3 docs blaze community health care trail in S. Tahoe

By Kathryn Reed

No white coats, no stethoscopes around their necks. One could easily mistake this threesome for just an ordinary group of friends.

But they aren’t.

Paul Rork, Greg Bergner and Brooks Martin are the reason the Barton Community Clinic exists. In 1989, they were the doctors who made up Tahoe Family Physicians. That year they opened what was called the El Dorado Community Clinic. For six years the doors stayed open under their care despite the red ink getting brighter and more voluminous.

Today the clinic is still thriving. More people are using it than ever before (about 1,900 a month) and it has outgrown its current location. Proceeds from the annual Festival of Trees and Lights (Dec. 2-4 at MontBleu) will go toward renovation of the clinic, which will begin next year.

Permits are in hand. Moving into the new facility is slated for between Thanksgiving and Christmas 2012; then renovation of the older section begins.

“It will be more efficient,” Martin said.

The clinic is the original Tahoe Fracture office. What was the X-ray room is in the middle of the clinic, which makes it a bit dysfunctional when it comes to the flow.

Recognizing hard work

But it was their vision, their generosity and their commitment to their profession that has earned them the Spirit of Philanthropy Award that will be presented at the annual Barton Gala on Dec. 3. (The event is sold-out.) The award recognizes a person or people who have demonstrated extraordinary dedication to the health of the South Lake Tahoe community in general and to Barton Health in particular.

Rork, Bergner and Martin sat down with Lake Tahoe News this month to talk about life 22 years ago and what is in store for 2012. All have been practicing medicine on the South Shore since at least 1981.

While they remain steadfast friends and doctors within the Barton Health Care system, only Martin is an integral part of the clinic. He manages it.

Barton Hospital took over the clinic from them in 1995 and a year later moved it to what is the old part of the hospital – where the emergency room used to be. In 2002, it was officially designated a rural health clinic.

The clinic has had a few homes, including in the building where Sprouts restaurant is. Those were the days of brown walls and orange carpet.

The docs were the only primary care physicians at the time taking Medi-Cal patients. That’s what led them to start the clinic. It was better to break that segment off from their main practice. Midlevels were brought in to provide much of the care – which is the same today.

Today, like when things started, the clinic is overseen by doctors, with one going to the facility each day.

But it was a Catch-22. Two midlevels (which are nurse practitioners or physicians assistants) were seeing 25 patients a day, five days week. That pace could not be maintained, nor could the financial loss be sustained.

That’s when Barton took over.

Time brings change

The three pioneers have seen many changes over the years.

“You could work in the casinos in the ’80s at a low level job and have insurance. Then the casinos laid people off and rehired them at part time,” Rork said. “There are a lot more unbenefitted patients.”

In the 1980s and 1990s the county public health clinic was more vibrant, too. Now the services it provides are few and far between.

“The community clinic has become more and more important,” Bergner said.

None of the doctors foresees the day when the clinic won’t be needed.

“As long as the American health care system has a work related health system, not everyone will be offered it,” Martin said. “And private is not affordable, so the clinic is clearly needed.”

He says clinic patients involve more psychosocial issues because usually there is more than just the medical issue to deal with. Loss of job, financial problems, possible language barriers – this all contributes to what Martin says becomes some of the most difficult patients to care for because of the complexities of the whole patient.

Evolution of care

Changes since they started the clinic include specialists going to the clinic, telemedicine and psychiatric care.

“There is so much more chronic care involved in primary care,” Bergner said.

They pointed to how just a couple decades ago a cancer or HIV diagnosis would be a death sentence – that’s not the case now.

But all the changes are not welcome.

“Only one country in the world allows television prescription ads,” Rork said.

Martin said with the number of studies funded by drug companies there is “corporate pressure to increase the use of medications.”

More than doctors

All three have been chief of staff. Rork and Bergner are on the board of directors, while Martin has been chairman of the physician advisory committee at Barton Hospital for more than 17 years.

They have participated in and coached local sports teams. They helped the local library when it needed funds, and have regularly donated to fundraisers for community organizations.

Their families grew up together.

The night before the interview they had dinner together.

While one day they will retire, they envision a more tapering off approach instead of all or nothing.

One thing won’t change no matter how many hours they devote to medicine – that’s their friendship.

“We’ve been best friends forever. That will never change,” Rork said.