Five physicians from the Indian Health Services clinic in Warm Springs are no longer serving patients when they are hospitalized at St. Charles Madras.

Physicians from various practices in the area have all taken care of their patients in the hospital, said Jeanie Gentry, CEO of St. Charles Madras, formerly Mountain View Hospital. The physicians came from the Indian Health Services’ outpatient clinic, called the Warm Springs Health and Wellness Center, the Madras Medical Group and Mosaic Medical in Madras.

The doctors from the IHS clinic are no longer offering in-hospital services so they can better focus their time and energy on primary care at the clinic, said Diane Fuller, a registered nurse and the quality improvement coordinator at the clinic. Getting tied up with patients in more complicated circumstances at the hospital could take them away from the clinic, which is about 17 miles away.

Of all the IHS facilities in Washington, Oregon and Idaho, the clinic in Warm Springs was the only one that had physicians offering hospital coverage, Fuller said. The agreement to provide inpatient services at the hospital originated long ago because there was a need in a small community with limited medical services. Now there are a growing number of health care providers in the area.

The federal IHS program provides health services for American Indians and Alaska natives, so the clinic’s patients are mostly members of the Confederated Tribes of Warm Springs, said Fuller.

Previously, when tribal members were admitted to the hospital, they were typically cared for by their primary care physicians from the IHS clinic. The most common conditions that bring tribal members to the hospital are pneumonia, respiratory illnesses, and gastrointestinal symptoms, as well as complications of diabetes, Gentry said. Now, if a patient from the IHS clinic is hospitalized, doctors from Madras Medical Group or Mosaic Medical will be there take care of them.

Doctors from Mosaic and Madras Medical have been working closely with IHS doctors to make the handoff of patients smooth, said Gentry. And, she added, some tribal members have chosen primary care physicians from these practices already, so these doctors are familiar with tribal customs and practices.

The doctors who will continue to provide inpatient services at the hospital will see an increase in their patient load, and they’ll have the additional responsibility of talking to the doctors at the IHS clinic when patients are discharged from the hospital, Gentry said.

There is some concern that there may not be enough physicians on hand, Gentry said, but both Madras Medical and Mosaic are working on expanding staff, and St. Charles will probably recruit some primary care physicians for a clinic in Madras, too, Gentry said.

The various care providers have been working toward this change for years, Fuller said, and the change is unrelated to St. Charles’ acquisition of the hospital, she said.