Fields of Care: Winter Edition 2024 : simplebooklet.com

02FROM THE RPG FOUNDERAs Rural Physicians Group (RPG) celebrates 20 years ofserving rural America, it provides us an occasion to reflectupon the two decades of effort and experience thatshaped our approach to solving the problems faced byone-fifth of the US population, namely our ruralcommunities.The genesis of the challenge lies in a demographic shift inphysician demographics. Over time and for many reasons,fewer physicians were inclined to practice in rural settings.By early 2000’s the problem had turned into a crisis wherethe rural community physicians were expected to managebusy office practices and cover hospital admissions alongwith on-call duties. Since hospitalized patients need a disproportionate shareof time, effort, and vigilance, it was practicable to transferpatients to nearest urban facilities. This created manysetbacks to the rural communities and the hospitals thatserved them. Since the patients could not receive carelocally, the hospital admissions dropped, and hospitalsreduced employees accordingly. The rural communityhospital is usually one of the largest local employers andthe workforce reductions adversely affects the entire localeconomy.The solution to this problem was to engage physicians whocould focus exclusively on the hospitalized patients. Aconsistent team of physicians would take turns to providecare at a facility in stretches of seven to ten days.However, these physicians would not have to move to thecommunity as they would travel to the facility for theirassigned shifts in the month. This team becomes intimatelyfamiliar with the functioning of the hospital and works toprovide great patient care with the understanding thateach hospital and community has unique characteristics.This model, that satisfies all the stakeholders was the onethat RPG uses to date, reflecting on the stability and thesuitability of this choice.Implementation of this process worked well and producedgood results. This created an interest from other hospitals.Since the model was scalable, it was initiated at multiplehospitals. It took the cooperation of a large group ofcommitted physicians and staff to make this happen.Enormous time and incredible hard work made RPG what itis today.Historically, physician leadership at RPG has come fromwithin RPG. One such standout leader is Matt Pappy, M.D.who joined RPG in 2016. He has demonstrated an amazingand effective approach to create solutions and innovationsthat enhance operations and future growth. Dr. Pappy hasbeen serving as Chief Medical Officer with distinction atRPG.To be successful, organizations need an individual who canprovide broad-based overall leadership. RPG wasfortunate in 2022, when Mike Patterson, FACHE joined asCEO. Mike possesses an incredible experience in thehealthcare industry and RPG has been a beneficiary of hisexperience and acumen. With his senior leadership team,Mike has created an amazing track record in everymeasure and aspect.In closing, I am very grateful to be working with thewonderful people at RPG who have integrity and a greatwork ethic. These are the people who have created aculture which is respectful and encouraging. This culturecreates a great service for our hospital partners andcommunities we serve across the nation.WINTER EDITION 2024FOUNDER & EXECUTIVE CHAIRMANDr. Sukhbir Pannu

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45PROGRAMSRPG currently has45 programs in21 statesacross theUnited States.GROWTH8In recentyears, we haveexperiencedgrowth at arate of 8 newhospitalpartners peryear!PROVIDERS25050% of RPGProvidershave workedfor 6 years ormore!20% of thosehave beenwith RPG 10+years! 06WINTER EDITION 2024PATIENTS1.1RPG has had apositiveimpact oncountless livesin ruralcommunities.MILLIONOver the past 20 years, RPG has achieved significant milestones in service ofnumerous rural hospitals, including the launching of our surgical service line, theaddition of our ED/Hospitalist hybrid model, and most recently the introduction ofCOMPASS - our full-spectrum teleSpecialist support system. We’ve had the privilege of partnering with hospitals in rural America, supporting theircommunities, and driving innovative care in rural medicine. This achievement wouldnot have been possible without the trust and loyalty of our Partner Hospitals, thededication of our highly skilled Physicians and Advanced Practice Providers, and theunwavering support of our staff!two decadesgrowth...ofPER YEAR

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Attract & RetainPhysicians:AMID PROVIDERSHORTAGESNATIONWIDE,which is unfortunately most pronounced in rural communities and hospitals, wherethere is already no room for error, it is more important than ever for hospitaladministrations to take intelligent actions and steps to avoid disaster and stabilizefor the long-term future. This could induce tremendous pressure and cognitiveburden on hospital administrators to achieve mastery of all the key elements thatgo into, say for example, implementing and running a respectable Hospitalistprogram, day after day, month over month. Alternatively, for many rural hospitals, ithas become significantly easier and cost-effective with great return-on-investment,to simply partner with a qualified, trusted organization like Rural Physicians Group(RPG), the industry-leading experts in implementing, managing, and providinginpatient Hospitalist and Surgical services in rural hospitals across the country. RPGprovides expert guidance and recommendations throughout the launch process,does all the heavy lifting to stand up the program, and then manages it throughoutits lifetime. HOW TO SHIELD YOUR HOSPITALAMID THE SHORTAGE CRISIS By Kerianne Wright and Matt Pappy, MDThere continues to be a critical concern over the growing national physicianshortage, that has no end in sight. Jesse M. Ehrenfeld, MD, MPH, President of theAmerican Medical Association, has been sounding the alarm, specificallyidentifying “… critical strains on physicians, including enormous administrativeburden, burnout, attacks on science, increased consolidation across health care, abroken Medicare payment system…” that are all contributing to this health crisesthat continues to worsen each day. 07WINTER EDITION 2024

