past seven years, the last five years at JMH, is originally from the small town of Fitzgerald, GA. He moved to Monticello with his wife Michelle Toller Strickland, whose family is from Jasper County, and their three children, to work at JMH after working first as an RN at The Medical Center in Macon.
“I like taking care of people. I feel like I’m called to serve,” Strickland said, stating that he had worked for many years managing a Christian camping organization and in teaching, working in locations from Americus, GA to Seattle, WA.
He describes the partnership with RPG as a “win-win,” and believes the continuity of care model will benefit everyone—the patients, the ER and JMH. “It’s not RPG’s and their NPs and PA’s first rodeo,” Strickland added, stating that RPG has been around long enough for RPG to have already had any growing pains.
CEO Robert Cumbie, who lives in Monticello with his wife Michelle and their four children agrees. Cumbie, who began his career at JMH as a part-time pharmacist back in 2010, came on board as CEO in January 2023.
He is appreciative of the on boarding process used by RPG. It included a 120 day period after the initial signing of their partnership contract of joint meetings with JMH, RPG and other stakeholders, like meeting with Jasper County’s Fire Chief and Emergency Medical Services Director Chris Finch, before RPG went live and started their actual work in the ER.
The meetings and transparent relationships with other stakeholders responsible for ensuring care, such as Fire and EMS, can only help to build trust among all agencies to provide the best care for the community. The relationship with EMS already includes trust that EMS makes on site emergency transport decisions based on their extensive knowledge of what care is needed for their patients and if transport is necessary, where the patient needs to be transported and subsequent trust that the ER providers, that now includes RPG, make the best decisions for patients who do end up at the ER. Those decisions can include being discharged from the ER, admittance to JMH or stabilization of the patient and subsequent transport to other area hospitals when patient care exceeds the capability of JMH.
“The partnership with RPG is already showing promise,” Cumbie said, stating that one of the first patients transported by EMS to the ER and later admitted to JMH told Cumbie upon his discharge that from the moment he arrived at the ER he received great care and felt like he was the most important person in the hospital. “That’s what the best we can hope for, it’s what we strive for for all of our patients,” Cumbie shared.
