There were many reasons that Sitka Community Hospital closed its obstetrics program in 2009, and a number of factors and people involved in its re-opening two years later. In part two of our series on the importance of obstetrics in rural medicine, we talk with a physician whose commitment to a full-spectrum family practice has made a big difference to Sitka’s local hospital.Listen to iFriendly audio.
Dr. Debra Pohlman is a family physician at Sitka Community Hospital. She’s letting a pregnant patient listen to her baby’s heartbeat with a stethoscope.
Brooke Chartier is due at the end of April. She has been seeing Dr. Pohlman as her primary physician during her entire pregnancy. She says her mom knew Pohlman from when she had children at Sitka Community.
“Since my mom had all her kids here, she knew all the nurses, who to call,” said Chartier. “It made it easier that she had been through it and I just did what she told me to do.”
Pohlman delivered babies at Sitka Community in the early 1990s. But by 1995, she had developed an interest in teaching residents – graduates of medical school – who were going into family medicine. Her first stop was in Vancouver, Washington, where she helped set up the OB portion of a family practice residency program.
But Vancouver was a little too urban for her, so she moved back to Alaska — to Anchorage — to work in the state’s only medical residency program.
In the meantime, in 2009, Sitka Community Hospital closed its OB program because of a lack of properly qualified physicians.
“There were folks who would periodically get in touch with me and say, ‘Would you reconsider coming back down?'” said Pohlman. “It was always tempting, but it was hard for me for a long time to consider giving up teaching.”
Hugh Hallgren became the CEO of the hospital several months after OB program had ended. At the recommendation of the board, he began planning to rebuild the program.
“This was a need that was felt by a number of people in the community, that they should be able to have their babies here,” said Hallgren.
Eventually, in 2011, Pohlman did come back to Sitka and resumed her full-time family practice. She says although it was a struggle to decide to stop teaching at the medical school, she felt compelled to return to the rural community, partly because she saw a need that wasn’t being met by newer doctors.
“Perhaps disappointment in the success that I had hoped I might be a part of in getting some of our Alaska graduates to go to rural areas,” said Pohlman.
Even the best training can’t guarantee that someone could make it as a doctor in rural Alaska. It takes a long time, and young doctors often form their own families and start to put down roots in the more urban areas where they learn their profession.
“We have a number of wonderful graduates who have gone to OB/GYN programs,” said Pohlman, “and I haven’t seen any of them coming back and going to places like Soldotna or Juneau…”
Pohlman is candid about the challenge of working as a rural physician. Rural hospitals have fewer resources and smaller medical staffs. She says staying current in her skills is a constant worry.
“The fear of not being up to date or not learning of a new recommendation that might make a difference for your patient…it’s always in the background,” she said. “It weighs heavily on you.”
Dr. Pohlman continues to build her practice, and says she enjoys getting to know her new patients. Brooke Chartier says she is more than ready to the baby to arrive, and she has a plan for the big day.
“I have invited people, and we’ll see,” said Chartier. “I have my best friend, who was in, I was outside the door of her birth because I was feeling lightheaded. And everyone has said, ‘If you decide to kick us out, it’s okay…so, we’ll see. Oh! And my husband. That’s a good one to include in there. He’ll be in there. Hopefully.”