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From start to finish, this means recruiting a number of Hospitalist candidates, intuitively gauging their alignment with the hospital’svalues and strategic goals, earning their buy-in, properly vetting out the pretenders from the contenders to ultimately select thebest-fit, negotiating their contract to satisfaction, skillfully orienting and onboarding them for success, providing key insights andmentorship through our leadership structure, investing in their growth and development, monitoring their progress andperformance, managing the Hospitalist program over time, developing strategic plans to achieve hospital-specific goals, handlingconflicts or issues (interpersonal or clinical), etc. Imagine the level of stress and workload that hospital leaders can offload by leaningon an expert in the field, like RPG, to help make it a turn-key operation – we do it all. At RPG, we handle all the complexity, anddeliver on the simplicity. What are the features most desired or attractive to providers, that make them want to join your healthcare organization for thelong-term? At Rural Physicians Group (RPG), our various program models have been wildly popular for physicians and advancedpractice providers (APPs) over the past 20 years. We’ve learned a lot from our experiences with the highs and lows of recruiting,and we talk to physicians and advanced practice providers, all day, every day (well, just about) – so we know a thing or two aboutthe matter, and how to solve for it.When it comes to recruiting and retention, there are multiple factors thatphysicians highly consider: having access to various clinical support resources,leadership support structure, having a voice in decisions, feeling valued, etc.However, Compensation and Lifestyle are two areas that will likely always reignsupreme. While one may naturally draw a direct correlation betweencompensation and lifestyle, the relationship is actually quite complex and morenuanced than it appears. Let me explain: One may assume that the more youwork, the higher the compensation, and therefore the more you can afford tosave, invest, or spend, which to some, may translate to a more favorable lifestyle.On the other hand, one may assume that working all the time takes away fromquality time with family, friends, vacations, meaningful memories, and negativelyimpacts mental/physical well-being, which translates to an unfavorable lifestyle.Now throw in the high demands of the medical field and growing concerns forburnout, and the relationship between compensation and lifestyle becomes evenmore complicated. So what exactlydoes work/lifebalance mean? It depends on who you ask, what their goals are, how many children they have,what chapter of life they are in, what “balance” means to them, etc. However, onething that is universally accepted, is the idea that having ownership of your workschedule, is the penultimate level of freedom you can have, in terms of work/lifebalance. Providers like to feel like they are in the driver’s seat. Own your schedule,own your life. At RPG, you have ownership of your schedule, you get to determinethe number of shifts you want to work per month. The traditional schedule ofworking 7-on-7-off introduces a level of rigidity that places shackles on yourpersonal life. Having the ability to plan out your days of work, and days you haveoff, is essentially unheard of in the medical world – unless you work at RPG. Honestly, it has taken many years to develop an entire infrastructure andecosystem around RPG’s unique scheduling model that is quietly sophisticated; its high complexity requires significant management and oversight by our scheduling department.However, it is directly related tothe critical need for flexibility in the work schedule – a key element necessary for ownership of your time, which dictates how youperceive work/life balance and drives physician retention. Hospital staffing models simply cannot create that type of aninfrastructure to support flexibility in scheduling, which leads to the classic, rigid scheduling that ultimately impacts retention, whenproviders feel their work/life balance is poor. 06WINTER EDITION 2024

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Lifestyle -vs-Compensationrelationshipcurve CompensationLifestyleShifts Per MonthDollars ($)CompensationLifestyleShifts Per MonthWell - BeingLEARN MORE ABOUT OUR RPG RECRUITMENT TEAM AND HOWWE CAN SERVE YOUR COMMUNITY WITH TOP TIER CAREOver the years at RPG, we have essentially derived a Lifestyle-vs-Compensation relationship curve, where our providershave control on the most optimal intersection point betweenthe lifestyle and well-being they desire for their life, how manyshifts they want to work, and what that compensation lookslike – the “sweet spot” so to speak. While no work experiencein the medical world is perfect, our proprietarymethodology/algorithm is uniquely designed to deliver a“best of both worlds” opportunity for our providers, as itpertains to lifestyle and compensation – the two mostimportant factors in recruiting and retention. As we journey through the evolution of the rural healthlandscape, the supply-and-demand mismatch of providers thatseem to be on back-order is a crisis that will extend long intothe future. Having central intelligence on how Hospitalists,Surgeons, and APPs think and feel, what they value, how torecruit and retain them in a challenging labor market, what theirroles/expectations look like in today’s world as they work tomeet the demands of patient care, the strain on rural hospitalleaders – and knowing the “How To” in all of this – is our breadand butter, and the reason RPG still exists as an organizationtoday. We hope to continue serving rural communities bydelivering high-quality providers, implementingservice lines, and expertly managing them for ourgrowing number of current and prospective hospitalpartnerships across the country. 1.Ehrenfeld, J. “AMA President sounds alarm on national physician shortage.”American Medical Association, 25 Oct. 2023, https://www.ama-assn.org/press-center/press-releases/ama-president-sounds-alarm-national-physician-shortage) 09WINTER EDITION 2024

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FOR THE ceo10RURALWINTER EDITION 2024THE BENEFITS OF TELEMEDICINEIn the vast, often remote corners of the country, where healthcare services are limitedand traveling to a doctor’s office can mean hours of driving, telehealth has emerged as agame-changer. For rural hospitals, which face unique challenges due to geographicisolation, limited resources, and staffing shortages, telehealth offers a critical lifeline. Thisinnovative technology not only expands access to care but also enhances the quality oftreatment and reduces the burden on rural healthcare systems.For many rural residents, especially those living in underserved areas, access to medicalcare can be a major challenge. According to the National Rural Health Association, morethan 60 million Americans reside in rural communities, where healthcare facilities areoften few and far between. The lack of healthcare providers and Specialists available forthe inpatient setting can mean that many patients get transferred out of town for theircare.COMPASS by RPG addresses these issues by providing a platform, and the resourcesneeded, to allow our hospitalists to order video consultations for their patients. Thistechnology can make consultations with Specialists — who are often not available locally— as easy as a phone call or video chat. The Specialists can see patients, talk to them,and perform examinations with a digital stethoscope and other modern-daytechnologies. Specialties ranging from Cardiology, Pulmonology, Infectious Disease,Nephrology, Critical Care, and others, working together as a comprehensive unit, and intandem with the Hospitalist onsite, allow hospitals to reduce unnecessary transfers totertiary sites. This further solidifies the community’s perception and trust in the localhospital to provide excellent care for their needs locally.

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11WINTER EDITION 2024By: Mike Patterson, CEO - RPGWhether it’s a rural patient with congestive heartfailure, kidney disease, or sepsis, bringing medicalSpecialists right to the bedside of the patient viatelehealth, helps increase the breadth and width ofmedical cases that can be safely treated locally,eliminate long-distance travel, and provide timelycare to the patient from the comfort of their localhospital.Emergencies can strike at any time, and in ruralcommunities, the closest Specialist is usually hoursaway. COMPASS by RPG is also designed for use in theemergency room (ER), by enabling ER providers tocommunicate quickly with Specialists in real-time andallowing them to manage complex cases and developa plan of care. Telemedicine consultations with acardiologist, for instance, can guide ER physicians inmaking real-time decisions about treatment – can the patient be safely admitted at their local hospital, or are there concerning clinical featuresthat require transfer to a tertiary hospital for intervention, or other services not availablelocally? Telehealth is not just a temporary fix; it’s a permanent solution to many of the challengesfaced by rural hospitals. By expanding access to care, reducing costs, and improvingpatient outcomes, telehealth has proven itself to be an invaluable tool for ruralhealthcare systems. As technology continues to evolve, the opportunities for ruralhospitals to better serve their communities will only grow, ensuring that quality care is nolonger limited by geography.Rural Physicians Group (RPG) is dedicated to helping enhance the care of rural patientsand to keeping local patients local. COMPASS by RPG is our proprietary telehealth solutionthat will allow our physicians and advanced practice providers to be able to consultSpecialists, just like they would in a large urban hospital. It’s better for the patient, betterfor our providers, and better for the hospital. We have piloted this service successfully infour hospitals and are going to be rolling it out to additional hospitals within the RPGnetwork throughout 2025 and 2026. Look for more information to come soon! COMPREHENSIVE PATIENT ASSESSMENT & SPECIALIST SUPPORT

