{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/1r6n010z9h/manifest","type":"Manifest","label":{"en":["Dr. Beth Oller"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Date"]},"value":{"en":["2021-01-28 (created)"]}},{"label":{"en":["Language"]},"value":{"en":["English (primary)"]}},{"label":{"en":["Format"]},"value":{"en":["video"]}},{"label":{"en":["Subject"]},"value":{"en":["Covid-19 (topical term)"]}},{"label":{"en":["Keyword"]},"value":{"en":["Kansas","rural family medicine","telemedicine","house calls","masks","school closures"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/198/963/small/BethOller%281-28-2021%29.mp4_1689792412.jpg?1689792413","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963","type":"Canvas","label":{"en":["Media File 1 of 1 - Beth_Oller_(1-28-2021).mp4"]},"duration":1420.16,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/198/963/small/BethOller%281-28-2021%29.mp4_1689792412.jpg?1689792413","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/198/963/original/Beth_Oller_%281-28-2021%29.mp4?1689792411","type":"Video","format":"video/mp4","duration":1420.16,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963/transcript/46427","type":"AnnotationPage","label":{"en":["Transcript of Dr. Beth Oller interview [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963/transcript/46427/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Morgan Weiler: Would you please give your full name?\n\nBeth Oller: Yes, Beth Oller, O-L-L-E-R.\n\nMorgan Weiler: What is your current title?\n\nBeth Oller: MD, FAAFP and physician, co-owner of Solomon Valley Family Medicine.\n\nMorgan Weiler: Where did you attend medical school?\n\nBeth Oller: University of Kansas in Kansas City.\n\nMorgan Weiler: Where did you complete your residency?\n\nBeth Oller: Wesley Medical Center in Wichita, Kansas.\n\nMorgan Weiler: Great. Can you speak a little bit about your current position and what you do on a daily basis?\n\nBeth Oller: Yeah. So my husband and I own our own family medicine practice in a rural community in Kansas. Our primary clinic is in Stockton, Kansas, which is in Rooks County. The hospital that we practice out of is in Plainville, Kansas, Rooks County Hospital. So I see patients from the time I bring them into the world until the time they leave. I do nursing home care, inpatient hospital care, outpatient, hospice care and obstetric and maternity care as well.\n\nMorgan Weiler: Great. Could you tell me a little bit about the patient population you treat and a little background on them?\n\nBeth Oller: So we treat an almost entirely rural population here in Rooks County. We do care for patients not only from our county, but from the surrounding counties as well. Our county is about 5,500 people, mostly employed in agriculture and ranching. And so our surrounding counties are very similar as well.\n\nMorgan Weiler: Great. Okay. So we're going to do some questions, kind of more related to COVID-19. So what unique challenges do you and your practice face that's surrounding COVID?\n\nBeth Oller: So I think first off, when it first began, it was the same as everyone, the great uncertainty. How much should we be doing? How much precaution should we be taking? How bad was this going to get? So I think the first challenges in a rural area were figuring out how to still adequately care for our patients when specialists are farther away, when not everyone has access to high speed internet, when not everyone is tech savvy. So asking somebody to just change over to a telemedicine visit wasn't as easy. You also get some increased resistance in rural communities with political divides over things such as mask wearing and school closures. So we faced a lot of pushback on things like you can't come wait in the waiting room, or that you can’t come in for a visit without a mask, or that we don't have people accompany patients to visits if at all possible anymore. People weren't happy with no visitors in the hospital restrictions that we had to place, but eventually came to understand why we were doing these things.\n\nBeth Oller: And then just figuring out the logistics of what's it going to look like implementing parking lot waiting rooms, teaching patients what that looks like, figuring out which visits are appropriate to change to telemedicine and which ones you really need to see in person. So, that was tough. And there was a lot of fear being a rural and a physician-owned small practice and what was this going to mean to your bottom line, were you going to be able to still pay your employees? Were you going to be able to make ends meet? So in the beginning, that was a really big fear. And then trying to also make sure your hospital was as ready as it could be, because we knew we weren't the place best equipped to be taking care of extremely ill patients, but you want to be able to do the best you can.