2008 System Review

Access | Redefined

Keeping homegrown doctors closer to home

Reports about current and future shortages of physicians, especially in rural areas, are concerning. For aging baby boomers, not having enough physicians to provide care is a frightening prospect. Addressing the projected physician shortfall will take time and dedication. At Marshfield Clinic, the commitment to medical education and physician training has been in place since the Clinic’s founding in 1916.

In the early 1970s Clinic leaders, working with Saint Joseph’s Hospital and University of Wisconsin-Madison, began redefining this mission to address projected workforce needs and ensure a steady flow of physicians to serve our communities. This led to establishing formal residency training programs in dermatology, internal medicine, medicine-pediatrics, pediatrics, surgery and transitional year. Thirty residency graduation classes later, the Clinic is positioned as a key player in addressing physician shortage issues for years to come.

Residency training at Marshfield Clinic responds to the projected physician shortfall. Kori Krueger, M.D., (left) internal medicine-pediatrics, Marshfield Clinic Stratford Center, mentors Mark Gaulke, M.D., medicine-pediatrics resident physician.

An example of Marshfield Clinic’s commitment to education is Kori Krueger, M.D., an internal medicine-pediatrics (med-peds) physician practicing at Marshfield Clinic Stratford Center. Dr. Krueger, an Antigo native and one of more than 530 graduates of Marshfield Clinic’s Residency Program, started in Marshfield as a third-year medical student at the University of Wisconsin School of Medicine and Public Health.

“For me, this was a really good decision and a great experience,” he said. “I had the opportunity to meet several attending physicians who were excellent clinicians, strongly interested in teaching, and who had done a residency here themselves. They knew the system and could relate to my stage of training. Aside from that, this was my first taste of the electronic health record. My rotation allowed me to see some of what was available here as far as infrastructure.”

Six months after completing this initial rotation, Dr. Krueger decided to spend his entire fourth year of medical school training with Marshfield Clinic. He then entered the Clinic’s Internal Medicine-Pediatrics Residency Program.

“I was especially pleased with my residency,” he remembered. “It did a terrific job of training me for whatever I wanted to do. The further I moved along in my training, the more I realized my heart was in primary care: taking care of families and lifelong care for patients in a smaller-town atmosphere. I wanted to do something where every day I felt like I was making a difference for people.”

Training comes full circle

Practicing in Stratford has been a perfect fit for Dr. Krueger because of the closeness between the Clinic and the community, and it meets his goal to provide care in a rural setting. He’s also serving as a mentor to a current med-peds resident, Mark Gaulke, M.D. The two doctors meet every six to eight weeks and talk more frequently if Dr. Gaulke needs support or advice. Like Dr. Krueger, Dr. Gaulke grew up in a rural area of the state and preferred to stay near his family.

“I am planning to stay in primary care,” Dr. Gaulke said. “I like the long-term interaction and relationship with patients that allow me to become their trusted adviser. I haven’t really felt pushed toward going into a subspecialty.” An outdoor enthusiast who prefers smaller communities, he knows he will have plenty of practice opportunities.

Help wanted

Dr. Krueger said more medical students and residents should be encouraged to consider a rural practice. The internal medicine and med-peds residents now rotate through the Stratford Center during their month of outpatient training. Rural practice can be a tough sell for many young doctors who have spent all or most of their lives in large cities, but it offers its own charm, Dr. Krueger said. In no way does his Stratford practice resemble a traditional stand-alone clinic because Marshfield Clinic provides considerable staff support and integrated resources.

Marshfield Clinic was designated an academic campus of the University of Wisconsin School of Medicine and Public Health in 2007. Later this year, Marshfield Clinic Rice Lake Center will be the inaugural site of the Wisconsin Academy of Rural Medicine. This innovative program aims to increase the number of physicians practicing in rural Wisconsin, and to improve the health of rural Wisconsin communities.