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OCTOBER 2024MATT PAPPY, MD12WINTER EDITION 2024Over the years, as RPG began to gradually expand its rural footprint across the country, thisgrowth inherently caused an influx of advanced practice providers and physicians to joinRPG’s workforce, serving rural populations across an expanding geographic radius. Whilegrowth is positive, it also tends to create a dilutional effect on a company’s mission, vision,and values – unless intentional effort is made to preserve the identity as an organization,starting with the growing body of clinicians scattered across the country. On the heels of theCOVID pandemic wreaking havoc on hospitals and organizations, isolation and lockdownsbecame the norm. Those were tough times, but great organizations find strength throughresilience. Recognizing the critical need to connect with our providers, re-establish our identity, andstrive for building a world-class culture, in January of 2023, RPG’s Executive Leadership Teamengaged in the initial plans to host our inaugural Leadership Summit, which was ultimatelyheld in October. The Leadership Summit brought RPG’s executive leaders and clinical leaderstogether under one roof, to connect, collaborate, and strengthen relationships with each “The Strength of an organization, lies within the collective skills and talents of its People”

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other, to understand the full scope of RPG’s operations, discussthe vision for the future, and derive solutions to the challengeswe face in rural healthcare – with the intention of adding value toeach other, RPG, and the hospital-communities we serve. It wasenlightening, solution-oriented, and productive, forming thevisionary framework for 2024. Building on the success of our inaugural Summit in 2023, RPG’s2nd annual Leadership Summit was held this past October 16 &17, 2024 in Denver, Colorado, and has become the official venueto foster RPG’s growth, culture, reach, and impact. At theLeadership Summit, seeing and experiencing the level ofengagement from our providers across the country, serving inthe roles of Chief Hospitalist, Chief of Clinical Services, Surgeon,core Hospitalist, etc, has been a dream come true for us as anorganization. This is because throughout the course of time,many of our physicians and advanced practice providers hadexpressed a desire to step into leadership and service at RPG, insearch of adding value to the organization, providing guidanceand key insights into strategic initiatives intended to shape thefuture of RPG, advocate for rural hospitals and communities – allwhile approaching it as an opportunity to invest in their ownprofessional growth and development... and we are delivering onthose opportunities. If you are reading this, and find yourselfwanting such an opportunity, get in touch with us. The strengthof an organization lies within the collective skills and talents of itspeople. As we chart a visionary path forward, we aim to enhancethe value we deliver to each other and the hospital-communitieswe serve - and it all starts with you. See YOU At The Summit!13WINTER EDITION 2024

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PRESTON ASHBY Chief HospitalistGLOBE, AZCYNTHIA HOUTROW, ARNPChief of Clinical Services MONTICELLO, GALEADERS IN ACTION14WINTER EDITION 2024JAY AFZAL, MDRegional Medical Director PRAIRIE DU CHIEN, WICAITLIN BRANDSDORFER, DORegional Medical DirectorHOULTON, MEDAVID CALL, MDChief HospitalistDELTA, COAMANDA CASEY, MDChief HosptialistFALLON, NVJACK CHILDRESS, MDChief HosptialistWARM SPRINGS, GAKELLI CRAVEN, DNP ENPChief of clinical servicesJEROME, IDMARCIA DAVIS, ARNPChief of clinical servicesKanab, utWILLIAM ELZI, MDHosptialistCANON CITY, COSANDRA GUIDRY, MDChief HospitalistWORLAND, WYSANDY HARMAN, ARNPChief of Clinical ServicesKNOX CITY, TX TIM HOCKENBERRY, MDDirector of EducationFALLON, NVJACOB KALLIATHRegional Medical DirectorLAKE CHELAN, WAJOHN LICHLYTER, NPCChief of Clinical ServicesDURAND, WIMADHURESH KUMAR, MDChief HospitalistFRANKLINTON, LACHRISTINE MALINO, MDGeneral SurgeonTOPPENISH, WAJESSICA CICORIA, MDHospitalistMOUNTAIN HOME, IDTHANK YOU FUS AT THE LEAD

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FRED WORKMAN, MD Regional Medical DirectorSTERLING, COFRED TERIBURY, MDChief HospitalistTITUSVILLE, PASRIKRISHNA VULAVA, MDChief HospitalistPASCO, WADAVID YERKES, DOCHIEF HOSPTIALISTFAIRFAX, SC LEADERS IN ACTIONANDRES NUNEZ, MDHospitalistCLARKSTON, WAANDREAS SCHNEIDER, MDGeneral SurgeonTOPPENISH, WANOT PICTURED:15WINTER EDITION 2024EDWIN BOGONKOHospitalistst. peter, mnRICHARD GARCIAHospitalistLAKE CHELAN, WALAINE MURPHEY, MDChief HospitalistGOLD BEACH, ORFARAAZ OSMANI, MDRegional Medical DirectorKING CITY, CAKEVIN OWENS, MD Chief HospitalistELLENSBURG & TOPPENSIH, WAJUSTIN PANZICA, PA-CChief of Clinical ServicesTAWAS CITY, MIMATT PAPPY, MDChief Medical OfficerROCHESTER, MNMICHELLE PAPPY, MDChief HosptialistWICKENBURG, AZNGUYEN PHAM, MDChief HospitalistOAKDALE, CAANDREW RAMIREZ, PA-CChief of Clinical Services HOLYOKE, COAARON PRICE, DOChief HospitalistYREKA, CAJESSICA SOCHA, DOChief HospitalistBRUSH, COSTEVE MILLER, MDGeneral SurgeonPrairie Du Chien, WIFOR JOININGERSHIP SUMMIT

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16WINTER EDITION 2024EXCELLENCE IN HOSPITAL LEADERSHIPC R O S S I N G R I V E R S H E A L T HP R A I R I E D U C H I E N , W IThe Excellence in Hospital Leadership Award for 2024 goes toCrossing Rivers Medical Center in Prairie du Chien, WI. Thisrecognition reflects their unwavering commitment totransparency, collaboration, and meaningful involvement in thecommunity.At Crossing Rivers, staff members are more than just employees;they are dedicated individuals deeply invested in the well-beingof those we serve. Through open communication and strongrelationships across departments, they ensure the highestquality of care for their patients. Rural Physicians Group (RPG) Providers are there for more thanjust a paycheck...it’s obvious that they are committed to bringinggreater value to both the hospital and the Prairie du Chiencommunity. What makes this partnership truly special is thatCrossing Rivers sees RPG not as a contracted group but as a truepartner. This mindset strengthens our collaboration and fostersan environment where innovation and compassion thrive. In fact,the hospital trusted RPG to not just provide a Hospitalist Groupbut also a General Surgery Group.This award is a testament to the dedication and hard work ofboth the RPG team and the Crossing Rivers staff, whoconsistently go above and beyond to make a difference eachday.We are proud to give out this incredible honor to Crossing RiversMedical Center and are excited to continue our journey ofexcellence and service.

