Posted by Jim Garrett
Our speakers provided an update on changes at the Pagosa Springs Medical Center, plus some insight into possible future developments.
Jesse Hensley is the Medical Center’s Marketing Director.  He reported that in the space opened up by the construction of the new clinic completed last year, the Medical Center has now opened a new Oncology Center.  And, he said, it is currently planning to expand its radiology department to provide 3-D mammography, and is already accommodating as well doctors with an expanded range of specialties, who are sharing the limited space on a rotating basis.
But, he added, with the completion of the Oncology Center and the addition of other new services, the Center’s presently available space is already fully utilized.  Thus, its MRI unit continues to be housed in a trailer, outside the building.  Despite that, he said, it is the best unit in terms of imaging performance available in the Four Corners Area.
However, Jesse emphasized, despite its present lack of unused capacity, the Center is evaluating what additional expansion might be appropriate to meet needs in the community.  As an example, he mentioned, Obstetrics and Gynecology.
Dr. Tinguely, the new Director of General Surgery at the Medical Center, elaborated on the difficulties associated with providing OB/GYN services in a small community, which are driven by a simple fact: babies don’t arrive on schedule. 
Consequently, Dr. Tinguely explained, there need to be at least two local doctors available to handle deliveries, at least one dedicated operating room that can be available for use at any time, as well as a staff of nurses trained in the specialty.  To support these expensive, basic components, he said, requires a substantial volume of deliveries: probably at least 300-400/yr. before it would be feasible.
Dr. Tinguely, who took up his position with the Medical Center last July, spent some time introducing himself to Rotarians.  He grew up in North Dakota, got his medical degree at Notre Dame, most recently practiced in Fort Madison, Iowa, is married to a pharmacist (who remains presently in Iowa, pending the sale of their house) and has five children.
The doctor said he came to Pagosa, to “do something different” in the mountains.
As a general surgeon, Dr. Tinguely said he does most everything except surgery on the brain, heart, female reproductive organs and bones (the Medical Center has an orthopedic surgeon on staff). 
Dr. Tinguely was an engaging speaker.  Among other anecdotes, he recounted the patient who said he needed a colonoscopy because he was experiencing a large, soft bowel movement every morning at 6 am.  The Doctor recalled, he was a little mystified, and pointed out that sounded pretty good.  “Yeah,” replied the patient, “but I don’t wake up until 7 am.”
Maybe you had to be there.