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As Coulee Medical Center works to build up its business to a sustainable level, it’s finding success with a homegrown approach to recruiting talent, Chief of Staff Dr. Andrew Castrodale said Monday, and it needs to.

The feasibility study that underpinned the decision to build a new hospital several years ago called for staffing the facility and its clinic with four physicians by this time, plus a variety of “mid-level” health care providers. It’s been kept open by just two staff physicians, one of whom just left town on a one-year sabbatical, plus other part-time doctors who fill in at the emergency room, as well as its mid-levels providers.

But Castrodale said that, after conferring with Chief Executive Officer Debbie Bigelow on the level of staffing needed, he concluded the new number is more like six, including an “urgent care” practitioner, every week day. That staffing level would make it feasible to see 100 patients a day in the clinic, he said.

For years, hospital officials have reported that the most urgent complaints they receive are about an inability to schedule appointments with doctors within a reasonable time.

That may soon begin to change.

Castrodale ticked off recent successes in recruiting doctors to CMC, which by most standards is a very rural place, difficult in the best of recruiting circumstances.

“I mean, now it seems like people are falling out of the sky,” Castrodale said.

Next month, two physicians are coming on board to essentially fill one full time position. Dr. Andrew Nye and Dr. Shannon Servin-Obert will each take alternating two-week shifts, sharing a team of staff who can provide continuity for patients.

Castrodale listed several doctors who have indicated a real interest in working at CMC, a fact known to the larger medical community whose members question Castrodale at conferences on how the hospital is doing it, the doctor said.

The success, Castrodale said, was due to a more personal touch provided by the staff- and volunteer-based recruitment team targeting good candidates who could fit into the Grand Coulee setting and thrive.

“You don’t just send an email,” he said, “you call them” repeatedly.

Part of it also has to do with the teaching component that he and Dr. Jacob Chaffee have been engaged in for several years, taking in medical students for months of their education process.

“There’s stuff in the pipeline,” Castrodale said. “I think the education that we do is paying off for really good, well-trained people.”

Bigelow has stated that a surgeon and his wife, an endocrinologist, are also both interested.

The staff buildup over the next several months and years will be critical to the longterm success of the hospital, which has been hammered this year by what is essentially back-billing from the state Medicaid program.

That’s a problem every hospital in the state is facing, Bigelow said. She said the state agency lost experienced staff during budget rollbacks and new staffers less familiar with the system are making mistakes hospitals are questioning, including CMC.

Although those “cost reports” have been the largest factor leading to monthly losses for the hospital in 2014, Bigelow reported, October’s loss was a relatively small $4,800, even though Medicaid billed to take back $310,000. Through October, CMC has lost more than $3 million on total patient revenues of nearly $28 million.

Bigelow said CMC has hired Hall Babcock to take over as chief financial officer, starting Wednesday.

Babcock comes with 20 years experience in rural critical-access hospital finances, she said.

The father of eight lives in Spokane, but will spend all week at CMC, Bigelow said, and will consider moving to the area.