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HANDS OF HOPE - SURGICALEXCELLENCE AWARDS T E V E M I L L E R , M DThe 2024 Hands of Hope Award goes to a surgeon who hasworked with RPG since October of 2018, Dr. Steve Miller. Dr. Millerbrought with him a vast wealth of knowledge and training thathas expanded surgical services in rural communities on acontinual basis. He has worked collaboratively with emergencydepartments, primary care providers, anesthesia, operatingroom staff, hospitalists and administrations to safely reset theimage of what general surgery can and should look like in eachrural setting. For the past six years, Dr. Miller has selflesslydedicated himself to caring for those patients most in need intheir local community, surrounded by loved ones and friendswhen they needed that support the most.He began to build a general surgery program in a hospital with awell-established RPG Hospitalist service line. As with many of ourpartner hospitals, the surgical coverage was limited at best,making it difficult for hospitalists to stabilize and keep patientswithin the community. On day one, the inconsistency dissolved,and a quiet competence descended over the surgical program,supporting our hospitalists, local primary care practitioners, andemergency department physicians. All have said Dr. Miller setsthe standard for what a critical access hospital desperatelyneeds in a surgeon: availability, excellence, collaboration and theability to determine what should and should not be kept locallyto best serve the population. These abilities and demeanor havere-instilled confidence in the capabilities of this hospital as awhole giving not only the hospital staff a sense of great prideand accomplishment, but a deepening trust throughout thecommunity.It is for that and all of the above-mentioned attributes that RPGhave a great sense of pride in awarding Dr. Steven Miller the2024 Hands of Hope Award of Surgical Excellence. 17WINTER EDITION 2024P I C T U R E D F R O M L E F T T O R I G H T : J E S S I C A S T E I N A T , C A M E R O N B Y E R S , P A , S T E V E M I L L E R , M D , C H R I S D I C K , M I K E P A T T E R S O N , & M A T T P A P P Y , M D

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PRESIDENTIAL AWARD OFEXCELLENCEW I L L I A M E L Z I , M D18WINTER EDITION 2024The 2024 Presidential Award of Excellence goes to Dr. WilliamElzi, a physician who has been with Rural Physicians Group formore than nine years. To date, Dr. Elzi has worked 1,651 shifts ineleven rural hospitals and six different states for RPG. In caseyou were wondering, that works out to an average of greaterthan 15 shifts every month during the entirety of that nine-yearperiod.Dr. Elzi is one of those quiet, stalwart performers whoconsistently brings the highest quality of care in every ruralhospital and to every rural patient he touches. During theentirety of his tenure with RPG, Dr. Elzi has exemplified what itmeans to take pride in one’s work and to do so with a kindnessand humility that endears him to every patient he’s cared for.This has earned him the admiration of nurses, administrators,patients, and his colleagues as evidenced by his nomination forthis award. As the executive leadership team for RPG, we agree.Anyone working in a rural hospital knows that trust is built oncompetence first and foremost, followed closely by a sense ofkindness and empathy for those under your care. Those best atworking in this critically underserved space treat patients as onewould treat a family member. In Dr. Elzi, all these traits combinedfor the quintessential “country doc”, engendering trust and agenuine liking for him as an individual in addition to his role asphysician and healer.Time and time again, Dr. Elzi has demonstrated every quality RPGlooks for in a physician to serve rural communities and it is withgreat pride that we present him with the 2024 PresidentialAward of Excellence.P I C T U R E D F R O M L E F T T O R I G H T : C A M E R O N B Y E R S , P A , J E S S I C A S T E I N A T , W I L L I A M E L Z I , M D , C H R I S D I C K , S A N D R A G U I D R Y , M D , M I K E P A T T E R S O N , & M A T T P A P P Y , M D

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PRESIDENTIAL AWARD OFEXCELLENCE IN ADVANCED PRACTICEJ U S T I N P A N Z I C A , P A - CThe 2024 Presidential Award of Excellence in Advanced Practice goesto a clinician who has proven continual competence, dedication andfortitude under difficult circumstances including the entirety of theCOVID crisis, in a setting that proved most challenging for physiciansand advanced practitioners alike. He pioneered the addition ofinpatient advanced practitioners in a busy rural community hospital. Inthis unique role, he has quietly responded to emergent needs forcoverage on a multitude of occasions and almost single-handedlybrought stability and confidence to the community’s medical, nursingand administrative staff.Since his beginning with RPG in January of 2020, he has beenresponsible for a facility with a census frequently approaching 20patients including a high functioning 4-bed ICU. Due to his medicalacumen, calm demeanor and faultless work ethic, he has earned thetrust and admiration of every physician charged with coordinating carewith him. Again and again, this clinician has done the right thing for hispatients, demonstrating sound judgment in the utilization of availablehospital services, specialty consultation, and at times, transfer ofpatients to tertiary centers. In short, he has saved lives. As an organization, we can ask no more of anyone. We humbly say“thank you” for representing everything that RPG offers to ruralcommunities across the country, for doing so with a collaborative andcontinuously positive attitude, and for demonstrating the absolutebest we have to offer. It is with great pride that we award the 2024Presidential Award of Excellence in Advanced Practice to JustinPanzica, PA-C for his dedication and service to the community ofTawas, MI. 19WINTER EDITION 2024P I C T U R E D F R O M L E F T T O R I G H T : C A M E R O N B Y E R S , P A , J E S S I C A S T E I N A T , J U S T I N P A N Z I C A , P A - C , C H R I S D I C K , M I K E P A T T E R S O N , & M A T T P A P P Y , M D

