Steamboat Pilot & Today

Oak Creek — Dr. Dan Smilkstein is a modern-day rural doctor. He doesn't do home visits or even have a permanent office, but he still knows all of his patients by name and can tell you about their lives far beyond the medical history in their files.

For seven years, Smilkstein has been coming to the South Routt Medical Center one day a week to treat local residents so they don't have to drive all the way to Steamboat Springs.

When the clinic opens at around 10 a.m., people stop by to have quick chat with receptionist Donna Sullivan and Smilkstein before the patients start coming in.

The phone rings and it's someone else from Oak Creek, calling to give her an update on his or her life.

She smiles and listens.

"I worked in Denver during my residency," Smilkstein said. "The city is exciting, but it doesn't have that thing that sustains you as a doctor human contact."

When Smilkstein graduated from medical school, he owed time in a rural hospital as a trade for a scholarship he had received. He worked in a small town in southeastern Colorado for three years before realizing that rural medicine was where he wanted to stay.

He chose to move to Steamboat and serve the outlying areas.

He spends a day in Walden, a day in Oak Creek and a day in Steamboat.

The Walden clinic is remote enough to receive federal funding for equipment and staff.

The South Routt Medical Center may serve a rural community but is close enough to Steamboat that it is not considered remote.

"Oak Creek is two miles too close to Steamboat to receive funding," Smilkstein said. But it's also far enough away that doctors don't want to work there.

"Steamboat is considered an area overserved by doctors. They have more doctors than they need," said David Bonfiglio, pharmacist and medical center board member. "Oak Creek, on the other hand, doesn't have enough."

The problem is financial.

"It has to do with the economics of medicine," Smilkstein said. "Medicine has gotten complex and paper intensive, so there aren't too many doc shops in rural areas anymore."

Oak Creek has to rely on Steamboat Medical Center to supply its medical staff.

Steamboat Medical sends Smilkstein one day a week and a physician's assistant two days a week.

A third day of service is a new thing for the center that has been open two days a week for years.

The extra day is a big step for the center and also the result of work put in by the board.

Bonfiglio said the board decided to really focus on bettering the clinic about one year ago. Its goal is to open the clinic more days and for longer so area patients get accustomed to using local services instead of driving to Steamboat.

"If we get booked up at the clinic and have to turn people away," Bonfiglio said, "next time they don't even think of coming to us."

To increase the clinic's hours, the board has been trying to work with Steamboat Medical to make the changes, but, "we don't have the leverage to push them and it's not fair for us to ask them," Bonfiglio said.

To get what they want, the board is going to have to raise the money to pay for it.

"None of us have grant writing experience, but we have to try," he said.

The clinic itself was built with donations from the community, so the town government does not own it. The ambiguous ownership "the people of South Routt" has left it somewhat neglected in the past.

"It is amazing that this was built by the people, but it is also part of the problem," Bonfiglio said. "We need the people of the area to take more ownership of this place."

The town of Oak Creek doesn't charge the clinic for snow removal or other municipal services, but the clinic is otherwise financially on its own.

When the clinic was built in the '60s, it was opened with a large grant, but once that ran out, it was never replaced.

"You can tell by the dr," Smilkstein said. The clinic still has the original wood paneling and vinyl furniture popular during that era.

The board hopes to raise money for remodeling as well as the purchase of a new X-ray machine.

Even as the wish list grows, the board is trying to figure out how to write a grant or raise money to make the clinic what it could be.

"This clinic needs to be the first choice of residents," Bonfiglio said.

Clinic hours: As of Oct. 1, Dr. Smilkstein will be at the South Routt Medical Center, 300 Main St., on Mondays from 10 a.m. to 2 p.m. Physician's assistant Frances Jenkins will be available on Wednesdays from 9 a.m. to noon and on Fridays from 11 a.m. to 4 p.m. Planned Parenthood provides gynecological and birth-control services from 1 to 5 p.m. on the first and third Tuesdays of the month. For appointments, call 736-8118.