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Doctors reflect on a half-century of family practice

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Doctors reflect on a half-century of family practice

New clinic building opens July 21

By John Colson

Sopris Sun Correspondent

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Carbondale is about to take its next step in the continuing evolution of small-town medical care, when the doctors, nurses and technicians who have met the town’s medical needs for decades move into a new building and a new kind of business arrangement.

The Roaring Fork Family Practice clinic, 1340 Highway 133, will move later this month to a new home just two blocks away, at the corner of Euclid Avenue and Highway 133 — a short stroll for a pedestrian but a big jump for the doctors.

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The new building’s open house will be on July 15, which actually will be before the docs finish moving in and open up the doors for business.

That will come on July 21, after a hectic week of shifting furniture and records, equipment and everything else, which will be accomplished in part by the 25 people who work at the clinic, and in part by professional movers.

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After that, as they say, history will have been made and it will be time to settle down to business, in which the doctors and other staff will be employees of Valley View Hospital in Glenwood Springs.

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Half century of care

It all started back in 1958, when a group of local citizens decided Carbondale needed a doctor’s clinic and raised money to build one — a 1,200-square-foot Sears & Roebuck kit building that offered what was then the most up-to-date, small-town medical care going, in a practice known as the Tri-County Medical Clinic.

Now, 56 years later, the medical needs of an expanding community have outgrown that once-tiny clinic, and the Roaring Fork Family Practice will move into a new home with twice the space (10,000 square feet compared to 5,000 square feet in the current building), more patient-care technology, more medical specialists and more than twice as many employee amenities as the old one.

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The two senior doctors of the practice, who both have been working at the office for more than half of its existence, are still there and plan to stay on for the foreseeable future.

“I think I’ve got two or three years left in me,” said Dr. Gary Knaus, 65, who came to the practice in 1978 after growing up in Rifle and going to school at Colorado State University in Ft. Collins and the University of Colorado Medical School in Boulder.

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“I’d like to practice until I’m 70 or 71,” said Dr. Richard Herrington, 68, originally from Lincoln, Nebraska and later, Ft. Collins, Colorado. He went to medical school at the University of Colorado Denver in 1972, did his residency in Ogden, Utah and first arrived in Carbondale in 1974, after a harrowing drive over Scofield Pass (above Marble) in his then-new Scout International while on a trip to check out the region’s medical practice opportunities.

That gives Herrington 39 years on the job here and Knaus 35 years, at a practice that apparently inspires lengthy service from doctors and staff alike. Dr. Kimball Spence joined the practice in 1992 after a residency at the University of Nevada in Reno, which gives him 22 years here. And Dr. John Findley, who left earlier this year, was part of the practice for 15 years.

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And that, of course, does not include the office staff, such as Cindy Watkins in medical records, who has been there for 32 years, Herrington said; Dianne White, with 30 years; Susie Cheney in billing and insurance, 22 years; receptionist Connie Williams, 22 years; and receptionist Kathy Hunter, 15 years.

Herrington recalled that the Tri-County Medical Association board, which built the new clinic in 1958, included such local luminaries as John Holden (co-founder of Colorado Rocky Mountain School), and a long-time local veterinarian whom Herrington remembered only as “Doc” Harlan, among others.

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The association built the clinic in 1958 using money from a Sears Foundation grant, on a section of pastureland donated to the association by the late Elmer Bair, a rancher of considerable renown in this area.

A physician named Dr. Tubbs was the first doctor in Carbondale, as far as Herrington knows, and he practiced out of his house (the building that until recently housed the now-shuttered Six89 Restaurant and, further back was the home of long time locals Paul and Ginny Lappala). Herrington still has a large oak roll-top desk he bought from Tubbs’s children years later; the desk the old doctor had used in his practice.

Another physician, Dr. Harry Hendricks (the Hendricks Ranch subdivision is built on his old property) was the first to practice at the Tri-County Medical Center, but he left in the late 1960s, Herrington reported.

Hendricks was followed, after a short gap in time, by Dr. Al Waskie, who was still in residence when Herrington got here, but Waskie left in 1978, leaving Herrington as the sole doctor.