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DR. PANNU FOUNDER’S AWARDOF LEADERSHIP EXCELLENCES R I K R I S H N A V U L A V A , M D20WINTER EDITION 2024We are proud to announce that Dr. Vulava, of Lourdes Health in Pasco,Washington, has been honored with the prestigious Chief Hospitalist ofthe Year award, a recognition that highlights his remarkable leadershipand dedication to improving hospitalist services.When Dr. Vulava joined Lourdes Health, the hospitalist program wasfacing significant challenges. Communication gaps with administrationand unmet expectations led to strained relationships acrossdepartments. However, Dr. Vulava brought stability and transformationto the program with his visionary leadership and collaborativeapproach.One of Dr. Vulava’s greatest strengths is his ability to foster strongrelationships. By prioritizing communication with administration,nurses, and ancillary staff, he has created an environment of mutualrespect and teamwork. His joyful demeanor and “go-get-them”attitude have been instrumental in cultivating a culture of positivityand progress.Dr. Vulava’s commitment to excellence extends to his openness tofeedback. He actively listens, adapts, and implements solutions thatdrive continuous improvement. Under his guidance, the Lourdes Healthhospitalist team not only met but exceeded the expectations of theorganization.A testament to his impact is Lourdes Health’s decision to entrust thehospitalist program with managing the rehabilitation department—anarea the team had not been involved in before. This expansion reflectsthe confidence that the administration places in Dr. Vulava and hisleadership.Dr. Vulava’s leadership, dedication, and ability to inspire those aroundhim have redefined what it means to be a chief hospitalist. Hiscontributions have left an indelible mark on Lourdes Health, and we aredelighted to celebrate his well-earned recognition.P I C T U R E D F R O M L E F T T O R I G H T : C A M E R O N B Y E R S , P A , J E S S I C A S T E I N A T , C H R I S D I C K , S R I K R I S H N A V U L A V A , M D , J A C O B K A L L I A T H , M D , M I K E P A T T E R S O N , & M A T T P A P P Y , M D

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“The engagement of the hospitalists fromRPG is outstanding! They are a members ofour team, just like any other employee.They participate in meetings, processimprovement projects, and are trulyinvested in making our hospital a greatplace to receive care and work. We are veryfortunate to have such a great core groupof hospitalists!”DIRECTOR OF CARE COORDINATIONCROSSING RIVERS HEALTH MEDICAL CENTERAMANDA SCHULTZOCTOBER 2024WWWW. RURALPHYSICIANSGROUP.COM | @RURALPHYSICIANSGROUPThe impact of keeping local patients local through Rural Physicians Group!OUR CLIENTS... IN THEIR WORDS!In today's world, an organization is no longer what it tells clients it is; it isn’tthe words in their mission statement, or even their list of core values...An Organization is what their Clients tell others it is.21WINTER EDITION 2024

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In the fast-paced and high-pressure environment of emergency rooms (ERs)and hospitals, healthcare providers often face significant challenges inbalancing patient care with the demands of documentation, administrativetasks, and communication. Ambient AI, the use of artificial intelligence toolsthat seamlessly integrate into the clinical environment, is emerging as atransformative solution to address these challenges. As the demands onhealthcare professionals continue to rise, Ambient AI has the potential toaddress key challenges like physician burnout, administrative workload, andthe quality of patient care. Let’s take a closer look at some of the benefitsmost palpable and transformative in the doctor-patient setting. 22WINTER EDITION 2024How Ambient AI is Transforming Hospital Medicine

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Improved Face-to-Face Timewith PatientsIn a busy ER or hospital setting, physiciansoften struggle to maintain meaningfulinteractions with patients due to theconstant need to document medicalhistories, track lab results, and inputclinical data. Ambient AI is designed tooperate in the background withoutdisrupting the flow of patient care, and canautomate many of these administrativetasks. By taking over documentation, dataentry, and even assisting in decision-making, physicians can spend more timefocusing on their patients, engaging withthem directly, and providing personalizedcare. This leads to stronger patient-provider relationships, improved patientsatisfaction, and better overall outcomes.23WINTER EDITION 2024One of the most significant advantages ofambient AI is its ability to capture andprocess patient data in real time withoutinterrupting the clinician's workflow. WithAI managing routine tasks such as note-taking or cross-referencing medicalrecords, healthcare providers can remainmore attentive to the immediate needs oftheir patients. Doctors and nurses canrespond more quickly to patient concernsand notice subtle changes in a patient'scondition. As a result, patients feel moreheard and supported throughout theirhospital experience. Increased Attentiveness toPatient Needs“... physicians can spend more time focusing ontheir patients... This leads to stronger patient-provider relationships, improved patientsatisfaction, and better overall outcomes.”

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Physician burnout is a significant concern inhealthcare, with long hours, high stress, andincreasing administrative burdenscontributing to emotional exhaustion andjob dissatisfaction. A major contributor toburnout is the extensive time physiciansspend on documentation, particularly in theform of EHR updates, which can take hoursaway from direct patient care.Ambient AI addresses this issue byautomating much of the documentationprocess, allowing physicians to spend lesstime typing or reviewing notes. Thisreduction in administrative workload canhelp alleviate burnout by giving physiciansmore time to focus on their patients and lesstime on tasks that contribute to stress.Additionally, Ambient AI systems canimprove the overall quality of patientinteractions, as doctors are able to engagemore with patients instead of beingdistracted by the need to manuallydocument every detail of the consultation.Physician burnout is often linked to thegrowing volume of documentation andadministrative duties required inhealthcare today. Writing detailed notes,entering data into electronic health records(EHRs), and completing coding forinsurance purposes are time-consumingtasks that take away from time spent withpatients. Ambient AI significantly reducesthis burden by automating thedocumentation process. AI systems cantranscribe conversations, convert theminto clinical notes, and even suggest nextsteps in care, which saves physicianscountless hours of administrative work.This reduction in documentation timeallows healthcare providers to focus onpatient care, increases efficiency,streamlines workflow, and in the process,reduces the cognitive burden caused bylabor intensive workload. Reduction of BurdensomeDocumentation Reduction of PhysicianBurnout 24WINTER EDITION 2024

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devices, and incorporate relevant historicalinformation from the Electronic HealthRecord (EHR) system. This results in faster,more accurate, and completedocumentation, reducing human error, andfreeing up healthcare providers to focusmore on patient care. Furthermore, well-documented notes allow for better long-term continuity of care, as future healthcareproviders can quickly access acomprehensive, up-to-date record of thepatient’s medical history. Lastly, othermembers of the treatment team can betterunderstand the plan of care and goals oftherapy for their patients due to the higherquality as well as timeliness ofdocumentation. One of the most significant challenges inhealthcare is maintaining accurate,comprehensive patient records. Cliniciansoften spend a significant portion of theirtime documenting patient information,which can detract from time spent withpatients. Ambient AI tools can automatethe process of creating detailed, accurateclinical notes by listening to physician-patient conversations or analyzing theclinician's actions in real-time. Forinstance, AI can transcribe patientinteractions, pull in data from medical Higher Quality ofDocumentation of Notes25WINTER EDITION 2024

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In busy hospital settings, effectivecommunication is critical for patient safetyand quality of care. Ambient AI canfacilitate real-time communication betweenphysicians, nurses, and other healthcareprofessionals by automatically sharingupdates on patient status, test results, andtreatment plans. AI systems can generateclear, structured summaries that can beeasily shared between different departmentsand care teams. This streamlines carecoordination and reduces the chances ofmiscommunication or oversight.Enhanced CommunicationAcross Teams26WINTER EDITION 2024At Rural Physicians Group (RPG), we arealways looking for ways to provide ourphysicians and advanced practice providers(APPs) with the best tools that will enablethem to deliver the highest quality of care topatients - both safely and efficiently. RPG isexcited to announce that we will soon bemaking an Ambient AI tool available to ourcore Hospitalists, APPs, and Surgeons! Thatway AI can work in the background whileproviders can simply focus on what they dobest. An email announcement with all thedetails, will be released soon! Ambient AI: Are You Readyto go out and Crush it?

