Montana Family Medicine Residency Helps State Fill Doctor Shortages

Aug 27, 2018

Dr. Kelsey Hoffman, Montana Family Medicine Resident Class of 2018, with a patient. Dr. Hoffman is a graduate of the Chicago College of Osteopathic Medicine-Midwestern University in Chicago. She is on the medical team at Riverstone Health in Billings.
Credit Riverstone Health

Montana doesn't have enough doctors. The Montana Department of Public Health and Human Services reports that all but one of the state’s counties are underserved by health care professionals.

The state is working to fill the void.

Nearly two decades ago the Montana Family Medicine Residency program was launched, specifically to bring family practice doctors to rural and underserved areas.

For Dr. Ashley Quanbeck the idea behind this program is simple.

“There is good statistical evidence that people who train in the state are much more likely to stay in the state," said Quanbeck.

National statistics show 55% of family medicine graduates in the U.S. will set up their practice within 10 miles of where they did their residency.

Credit Montana Family Medicine Residency

Quanbeck fits the bill. This 5th generation Montanan, originally from Missoula, is a graduate of the residency program and chose to practice in Hardin.

“Being able to train in Montana made a huge difference for staying because I had the skills needed to stay,” Quanbeck said. “If I had trained somewhere else, I may not have developed the skills to be comfortable to be practicing rural medicine where there is not a lot of support and backup.”

Besides 3 years of hands-on medical training to become board certified in Family Medicine, these residents learn firsthand what it is like to live and practice medicine in this frontier state.         

The Montana Family Residency Program has become nationally prominent.

This past year it received more than 1,250 applications and conducted more than 80 interview to fill 8 openings for the class of 2021.

Dr. Roxanne Fahrenwald, a Montana Family Medicine Faculty member. Faculty are affiliated with the University of Washington School of Medicine.
Credit Riverstone Health

Dr. Roxanne Fahrenwald, the head of the program, said they look for people who are from Montana or have a Montana connection either through a partner or spouse.

“We look for people who are service oriented, want to be family doctors, to help care for their neighbors, want to make their town or community a better place,” said Fahrenwald, “and for those who have done volunteer work, worked in underserved communities.”

There is also a monetary benefit for those doctors who want to stay.

Brandy Kinchloe, primary care office specialist in the state health department, helps these physicians with their school debt.        

“We have the Montana Rural Physician Incentive Program, known as "Mr. Pip", a loan repayment program for M.D.s and D.O.s who want to work in health professional shortage areas,” Kinchloe said.

“There’s also the National Health Service Corps and the Montana State Loan Repayment program which the primary care office facilitates. All 3 offer providers with a loan repayment award in exchange for working in health professional shortage area,” she added.

Support and backup for these rural doctors is another factor that helps keep them in rural communities

Dr. Greg Holzman, Montana’s medical officer, says it’s important for these physicians to connect with specialist in the larger medical centers in the area.

"Medically not to feel isolated," Holzman said, "So that they have the backup for the challenges that come through their door and know they have the assistance and help around them.” man said.

And with the help of computers and telemedicine, Holzman said these doctors can even get some time off.

The Montana Family Residency Program is a partnership of Billings Clinic, St Vincent Healthcare and RiverStone Health.      

Since its beginning, 75 of its residents are practicing in Montana, out of the 129 graduates, or a 58% retention rate.

A residency program started in western Montana in 2013 has a 71% retention rate.

Fahrenwald says the bottom line of these residency programs: improving the health of everyone.