Growing with the town

To help him get established, Herrington said, the association offered him six months rent-free, and three local women agreed to work for him free for two months — Dorothy Marshall, a registered nurse, Betty DeBeque, who was an accomplished, if uncertified nurse herself, and Marge Velasquez, who served as secretary and all-around handy woman.

Once the two months were up, Marshall and Velasquez stayed on as paid help, Melanie Gianinetti was hired to be the new secretary, and DeBeque “retired … again,” Herrington said.

At about the same time, the ladies running the Near New second-hand store in town raised perhaps $20,000 to buy a modern X-ray machine, replacing the outmoded relic that was deemed to hazardous to operate for any length of time.

Herrington quickly got to know some of the leaders in town, which at the time was dominated by ranchers and coal miners working for the Mid-Continent mines in Redstone. Roaring Fork Bank (now Alpine Bank) President Bob Young was one, as was Reed Harris, who owned the Morrison-Knudsen trucking company that hauled coal for Mid-Continent.

Herrington said he lived on Maroon Drive, a relatively new subdivision at the south end of town. He recalled being kept awake nights for a week, until he got used to it, by the sound of coal trucks pounding past on the nearby Coal Road (also known as Snowmass Drive), a bypass built to take the trucks around town on their way to Mid-Continent’s loading facility on Catherine Store Road.

At that time, he said, Sopris Avenue was the only truly paved street in town, as Main Street was surfaced in chip & seal material.

Coal miners made up a considerable portion of his practice, he said, although not in emergencies. If a miner was seriously injured in those days, Herrington said, the mine’s practice was to “load him into a van and drive as fast as possible to Valley View.”

Once his practice was established, he continued, the van might stop at the clinic building “if the miner was still alive and if it looked like there was somebody there (in the clinic building).”

In fact, Herrington said, he was instrumental in setting up the first true ambulance service for Carbondale and the Crystal River Valley, along with newly hired Mid-Continent safety manager, Rich VanDellen. The two put together a series of emergency medical technician classes, at first just to provide medical care while transporting injured miners. Two well-known locals, Ron Leach and nurse educator Maureen Nichols, were among the first to take the class, Herrington said.

By 1976, Herrington had been hard at it as the solo doctor for a couple of years.

“We were so busy my wife told me, ‘You need to find a medical partner or a new wife,’” he remembered with a grin.

Knaus had recently contacted Herrington about a continuing residency at the clinic (Knaus already had finished a residency in Greeley), saying he wanted to return to the Western Slope but not necessarily to Rifle, and by January, 1977 he had moved to Carbondale and house-sat for a few months then returned for good in 1978.

In the ensuing years, Herrington and Knaus formed a partnership, naming the clinic Herrington & Knaus, P.C., for a number of years, before switching to Roaring Fork Family Physicians when Spence bought into the business in 1992.

The practice grew steadily over the decades, Knaus told The Sopris Sun, as did the building. There were two expansions, one in 1963 when the Tri-County board added an X-ray room and an exam room, and again in 1999 when it was brought to its current shape and size.

As the building grew, the staff did too, taking on new doctors, new physicians’ assistants, new clerical staff and nurses.

Today, Knaus’s son, Dr. Chad Knaus, who moved to Carbondale as a toddler in 1977 with his dad, also is part of the practice.

All through that time, of course, the patient load grew, too.

Knaus said the practice has 25,000 people in its patient data base (the clinic has been paperless for years, switching to electronic record-keeping long before it became the industry standard).

An audit of the records over the last three years, he said, revealed that the clinic had seen about 10,000 patients over that period.

Knaus acknowledged there is “a little bit of angst in the community about us being part of Valley View,” but added, “the business of medicine is so complex these days, a small mom-and-pop operation just can’t do it.”

For instance, he said, a new X-ray machine to replace the 40-year-old model still in use, would cost as much as $400,000.

The hospital, he said, can absorb many of the functions and costs that a small practice finds impossible to deal with.

But, he stressed, other than the size of the building, increased efficiency and better equipment, the practice is not supposed to change.

“We have no plans to change anything,” he said. “The bottom line is, we’re not raising prices because we’ve moved into a new building.”