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This season at Rural Physicians Group (RPG), we aretaking a moment to reflect on the past 20 incredibleyears we have had the privilege of serving ruralhospitals and communities across the country.As westroll down memory lane, I want to take you way backto the birthplace of RPG – Fallon, Nevada. On thesurface this town seems ubiquitous with all other small,rural American towns, but hold on! When you peelback the layers, Fallon comes alive with rich history,and importance that continues to play a vital role in thedefense of this country. Fallon is in the Lahontan Valley, a pre-historic lakebedand home to the Paiute Shoshone Native Americantribe. Evidence of early inhabitation by theseindigenous people still exists in the petroglyphs foundat Grime’s Point along with a cave that is an activearchaeological dig site complete with baskets, fooditems, articles of clothing and other artifacts datingback almost 4,000 years. On the opposite rim of thevalley you can hike to Salt Cave, complete with sootstaining from the fires of early inhabitants thousands ofyears ago as well as red ochre pictographs. One cansee handprints, dots, rosette-like features, and wavylines representing either snakes or water among othermore enigmatic designs matching the petroglyphs onthe opposite rim of the valley. As the American West was settled, particularlyCalifornia, Fallon became important as a waypoint forthose traveling to the gold fields. The “49’ers” stoppedhere after crossing the 40-mile desert and the CarsonRiver, resting, and replenishing their water and foodstores. Next came the Pony Express Trail during its 18 RPG HOSPITAL: BANNER CHURCHILL COMMUNITY HOSPITALDID YOU KNOW? FALLON IS THE HOSPITALWHERE RPG LAUNCHED!WWW.FALLONNEVADA.GOVFUN FACTSRURAL TRAVELS:28WINTER EDITION 2024

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months of operation from 1860 to 1861. Theseoutposts were marked by stone buildings in thisarea, the ruins of which can still be seen just outsideof town. The town was finally founded in 1896 byMichael and Eliza Fallon, the first known ranchers tothe area. At that time the town had only their ranchand a shack that served as Fallon’s first post office. In 1903, the Department of the Interior signed theLand Reclamation Act, resulting in the NewlandsProject in the Lahontan Valley. The NewlandsProject created the Lahontan Dam in 1905 andirrigation ditches networked across the valley,bringing life to 57,000 acres of arid desertlandscape surrounding Fallon. Consider theengineering feat this was – all of the ditchesdelivering water had to follow a slight grade alongwith the fields they irrigated, so that water enteringfrom one side of the land could drain into collectingditches on the opposite side! This is all nowaccomplished with lasers and combustion engine-powered equipment. In 1905 it was all done byhand and horse! The flood irrigation systempermanently established Fallon as an agriculturaloasis. That moniker stuck and today every signwelcomes you to “Fallon, the Oasis of Nevada.” In the 1950s, Fallon became important andinfamous militarily. There’s a famous front-pagenewspaper article showing a pre-dawn mushroomcloud glowing just beyond the mountains to theeast. Several nuclear tests were known to havebeen conducted in the desert east of Fallon duringthis era and some of the oldest residents of thetown can describe the ground shaking and themushroom clouds in the eastern sky. In 1996 as the area surrounding Miramar, CA, siteof the Navy’s famous Navy Fighter Weapons School(popularly known as “TOPGUN”) becameincreasingly populated, the school was moved toNaval Air Station, Fallon, boasting 360 “fly-days” peryear and miles upon miles of mountainous desertlandscape over which to train the most elite pilots inthe world. In the cold dawn mornings of winter,fighter jet contrails zig and zag across the sky overthe mountains to the east showcasing the extremecapabilities of the pilots and their machines.FALLON,WINTER EDITION 202529WINTER EDITION 2024

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And here’s a fun fact for you: Most of the desertfootage from the recent “Top Gun II, Maverick” wasshot over the training landscape of the Naval FighterWeapons School. Medical care in Fallon can be found at BannerChurchill Community Hospital (BCCH), a 25-bedCritical Access Hospital (CAH). In the early to mid-2000’s, Fallon was struggling to maintain primary carecoverage, losing three of the six primary carephysicians during a six-month period. Those physiciansprovided 50% of the inpatient coverage at the hospitaland more than 15,000 outpatient visits per year,leaving the remaining three physicians with a herculeantask covering the inpatient service with one-in-threecall, while maintaining primary care practices. Theywere often double-booked to try to preserve the careof the community.In 2004, the hospital recognized theurgency of providing relief for those physicians byhiring a team of hospitalists.The rest is our history. Dr. Pannu, founder of RPG andone of the group’s original hospitalists, quicklydiscovered that 24-hour shift rotations left a lot to bedesired for patient continuity of care and work/lifebalance. Dr. Pannu then developed the model that isstill in use today in Fallon under the name “RuralPhysicians Group.” This model allowed the primarycare physicians to re-focus on their outpatientpractices and established great continuity of carebetween Hospitalists and their patients. This meantthat a physician was now in-house 24/7, allowing forgreater focus and utilization of the hospital and itsresources. Hence the origin of our motto, “We KeepLocal Patients Local®” Twenty years later, BannerChurchill Community Hospital is a thriving and well-respected hospital, and one of those original primarycare physicians still works full time with RPG atBCCH, continuing to provide comprehensive inpatientcare to the community. Fallon is still a vital crossroad, with Las Vegas to thesouth, Salt Lake City to the east, Reno/Tahoe and thenSan Francisco to the west and Boise to the north. Ifdriving across the high desert of Nevada, you’ll haveplenty of time to reflect on the rich and often arduoushistory that built Fallon – the birthplace of RPG. NEVADA30WINTER EDITION 2024

