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A doctor talks with a patient while she sits on an exam room table.
Dr. Kevin Borchard discusses a hip surgery procedure with patient Tammy Wonders, inside the Pioneer Medical Center, Nov. 22, in Meeker. “He’s one of the best,” says Wonders, who traveled from Grand Junction to see Dr. Borchard. (Hugh Carey, The Colorado Sun)

When Rich DiPaola needed new hips this year, the retired engineer headed north. He lives in Grand Junction — the regional medical center of western Colorado — but he chose to travel two hours to an out-of-the-way town long known as a hunters’ haven, not a medical destination.

He had heard from friends and acquaintances that he could get top-notch orthopedic care in Meeker, a town of 2,600 people, 100 miles up Colorado 13 in the middle of some of the emptiest land in Colorado.

His choice to make that trek put him among more than 6,900 “medical tourists” who have traveled to Meeker in the past two years for treatment for their creaky knees and unstable hips.

Since 2020, when Pioneers Medical Center in Meeker added a full-fledged orthopedic wing to the small county-owned hospital, Meeker has become a go-to place for orthopedic care. More than 11,480 patients have sought joint replacements and other orthopedic treatments at Pioneers’ Colorado Advanced Orthopedics, Sports Medicine and Spine Center.

A map shows clients from all over the country. (Hugh Carey, The Colorado Sun)

More than 60% of those came from outside Rio Blanco County, many from around western Colorado and southern Wyoming. There have also been patients from across the country, as evidenced by a map pinned to a clinic wall under the message, “See how far our care has spread!!” A web of strings and pins stretches from Colorado across the country. Several patients have come from Iraq and Germany.

“It’s quite a deal. It has had quite an impact on our little town, for sure,” said Bobby Gutierrez, who with his wife, Wendy, owns Wendll’s coffee shop on Meeker’s main drag where patients with canes, walkers and slings show up at his takeout window for breakfast burritos and coffee. Gutierrez said he also sees lots of blue and green scrubs. Surgical staff members are regular customers.

An odd destination for medical tourists

If Meeker seems like an unusual place for a growing medical tourism market, that’s because geographically and sizewise it is.

Meeker sits in the middle of 3.5 million acres of public land, a big chunk of it the White River National Forest. It is named after the Indian agent Nathan Meeker, who died in the infamous Meeker Massacre in 1879 when the Utes attacked an Indian agency, leading to the ultimate removal of the Utes from their homeland, and to the establishment of the town of Meeker six years later.

Meeker became a hub of banking and trade for northwestern Colorado, mainly serving sheep and cattle ranchers whose descendants still populate the area. 

Doctors perform a surgery.

(Left) Town of Meeker has approximately 2,600 residents. (Right) Dr. Kevin Borchard, in front, operates during a hip surgery as the Surgical Services Director Kristofer Borchard, back center, and Ashley Garcia, back right, assist with the procedures. (Hugh Carey, The Colorado Sun)

In modern days, gas and oil drilling and coal mining have become the largest employers and kept the town alive, albeit with the roller-coaster economy those industries tend to bring.

A Rio Blanco County Economic Update completed earlier this year shows oil and gas drilling on a steep decline and coal mining dropping to a lesser degree. After energy sector jobs, health care and social assistance now account for the second largest source of jobs.

Outdoor recreationalists contribute to the economy seasonally — hikers in summer, sled-dog aficionados and ice fishing enthusiasts in winter. An annual sheepdog competition has put the town on the global map. And hunters paint the town orange during deer and elk seasons because of all those wide-open spaces that hold an average of only two people per square mile.

Meeker’s hunting pedigree is evident in photographs of Theodore Roosevelt that dot the town. He came to Meeker twice to shoot bears and mountain lions.

Billionaires have also discovered the Meeker area. Henry Kravis had owned a 4,000-acre ranch and a 19,000-sq-ft home east of Meeker for two decades before he sold it to a foreign LLC in 2020. Former Goldman Sachs president Jon Winkelried owns two nearby ranches.

Dr. Kevin Borchard — the magnet for the medical pilgrimages to Meeker — was still a toddler when his attorney father, Kent Borchard — currently the mayor of Meeker — moved his family to town from Boulder. Dr. Borchard said he grew up loving the small-town atmosphere of Meeker. After medical school at the University of Colorado, a stint as an Air Force doctor, a Boston fellowship in adult reconstructive surgery under some of the top surgeons in the country, and a couple of years practicing in neighboring Craig, Borchard decided he wanted to practice full time back in the place that feels like his hometown.

The hometown feel for Borchard has broad tentacles. Besides his father, the mayor, Dr. Borchard’s brother Kristofer is the director of surgical services for the orthopedic clinic. Two of his sisters are physicians. Borchards are on nearly all local boards. Borchard’s father-in-law is a retired physician in Meeker. Dr. Borchard and Kristofer also opened the Smoking River Brewery in Meeker last year, which has become a local gathering place.

The Meeker Hotel, established in 1896, hosted prominent guests in the past, such as Teddy Roosevelt, on the town’s Main Street. (Hugh Carey, The Colorado Sun)

That tight-knit fiber of Meeker is part of what makes the orthopedic clinic work, Borchard said. To him, Meeker is an ideal place to combine high-caliber surgical care with a small-town-friendly atmosphere surrounding that care.

“We keep a focus on good, high-quality surgery with a sharp attention to detail and processes designed to keep patients safe,” Borchard said. “And we never want our patients to feel they are rushed or they aren’t important.”

