Providing Care for the Periphery of Lane County

Medical Matters, Lane County Medical Society

“I had to drive an hour and a half to get to the dentist when I was growing up,” said Dr. Ronald Shearer. That was Gilliam County in the 1960s, which is actually about half the size as Lane County, where he currently serves as Medical Director with PeaceHealth Medical Group in Florence. Coming from a provincial upbringing, there is arguably no one better than Dr. Shearer to administrate over, and advocate for rural medicine.

Dr. Shearer completed his residency in Bakersfield, California, in stark contrast to his past and future. While there, he oversaw rounds at four different hospitals, commuting between each one on a daily basis. “Versus now, I don’t actually go to the hospital.”

Comparing the two is almost impossible, and something Dr. Shearer refuses to do in concrete terms. Suffice to say that they are on opposite ends of the medical provider spectrum. Nevertheless, Dr. Shearer signed his contract with PeaceHealth the same day he visited in 1995. “It was too good to pass up,” said Dr. Shearer. “I liked the community, the area, all it had to offer—lot of fishing and beautiful country, nice people to work with.”

“Five minutes after I’m off work, I’m on vacation. I’ve used that phrase for recruiting before. My search was over.”

Over here, you are the pulmonologist, you are the infectious disease specialist, you are the neurologist, the cardiologist... You’re the only person available to that patient.
— Dr. Shearer

Dr. Shearer has been the medical director since 2007, his duties remaining largely consistent: understanding the needs of the community, and meeting them as best he can with the resources that are available. This comes as a challenge, however, as Florence is roughly 60 miles from Eugene—the nearest city with substantial resources and providers. “A lot of people over in Eugene don’t realize we are in Lane County, sometimes even caregivers at PeaceHealth don’t,” said Dr. Shearer, explaining how often grants and funds dedicated to Lane County as a whole don’t make it out to his community. “Services get pulled out of smaller towns, thinking they can provide it peripherally, and realize they can’t.”

“The Health Department got pulled out. It used to be that low-income families could go there for free immunizations, and now they can’t. We’ve had to take that over. There’s no FQHCs for low income people in Florence.” The patient shoulders the consequences. At best, seeking care beyond what is available involves taking a day off of work and driving to Eugene; at worst, it further endangers vulnerable populations like the homeless and mentally ill. 

“Well, you make it work,” said Dr. Shearer. The Health Department supplies PeaceHealth with immunizations, and they distribute them for free. “We don’t have a whole lot of mental health services out here on the coast. We are trying to boost that up. We just now are hiring a part-time psychiatrist.”

While urban hospitals can employ a variety of subspecialties, Dr. Shearer has to prioritize what is needed most and work from there. Currently, they have a shortage of hospitalists, yet it is difficult for a provider from a larger community to come over and assist because the skill sets may not be the same. “Over here you are the pulmonologist, you are the infectious disease specialist, you are the neurologist, the cardiologist,” said Dr. Shearer. “You’re the only person available to that patient.”

Dr. Shearer has seen his coworkers go above and beyond the call of duty on more than one occasion. He, himself, lends a hand when it is needed, making house calls to homebound patients. “I’ve known providers that knew of homeless people in town and brought them tents, clothes, and food,” said Dr. Shearer. “One of the nurses in the emergency medicine department does things like that on a regular basis. It’s the type of people that see a need and what they can do to help with it—whether it’s a program in town, or in Eugene or some other community, or if it’s something they can do themselves.”

Beyond that, the community plays an active role in voicing their needs, and crowdsourcing the funding to match. Dr. Shearer chairs a number of committees side by side with local residents. “We just started an outpatient county care program with a single $200,000 donation from a community member with a desire to see the program exist in Florence.” Acts like that make a tremendous impact.