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WHAT’S STILL MISSING INTHE RURAL HEALTHCONVERSATION?D E E P A K S H A R M AJ I N D A L H E A L T H C A R Eimmediate challenges even as we optimisticallyawait these reforms.To achieve financial sustainability rural andcommunity health requires a multi-facetedapproach encompassing statutory support,compliance, human capital, infrastructure, clinicaland technological innovation, and revenue cycleefficiency. Among these, one area stands out asbeing largely within the providers’ control and candeliver impactful results without necessitating alarge-scale movement: Revenue Cycle Management(RCM) Optimization.Why RCM Leaders Hold the Key to Rural HealthSustainability?Here’s an easy answer to a tough question: ruralproviders are bound by geography. This constraintmanifests in three distinct ways:1. Limited patient volume = limited topline revenuepotential.2. Uncompensated and under-compensated care =further strain on operating margins.3. Higher relative costs for staffing, technology, andinfrastructure = further pressure on bottom-lineperformance.32WINTER EDITION 2024One of the most prominent conversations this pastyear has centered on rural healthcare. We mustcommend everyone leading the charge in thiscritical effort. Rural and community healthcareproviders have remained the backbone ofhealthcare at large, demonstrating remarkableresilience and a (sometimes miraculous) ability toserve more with far less. These qualities earn themthe well-deserved title of healthcare “heroes.” Thanks to sustained advocacy and policydiscussions, significant improvements have beenrealized. One pivotal development was theintroduction of the “Save America’s Rural HospitalsAct.” This legislation, aimed at expanding CriticalAccess Hospitals, pushing for innovative paymentmodels, and easing restrictions on paymentprocesses, marked a key milestone. This will ensurethat rural hospitals receive more appropriatepayment amounts for the care they provide to theirpatients and enable better accounting for risingcosts in rural communities. Introduced on February6, 2023, the bill has progressed to multiple HouseCommittees and, as of December 17, 2024, is underreview by the Subcommittee on Health.Despite these strides, rural providers must address

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33WINTER EDITION 20242. What’s Getting in the Way?Identify recurring issues, such as eligibility orbenefits-related denials that persist despiteverification processes or recurring medical necessitydenials. A continuous feedback loop between theAR team (which monitors payer behavior) and front-end teams (like patient access and coding) isessential to address these barriers.3. Which Levers Do We Pull and Push?Process documentation, standard operatingprocedures, and root cause analysis sessions provideessential support. Once these are established, thenext step is to identify the revenue cycle areaoffering the best ROI opportunity for AI andtechnology (which have become more accessibleand affordable). For example, verification bots couldresolve inefficiencies in patient access workflows.The focus should be on understanding youroperations and prioritizing impactful innovations.4. Measure, Adjust, and EvolveThe strength of an RCM team lies in its ability toiterate, measure results, recalibrate strategies, andevolve. This cyclical approach fosters agility,consistency, and scalability.A New Year, A New PerspectiveAs we move into the new year, I encourage ruralhealth leaders to step back and view the biggerpicture. Instead of focusing solely on short-termmetrics, assess the structure underpinning youroperations. A robust framework, aligned with yourspecific challenges and opportunities, can unlockbetter revenues and outcomes.Here’s the harder truth: none of this will inherentlychange due to the very nature of rural andcommunity healthcare. This makes the role of RCMleaders critical. Their mission is to maximize revenuewith precision and urgency until systemic issues areaddressed. That additional monthly revenue can bethe deciding factor for hiring a nurse practitioner,purchasing diagnostic equipment, or even simplykeeping the lights on. Revenue cycle optimization has historically taken aback seat in priorities. It’s time to change that anduse RCM to mitigate geographic constraints anddrive financial sustainability.What Does an Optimized RCM Department LookLike?While it’s tempting to define success solely by highcollection rates, sustainable growth comes fromconsistency, not isolated achievements. A successfulRCM team builds strong structures, lays out clearprocesses, and fosters seamless collaboration amongits parts. This enables them to adapt and respondwith agility.Rather than focusing solely on metrics like “Days inAR” or “Cost-to-Collect,” important as they are, thebest RCM teams align with a customized frameworkaddressing these key questions:1. What Does Efficiency Look Like for Me?Every environment is unique. For instance, mostrural hospitals want to track revenue per encounterbut if your hospital does a lot of inpatientrehabilitation, you cannot afford to not look at yourcase-mix Index. Similarly, readmission rates mightnot make the top 5 KPIs right now, but for mostproviders it could be a critical concern as value-based care gets more widely adopted.Deepak Sharma is General Manager and Head of Operations for JindalHealthcare, a Revenue Cycle partner leveraging automation, AI, and best-in-class processes to enhance the financial performance of rural providers acrossthe country.

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+1 424-250-7182info@jindalhc.comScan the QR Code toLearn More!Custom robotic process automation (RPA)bots automating 70% of the volume, paving the way for seamless patient intakeExperts updating SOPs to align with payerpolicies, expediting prior auths and reducingrescheduling and denialsCustom Power BI dashboards offeringactionable insights into critical KPIs, enablingtimely interventions360-degree view of the revenue cycle withdrill-down analytics helping spot trends and missed opportunitiesCertified coders bringing precision to everyclaim, boosting the clean claim rateRegular internal audits and training on payer policies and regulatory guidelineskeeping compliance in checkProprietary HealthX AI propensity-to-paymodel helping prioritize high-value claims and capture more revenue fasterSOP-based decision tree helping work claimsright the first time, cutting down rework touchp oi ntsPatient AccessClient-Centric IntelligentDash boardsNo-Risk Strategic Partner ReviewPrior to onboarding, we conduct a comprehensive Strategic Partner Review at our expense to thoroughlyevaluate your revenue cycle performance. We identify factors contributing to revenue leakage or delaysand provide you specific recommendations and sustainable solutions to drive your financial success.AR ManagementMedical Billing andCodingLPowered ByHEALTHXProprietary AI PlatformYOUR TRUSTED PARTNER FORREVENUE CYCLE OPTIMIZATIONJindal Healthcare is committed to empowering rural healthcare providers to overcome theirunique challenges, adapt to evolving payer needs, and improve their financial outcomes andpatient experience with tech-enabled RCM solutions.34WINTER EDITION 2024

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THE DAVID GOGGINSAPPROACHTHE ROLLING APPROACHGOALS VS. BUCKET LISTOR WISH LIST NO PRESSURE APPROACHDearDr. AbbyBY ABBY KRONEWELCOME! Here you will find a dedicated space toall things wellness and something Iconsider advice from your “loving bigsis.” The column will showcasequestions from “you”, the readers, witha compassionate response along with adash of clinical expertise to support ouradvice. My hope is, you are able to takeaway a nugget of knowledge andmotivation to learn something new; andnurture any desire to become a betterversion of yourself by practicing thewellness tips and tricks provided. THIS MONTH DR. ABBY COVERS:35WINTER EDITION 2024New Year, New Me. Why turning a new calendar year won’t magically make you a new person.The end of each year is always an opportunity to reflect and make goals for the next year. Someview it as a fresh start but without changes to your habits, a crispy new planner, new felt tips pensand buying a new gym membership will not lead to a sustainable change. Speaking from personalexperience here! And this is not to be a Debbie Downer or to say your goals are too big orimpossible to achieve. The concept of a new year and the desire of fresh start and changes isthere, but it unfortunately will come from the consistency of daily choices and the commitment toremaining consistent. Below are two VERY different paths to making changes in 2025.

