Daniel Keuning, FNP Family Nurse Practitioner Pagosa Family Medicine, Pagosa Springs, CO

How is your practice organized?

We have 2 MDs and 2 NPs at this clinic and 2 more MDs that serve in a private clinic next door with whom we share on-call. In addition our clinic employs an appointment person, a receptionist, 2 billers, 2 RNs, 1 LPN and an x-ray tech.

The clinic is owned by the Upper San Juan Health Service District as a tax supported clinic run by a volunteer oard of directors. We have monthly meetings at which providers can provide input and also monthly public meetings fro input from the tax payers.

The clinic is open 7 days a week. The nearest hospital is Mercy in Durango which is where we send all of our referrals. We do quite a bit of emergency/urgent care that needs consultation with Mercy. We would like to get a digital radiology system going and a telemedicine cart including digital camaras, oto/opthalmascopes, etc. so that we could develop more comprehensive telemedicine capacity. The radiologists in Durango have been more than willing to work with us.