A new era for ER

Some doctors enjoy working in a small town, where they can develop more personal relationships with their patients.

Some doctors specialize in a particular field, focusing their time and attention on a specific goal.

Some doctors thrive in the hustle and bustle of the emergency room.

And some doctors enjoy traveling to different hospitals, working in different environments in a variety of communities.

The doctors with Innova Emergency Medical Associates enjoy all of the above.

That’s what brought them to hospitals in Allen and Anderson counties.

Starting in July, a team of physicians specializing in rural emergency care took over the ER departments at Allen County Regional Hospital and Anderson County Hospital. 

Dr. Pete Byers is the medical director for the ERs at both hospitals. He’ll be overseeing a team of physicians that specialize in ER care. 

Dr. Laura Edgerley-Gibb is Innova’s chief medical officer. She’ll be spending quite a bit of time at the hospitals in Iola and Garnett over the next year or so, although her job takes her to all the hospitals in the Innova system.

Innova provides board-certified physicians who specialize in rural emergency and critical care. The group, which began in 2010, is based in Denver and serves hospitals in Colorado, Arizona, New Mexico and Michigan. The two local hospitals mark the group’s first foray into Kansas.

And though the physicians might travel to multiple hospitals, they will become fixtures in those communities.

“We’re here to stay,” Byers said. “We’re not temporary. We’re not filling in a gap. We’re here for the long term to partner with these hospitals.”

At Allen County, Innova will provide seven physicians, including Byers, to cover the emergency room on a full-time basis.

Having specialized ER physicians will improve scope of care, Edgerley-Gibb said. 

“We know how to manage really critical patients and a lot of our training is in trauma, so if there’s a bad trauma — a gunshot wound or someone falls off a horse — they’re going to come here to be stabilized. We can provide much of the level of emergency care that you might get in an urban center,” she said.

That could mean some conditions can be treated without patients having to be transferred to a larger hospital in another city. And even when a patient needs to be transferred, Innova’s physicians will work with those emergency doctors. 

“A lot of it is recognizing who needs to be transferred and who doesn’t. Before we started, we developed a very strong connection with the Saint Luke’s Health System,” she said. “Some of it is education, too, because doctors who work in an urban setting don’t always understand what smaller hospitals have and don’t have.”

In fact, the types of conditions that bring patients to a rural ER might be very different from those at a larger city.

“We see a lot more horse riding injuries,” Edgerley-Gibb said. “In a lot of our rural communities, ranchers and farmers tend to be way more active people.”

She listed others: barnyard injuries, outdoor mishaps, injuries caused by mechanical equipment, ATV accidents and the like.

“This emergency department can get quite busy and all the rooms fill up,” she noted. “Also, if we get a really critical patient, that can take all of our attention and can back things up.”

Of course, there can also be quite a bit of downtime at a small, rural hospital.

You never know what might happen next, and that’s part of the allure for ER doctors, Byers said.

“The craziest thing you’ve ever seen could be pulling up to the door right now.”

INNOVA’S ER physicians are passionate about rural communities, Edgerley-Gibb said. Many of them, like her, come from small towns.

She grew up in a rural community in western Colorado. 

She earned her undergraduate degree at the University of Colorado at Boulder followed by her Doctor of Medicine from Stanford University School of Medicine. She completed her residency in Emergency Medicine at Stanford, where she worked at Stanford University Hospital and San Francisco General Hospital among other sites. 

She joined Innova in 2011 and was named chief medical officer in 2015.

“At one of my sites, I’ve been there 11 years so everyone knows me,” she said. “I take care of multiple generations of families. I like going to the grocery store and seeing people I know.”

The COVID-19 pandemic, in particular, exposed the need for smaller hospitals to have a higher level of expertise when it comes to caring for very sick people, she said. 

“During COVID, we had patients who often had to wait for a long time before a bed became available,” she said. “It’s much better than it was. Primarily the issue I see now is staffing shortages throughout the country.” 

Edgerley-Gibb said she will spend quite a bit of time on site when Innova takes on a new hospital, and she’ll get to know patients and staff at the Iola and Garnett locations.

“I like to be heavily involved. Then as our physicians take over the shifts, I get pushed out,” she said. 

She still visits each hospital at least once a quarter.

Byers has been working in emergency medicine since 2012 and joined Innova in 2015.

In addition to Iola and Garnett, he also works at a hospital in Michigan. He was born and raised in a tiny town in Nebraska just miles from the Kansas border “but I never made it to Kansas until a few weeks ago.”

He earned his Doctorate of Medicine from Michigan State University’s College of Human Medicine with a focus on Leadership in Medicine for Vulnerable and Underserved Populations. Following completion of emergency medicine residency training at Eastern Virginia Medical School in Norfolk, Va., he worked in urban and rural hospitals in New Mexico. He volunteered with the Peace Corps and served as a teacher in Cameroon. He has traveled and worked extensively in Africa. 

He lives in Colorado.

Typically, Innova’s physicians travel to hospitals for a few days and then go home. 

“I never wake up in my own bed and go to work. I always travel somewhere for work, and then when I go home it’s like I’m on vacation,” Byers said. 

“It’s a different way of working.”

And though the hospitals in Iola and Garnett are both managed by Saint Luke’s and share some administrative staff, they’re also distinctly different facilities. 

“Working within two different places is really two different places. They’re different hospitals and different staff. There’s really not a lot of overlap,” he said.

Innova’s physicians understand the need for expert care in rural areas where it can be difficult to attract and keep specialists.

“That is certainly the draw and the honor,” he said. 

EVERY CHANGE is also an opportunity, Byers notes.

Bringing in a team that specializes in rural emergency medicine at hospitals across the country offers a fresh set of eyes, he said.

“We can identify things that maybe nobody else has seen. We’re always looking for ways to improve,” he said. 

Emergency services previously were provided by The Family Physicians group of local primary care doctors. 

The transition to Innova was smooth, Edgerley-Gibb said.

“We’ve been welcomed with open arms by the medical staff here,” she said.

Maintaining good relationships with primary care physicians is important, she said. Emergency room physicians need to communicate with a patient’s primary care doctor. They can discuss medication, conditions and treatment protocols. They also encourage patients to follow up with their primary care doctors for any further medical care that may be needed. 

“Of course, some people come in for something really simple, like a cut finger, and we don’t need to bother their primary care physician. We’re also a safety net, as many of our patients don’t have a physician,” she said. 

“There really does seem to be a strong family physician presence here, which is nice.”