\n\nBeth Oller: And we definitely have experienced a lot of challenges with transfers in the past months. If we had to call a second place in the past to transfer a patient, that was odd and it was usually only if there was weather the first place you called keeping the ambulance or plane from being able to get there, now calling five or six places and having to keep a patient for several hours isn’t abnormal. That just wasn't something that ever happened before. So that's been very challenging and it's hard for patients that they have to be transferred farther away.  The closest place is where they would like to go so that they could be closer to their family and to home, but that place isn't always able to take them.\n\nMorgan Weiler: So those are some of the challenges. What are some of the barriers and obstacles? You mentioned already some pushback on masks and transferring patients, but were there any other barriers or obstacles that you all faced?\n\nBeth Oller: I think we still face a huge barrier in getting our community to wear masks.  Like I frequently still go out around town,  and if I'm at the gas station, if I'm at the grocery store, if I'm at Dollar General, I'm the only person wearing a mask. That's frustrating. That's really, really frustrating. I think we kept thinking, \"Well, when COVID comes to our county, when there are infections here, that will change how people think about it. When COVID comes to the county, that'll change and people will take it more seriously. Well, now that school's shut down, people will take it more seriously. Well, once we have the first death in the county, people will take it more seriously.\" And none of those things have changed the patterns. We had a lot of fighting in the beginning too when we came back to school, there were people very angry about the fact that schools were requiring masks.\n\nBeth Oller: Providers went to school board meetings to support the school boards and their recommendations to wear masks and are happy to say that that has kind of blown over as a point of contention. It's kind of just accepted now even if people don't like it. So, that was a big barrier. And then there's things with vaccines, we are lucky that we work really, really well with our health department. And so we have a great strategy in place. We're going to be able to start our first vaccine clinic of 240 patients on Saturday, which we're very excited about. We're so happy that we have a secure list through our office and the hospital and the health department that we share. And we have over 750 people on it right now, which is very exciting for us, because we feel like as more people get it and see that it's okay, the more people will sign up, and it will keep going.\n\nBeth Oller: So, there's been the barriers of just knowing like anyone though, when are we going to get it? How much are we going to get? How often are we going to be able to offer it? And we're signed up as a physician clinic to receive it, but we don't know if we ever will. We're lucky and blessed to have a health department, like we said, that work so closely with us that we're able to help each other. We're able to get more doses in people because it's a small health department with not a lot of employees. So by us adding the hospital and our clinics staff, we're able to give many more doses, but we also are relying on... We're giving their doses. So how much more could we do if we also could get vaccine? Like we could give more, just don't have it right now.\n\nMorgan Weiler: Yeah. So how do you see COVID-19 impacting the learning of students in residents and family medicine?\n\nBeth Oller: Oh, it's stunk, of course, like recently one of my last patients I delivered had COVID, asymptomatic. We swabbed her when she came into the hospital and she was positive. So I had a student with me and that would have been a perfect patient for them to have been able to follow me with, but they couldn't. So I think in general it was super hard last year when nobody was able to go to sites, that's horrible. You really cannot learn unless you're onsite doing the hands-on. So I think now that you're able to go to sites and be on rotations, it won't affect it as much. I understand the no, you can't see a COVID patient. That's more of a risk. I think some of that will change with vaccination to be able to see that more. So hopefully I foresee that this year it's not going to be as disruptive as it was last year. And then in the future, I don't think it will be all that disruptive at all.\n\nMorgan Weiler: Yeah. So what changes brought by COVID-19 will be permanent that you think, will be permanent?\n\nBeth Oller: Telemedicine!