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36WINTER EDITION 2024THE DAVID GOGGINS APPROACHThis is not for the weak or easilydiscouraged. David Goggins was a bigmotivator for the first half of my 2024 year. Iread his books, listened to his motivationalspeeches and podcasts on repeat and theywere the dose of motivation I needed at thetime. The keys here are: Be mentally calloused. Embrace Suffering.Be accountable. Be self-disciplined overbeing motivated. Let’s break these down a bit: This meansgetting through any situation withoutseeing adversity as a ticket to give up. Here’s an example of how to take the DavidGoggins approach: Didn’t get to sleep on time last night?Well, when the alarm goes off at5:00AM to work out, you better be upand moving because there are noexceptions.Planning on going out with friends fordinner? The “well I can just eat mymeal prepped dinner tomorrowinstead” is not going to work on this. By now you should realize that excuses haveno place here. Be okay with getting uncomfortable.We’ve heard it time and time againthat growth comes from gettingoutside your comfort zone. Thismeans putting in the effort on a dailybasis regardless of the circumstancesthat vary each day.

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37WINTER EDITION 2025THE ROLLING APPROACHThis is where you take things day by day andmake choices that support your overall goal,while incorporating the flexibility tochanging circumstances. Everyone has changing circumstances thatcan sometimes lead us to forget about a goalall together. This approach allows you tokeep the goal but have modifications as thedays and weeks move on, sometimes havingseveral short-term goals versus a lifestylechange. Here are a few examples:Exercising: doing a couch to 5K planwhere you are changing and increasingyour workouts each day and week butonce you have completed a 5K, you nolonger keep the goal. This can be a goalfor 1-3 months.Saving money: you can startautomatically transferring money eachpayday and then after a set amount oftime, you can choose to increase ordecrease the auto transfer.Weekly Goals: Maybe this looks likechoosing a 1 day a week activity withoutcommitting to a set day. This allows youto coordinate each week instead of “well Imissed my Monday commitment, so Iguess I’m giving up that goal alltogether”If you have any questions forDear Dr. Abby, please scanthe QR code or you can email:DearDrAbby@RuralPhysiciansGroup.Com WINTER EDITION 2024

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38WINTER EDITION 2024BUCKET LIST OR WISH LIST This style is truly for those who needsimplicity, modifications, or have a littlemore unpredictability that can affect theirconsistency. This past year I created a bucket list where Ilisted out everything I would like toexperience, but wasn’t going to beat myselfup if these things didn’t happen. I’ve lived inColorado for three years now and reallywanted to see a moose.It was on my list for all of 2024 and wasalways on my mind, but I never set out on myweekend adventures with the sole purposeof seeing a moose. However, In September, Iwas on my way to a hike and out of nowhere,I see two moose on the side of the road! Itwas such an unexpected surprise and mademy day.Had I been driving around each weekendonly looking for a moose, I probably wouldhave seen one but quickly followed by an“okay well crossing that off. what’s next?!”would have been quick to follow. Sometimes,just making a bucket list or wish list can helpget the creative juices flowing on what you’dlike to experience without the pressure ofmaking it happen. *Please note this doesn’t work on getting abs,we can add that to our wish list but weunfortunately have to still work for those.Here are some ideas from past and currentwish lists along with some suggestions onwhere to start your brainstorming: An Adventure…to a new city, town,sunset or coffee spot A book about…. your hobby, favoritecelebrity, someone from a historicalmomentA new workout…paddleboarding, hiking,boxing classA way to give back…. volunteering in yourcommunity or with church A way to meet new people…Meetups,going to events in your community,concerts, new restaurants

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39WINTER EDITION 2024NO PRESSURE APPROACHThis is for the people who are taking 2025off- I didn’t forget about you! And no, this isnot to shame anyone for not having goals torun a marathon or buy a house by the end ofthe year. There are some people who want toget through 2025 with minimizing stress,saying No to obligation not because theydon’t care but because they are focusing onnot stretching themselves too thin andprioritizing their own health, stability andwell-being. I recently started reading a book, theElimination of Hurry which focuses on justthat - leading a life that is paced for peace.I’m not a doctor but I did self-diagnosemyself with Hurry Sickness per the quiz inthe reading. If you think about it for a minute,we often hear how busy people are and theyrattle off everything they’ve done recently.To test this, the next time you talk to aneighbor or coworker, ask them how theyare and more time than not they will saysomething along the lines of “Oh I’m good,just super busy with...” and fill in the blankwith tasks. I’m just as guilty of this. Then Istart thinking…How has my pace of life impacted the qualityof the life I’m living. Does it really matter that I had my inboxdown to zero every Friday?Does it really matter that I took 12 days ofPTO this year compared to 18 the yearbefore? The answer is No. I love my job and have allthe dedication to working hard, beingaccountable and doing a good job. However, the past two years I’ve reallyadopted the philosophy of not working whenI’m sick. The emails can wait, I can ask acoworker about the meeting I missed, I canreschedule the monthly check in. I think wecan all relate to needing to recalibrate ourwork life balance and reprioritize where westand. It’s okay for priorities to be out ofbalance at times but the important step isknowing when to rebalance. For the group in2025 that has the sole focus to maintainbeing a good human being and having ahappy existence- you are a precious gem andneed to be protected at all costs. Regardless of the approach you take for thisyear, I hope you have a fulfilling year!

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TeleNocturnists working in rural hospitalscan significantly enhance the quality ofpatient care during overnight hours byoffering timely, direct, and virtual care.These specialists provide immediateconsultation, allowing for quicker decision-making and reducing delays in care byentering appropriate orders in real-timeafter assessing patients. Their presencevirtually eliminates the need for on-sitenocturnal coverage, ensuring that care isavailable without gaps, even in the absenceof local nighttime specialists. In addition to improving patient care,TeleNocturnists provide valuable support tophysicians and nursing staff, both in theEmergency Room (ER) and on the medicalfloor. By assisting with patient assessments,reviewing cases, and making clinical recommendations, they reduce the burdenon on-site teams, mitigating the stress ofmanaging complex cases overnight. Thisreduces physician and nurse burnout andhelps improve staff retention by fostering asupportive work environment. Ultimately, the presence ofTeleNocturnists helps elevate the overallpatient experience, leading to improvedpatient satisfaction scores. By facilitatingsmoother, more efficient care, patientsbenefit from reduced wait times, timelyinterventions, and more thoroughmonitoring, all of which contribute to apositive hospital experience. In turn, theseimprovements enhance the hospital'sreputation and contribute to a moresustainable healthcare model in ruralsettings.40WINTER EDITION 2024An Economical Solutionto Provider BurnoutNOCTURNIST:TELE

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