Pediatric Partners of the Southwest opened a clinic in Bayfield on Nov. 12. The new location provides child care closer to home for the Bayfield, Ignacio and Pagosa Springs communities.
Pediatric nurse practitioner Lisa Isenberg was recruited from Mercy Regional Medical Center to run the clinic that provides non-emergency services such as well exams for infants to 21-year-olds; immunizations; sick visits; on-site swab testing for common illnesses such as the flu, RSV and strep; adolescent care (birth control, acne, sports physicals, etc.); and behavioral health services.
The Bayfield clinic sees about 22 patients per day, which is standard.
“We’ve been busy, but we have the approach, if you need to be seen, just come. We are happy to see you,” Isenberg said.
She has been a pediatric nurse practitioner for nine years. She is originally from St. Louis but has lived in Colorado for six years.
“When I very first moved (to Bayfield), I was shell-shocked for the first six months,” she said. “Everywhere I went I saw someone I knew. I was like, ‘Oh gosh, I don’t have any privacy.’ Now, I love it.”
The clinic is located inside the old Bayfield Elementary School, 658 S. East St. The building is owned by the school district, and Isenberg said there are plans to revitalize the space, although Pediatric Partners is currently the only tenant. There are three small exam rooms and a behavioral health room, so she is always within earshot of her nurses.
Pediatric Partners’ main office is in Durango, with satellites in Durango and Silverton, and now, Bayfield.
“I enjoy having a smaller office. I feel a closer relationship with my patients and families,” Isenberg said. This helps Isenberg keep track of a patient’s history.
“It’s not the parent’s job to catch things and ask questions. That’s how harm happens,” she said, meaning oftentimes patients and families don’t know what is normal or abnormal in regards to health.
Isenberg said she communicates with school officials as well. “I can call and talk to Tod Lokey, who is the Bayfield Middle School principal, about a kiddo and we can develop a plan on how to keep the kid in school,” she said. This ensures they can support the student academically and make sure they are not duplicating services with the school counselor.
Pediatric Partners has incorporated mental health screenings into standard wellness exams throughout a patient’s care. The clinic’s behavioral health therapist, LeAnn Shaw, rotates between offices and is in Bayfield days per week.
“Our behavioral health therapists are utilized for the spectrum of ages,” Isenberg said.
For newborns through 12-month-olds, moms take a postpartum depression screening, an Edinburgh test, which can determine if a mother needs support. The clinic’s developmental screenings, for kids up to 5 years old, can catch developmental concerns such as communication or motor skills.
For school-age kids, the clinic follows a pediatric symptom checklist to look at social-emotional health and well-being. And the clinic screens for depression and substance abuse for adolescent-age patients. Isenberg said more clinics are incorporating behavioral health checks into their practice, but it is not standard.
Tamra Lavengood has a Master of Science in nursing and works at Comprehensive Primary Care Plus and is the State Innovation Model coordinator for Mercy Primary Care. SIM is an initiative to help primary care sites integrate behavioral and physical health practices.
“La Plata County has the highest rate of suicide in the state of Colorado. ... behavioral health is just as critical as physical health,” Lavengood said. There were 17 suicides in the county in 2012. In 2018, there were 54.
“Bayfield, in particular, has had an increase in adolescent suicide,” Lavengood said.
Isenberg said funding for behavioral health is lacking. Pediatric Partners accepts Medicaid, but Isenberg said the area could benefit from another Medicaid pediatric counselor other than Axis Health System. (Mercy received two competitive grants that will be used to hire a behavioral health provider for the Bayfield clinic.)
“The reason I say that is Axis will see kids, but there is a wait. There is a process to get in – a wait, schedule, intake, and then you get placed with a therapist,” Isenberg said. “If I have to tell my story three times, I don’t want to repeat the same thing again. And then consistency with a therapist is helpful.”
In addition to a Medicaid counselor, Isenberg said the clinic could benefit from more lab services. Mercy’s lab in town doesn’t have the staffing experience to draw blood from toddlers and babies and operates at odd hours.
But Isenberg said she thinks the Bayfield location will eventually be able to draw their own blood like the other Pediatric Partners locations, which uses a courier service.
She also said the Bayfield location could benefit from in-house X-ray services. Pediatric Partners works closely with Denver’s Children’s Health for patients who need to see specialists. The clinic has access to a specialist though TeleMed at the Durango office. Physicians also come visit monthly or quarterly to the Durango office.