\n\nLike we've been pushing for this forever. We've known that it would be a wonderful way to be able to deliver care to people forever. And so I do think this is a horse that is out of the barn and it's not going back in. So if there is something positive to come out of it, that is it. It's that we have the ability now and decent payments to be able to do telemedicine. So I think that's awesome. I also hope that it's going be another chance for the country to understand the importance of primary care and what primary care and the primary care workforce really does for our country. I think that could be a positive, a possible upside as well. I also would be super happy if something we saw was kind of routine wearing of masks during flu, cold and viral season. I think I've heard from multiple people. \"I haven't really gotten anything this year.\" \"My kid hasn't really been sick this year.\"\n\nBeth Oller: Yeah, we know it works and now that we're so used to it, it just doesn't even seem like a big deal. I don't mind wearing a mask in the clinic. So, I wonder if that might be a change that we actually see more widely adopted.\n\nMorgan Weiler: So if you could start the past year over again and do things differently regarding COVID-19, what would you change, if anything?\n\nBeth Oller: Just like from our practice level-\n\nMorgan Weiler: Yeah.\n\nBeth Oller: ... I had never thought of this question, but I really kind of happy to look back and say, not much. I hope you learned when you came out to Post Rock (our clinic), we have a tendency to be very forward-thinking. I would say we were offering telemedicine the week that everybody started talking about shut down, flatten the curve, that kind of stuff.\n\nMorgan Weiler: Wow.\n\nBeth Oller: We started offering it very quickly. We're a member of Aledade, which is an ACO. And they are very forward-thinking and they immediately came out and said, \"We're going to pilot this telemedicine platform, which is excellent. It's called Updox. It's worked great for us. We're going to pilot this. Who wants to be on board? If you say you want to be on board as one of the first practices, it'll be paid for. It's going to be free for your practice. Let's start it.\" And we all said, \"Yes, let's do it.\" So I went on for my first Facebook Live before schools were even shut down in our county and the first visit we were... First Live, we were telling people, \"There is a mask policy in our clinic now. We are switching over to a parking lot waiting room. No waiting in the waiting room. When you pull in, call and you're going to start receiving calls from our office to encourage you to change to telemedicine visits.\"\n\nBeth Oller: So I look back and I'm very proud of how quickly we pivoted and I then immediately said, \"Okay, I'll start doing home visits for pediatric vaccinations. I'll do home visits for newborns.\" And we figured out how to make that happen. We immediately had come up with hospital policies on what our guidelines should be on, when we should be at one visitor versus no visitors. And I feel like as a community, we have done a good job with attempting to educate. And I look at the fact I was doing the Facebook Lives daily for the first few months, and then continue to do it weekly.\n\nBeth Oller: I wish I could look back and say, \"Yes, we adopted masking as a community. And we did all these things.\" But what I can say is it was not for lack of me trying to educate in a loving way. So yeah, when I looked at this and looked back, I was like you know what, at a country level do I wish we could have changed the leadership and changed messaging and how much different could things have been, but as far as our community went and what we did as a practice and as an individual, I'm pretty proud of what we did.\n\nMorgan Weiler: Yeah, those Facebook Lives watching from someone who's not even a patient. Those were great. I hadn't seen anyone else do that. And I thought that was really great, the transparency and everything. So, that's awesome.\n\nBeth Oller: And we just did one last night, AJ, our CEO and me just did one last night that ended up over an hour because we wanted to do like a town hall about vaccines since we were going to start being able to vaccinate. And so we kind of thought, \"Well, I don't know how long it'll go.\" But that's how long we got questions through the Live. So, it was awesome and a great way for us to interact. And we're trying to do any of those things we can do to make people feel more comfortable with taking it. And I got my first vaccine live on one of my Lives. I told them that I would. And so we've tried to be really open about how we're doing it and really let people know too. We're following the State of Kansas guidelines that we have stratified based on risk and that people can feel very comfortable that there won't be line-jumping or it's not who you know or anything like that. We want to be very transparent about the order we're going in and who we're offering vaccine to.\n\nMorgan Weiler: Yeah. So you've kind of already mentioned some people that you worked with, the ACO, obviously your colleagues. Was there anyone else that helped you through COVID-19 and logistics?\n\nBeth Oller: Through like the logistics of it?\n\nMorgan Weiler: Yeah. That helped you all get through the pandemic?\n\nBeth Oller: I think our ACO has probably... We're proud of... I think from a micro standpoint, as a clinic, we've actually been one that some other people have modeled off of, how we've done things early and stratified, but from a larger aspect, our ACO has been extremely helpful with just so much of the information about how do you change to billing and coding for telemedicine visits? What things can you do to help keep your business afloat? What are the regulations coming down the pike? What is that going to look like? Keeping all of that information has been really helpful. And then our state Academy KAAFP and AAFP have also been very helpful with advocating for primary care and primary care reimbursement and keeping you knowledgeable about what's happening. And if there's anything that's changing also helping develop patient resources and community resources.\n\nMorgan Weiler: Yeah. Great. This is more of a broad question, but what is your sense of where family medicine's going in the future?\n\nBeth Oller: Again, hopefully with this and needing a robust, quick response to a pandemic. I think it was easily able to show that hospital care is important, but hospital care isn't what keeps people healthy when you started seeing health outcomes declining because people were putting off testing and visits and things like that. People that keep it together are family medicine, it just is. We're the people that people call regardless. People do try to still make those visits. Family docs are your ones who are going to be running your health departments and being in leadership positions and being on hospital boards and community boards and school boards and doing Facebook Lives to keep your people educated, go into your house to vaccinate your kids, or we do vaccinations and allergy shots and stuff and blood draws in our parking lot all the time now to keep them from being able to come in. Family physicians just plain and simple are the ones that are best suited and positioned to be the most trusted by the community as a whole, to be most involved in their community as a whole.\n\nBeth Oller: And we are best positioned to provide the care that's necessary to keep our country healthy. We know we're the ones that provide well care instead of sick care. We provide sick care too, but having that medical home has been shown to be so important in the health of communities. And also we know that places like rural communities, family docs are your only people you've got a large majority of the time. They're the ones that go to underserved rural communities, we're the ones that stay. We're the ones that organize when they need to go see specialists, but also you try to keep them from it as much as possible, try to do what we can there. So I think it's just that further importance... It just places that further importance or shows everybody how important family medicine is in truly keeping our nation healthy.\n\nMorgan Weiler: Yeah. So my final question, any views on important issues in this specialty related to COVID-19 that we have not addressed here or that you would like to share with us?\n\nBeth Oller: I think one of the things that I know, Shawn Martin, our EVP of AAFP and a lot of other AAFP folks right now are pushing hard on the fact that people are like, \"Who on earth can dispense all of these vaccines?\" And we're like, \"We can. We can.\" Family docs, offices, we do vaccines every day. We have the infrastructure, we know how to do it. We're the ones that are in every community instead of having to travel.\n\nBeth Oller: So I think that's one of the issues in this specialty is it's one of those kind of like raising your hand and saying like, \"Use us, we're here.\" And we're ready to do that. But I think also the importance of... We've talked about payment reform since the beginning of time, just ensuring that those who do primary care are fairly compensated to where people want to go into the specialty or where... Nobody goes into family medicine for the money, but that also doesn't mean you don't deserve to be fairly compensated for what you do and when you're starting your own business or going to a rural area, and you're coming out with hundreds of thousands of dollars in loans, you need to be able to know that you can pay them off someday and make things work.\n\nBeth Oller: And we know that in general, we take care of the sickest patients. We see patients for multiple chronic conditions every visit. And so I think payment reform and just making sure that family physicians are appropriately compensated and not penalized for not meeting certain metrics at times and things, if you are caring for an underserved population that's more at risk, that has a chance to have more comorbidities and less ability to care for themselves that you don't find doctors being penalized in that situation because their metrics numbers don't look as good as somebody caring for patients in an affluent area.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/2334/collection_resources/100616/file/198963#t=0.0,1420.16"}]}]}]}