He returned to practice in Meeker seven years ago and began doing surgeries in the 46-bed Pioneers Medical Center that includes about three dozen rooms in an assisted-living wing. News about his skills spread, and physicians and physical therapists from outside Meeker began advising patients to head there for their joint replacements, particularly for replacements of replacements. Borchard specializes in the tricky surgeries required to remove and replace artificial joints that have gone bad due to infection, misalignment, or simply wearing out.

Borchard’s growing patient load prompted Pioneers to add an 11,000-square-foot specialty orthopedic clinic two years ago. This summer, after Borchard drew five other physicians to the practice, another 4,000-square-foot addition was built. The clinic now has three operating rooms and a state-of-the-art Mako SmartRobotics system. 

Rachel Gates, marketing director for Pioneers Medical Center and a director of its foundation, said news about the clinic initially spread through word-of-mouth. She said that word no longer hinges on just happy patients talking up the clinic. Pioneers uses sophisticated search-engine tracking on social media to keep information about the clinic up front in the virtual world and also has an extensive print and digital ad campaign.

Longtime Meeker resident Joe Goedert, right, shake hands after chatting with a local friend, John Kobald, before entering the Pioneer Medical Center for an appointment on Nov. 23. “I never leave home without my (cowboy) hat,” Goedert says. (Hugh Carey, The Colorado Sun)

Becker’s Hospital Review recently boosted Pioneers reputation by naming it one of the top hospitals in the Western United States for patient experience. Pioneers was among 26 other medical facilities given recognition, and was the only critical-access hospital in the state to be included. Pioneers is considered a Level IV trauma care facility, meaning it can handle basic emergencies, surgery and critical care for patients who don’t need to be transferred out to a higher-level hospital.

Borchard’s record is also part of the equation. With the help of a staff that takes the sterile environment for surgery very seriously, he has had zero infections with his patients and zero readmissions to the hospital.

That is documented by Stryker, the company that makes the robotic arm, a technology that allows surgeons to more precisely place knee and hip replacement parts. Stryker’s statistics also show that the length of time for orthopedic patients in the hospital is 32 hours compared with 37 hours for the average joint replacement patient. All of Borchard’s patients have been discharged to home instead of into rehabilitation facilities. 

Borchard said the robot has led to faster healing times and fewer complications. He said looking at a CAT scan image while manipulating the surgical tools results in shorter surgery times and less damage to tissue and ligaments. Borchard also uses a technique that doesn’t require tourniquets, another factor lessening pain and damage from surgery.

Doctors use a Mako robotic arm to operate on a hip with precision positioning. The tool, by Stryker company, uses CAT scans to create 3D images of the patient’s anatomy. (Hugh Carey, The Colorado Sun)

Borchard doesn’t just do knees and hips, although those are his primary focus. The other physicians — all fellowship trained in different areas of expertise — whom he has attracted to the practice in Meeker, round out expertise in other body parts.

Dr. Dan Ward, also specializes in knees and hips; Dr. J. Alex Sielatycki is a spine reconstruction expert; Dr. Gregg Martyak focuses on hand and upper extremity problems; Drs. Justin Grant and Mark Purnell specialize in sports medicine. Grant lives in Meeker. The other surgeons travel to the clinic from other areas.

Pioneers hospital is an economic engine

Meeker doesn’t have quantitative data yet to say how much medical tourism is affecting the town. Mandi Etheridge, the Meeker town administrator, said trying to break out the hospital’s direct impact on the community has been “too complicated.” She noted that sales tax figures held steady throughout the pandemic shutdown period.

“I think the hospital certainly helped keep us afloat,” Etheridge said.

The county’s most recent economic update shows sales and use taxes up 10% in Meeker into the first quarter of this year. The update lists 452 employees in the mining sector and 387 in the field of health care and social assistance. Around 200 of those workers are employed at Pioneers, making it one of the largest employers in the county.

We keep a focus on good, high-quality surgery with a sharp attention to detail and processes designed to keep patients safe. And we never want our patients to feel they are rushed or they aren’t important.

— Dr. Kevin Borchard, a magnet for medical pilgrimages to Meeker

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The county and other area governmental agencies have given the 70-year-old Pioneers hospital strong support.  An intergovernmental group decided back in 2013 to replace the outdated hospital in the middle of town with a new facility on a hillside near the Meeker Airport.

Through the Eastern Rio Blanco County Health Service District, the town, the county, the fire district, and even the cemetery and sewer districts, signed on to an agreement to help Pioneers grow with the $9 million clinic addition and, in the process, to add an economic development tool for Meeker. The district did it without raising the hospital-funding 7.280 mill levy that in 2021 collected about $3.5 million in property taxes.

Etheridge said there was a general recognition that medical care is not a boom-and-bust industry like oil and gas and coal. There was also awareness of the need for proactive measures to keep the hospital’s bottom line healthy because so many small hospitals around the country are failing.  

“Everybody was on board to lift up that concept,” Etheridge said.

Medical “tourists” have a wider impact on the town because when they come for surgery, they usually spend two nights in a local motel or hotel. They have meals in restaurants. And their family members shop and spend time in cafes while they are waiting.

Roger Chang, the owner of the White River Inn, the motel closest to the hospital, confirmed that the orthopedic clinic has boosted his business, and lessened the workload for a cleaning staff long used to muddy hunters.

“We have guests coming for surgery about every week,” he said. “And those guests are very much better than hunters. Hunters make a lot more work for us.”

Andrea Gianinetti, who serves on the board of the Meeker Chamber of Commerce and owns Gianinetti’s Powersports Rental with her husband, said the orthopedic clinic doesn’t directly impact their business because patients don’t tend to rent ATVs and Razors for whizzing around the 580 miles of trails accessible from Meeker.

She believes it is positively impacting the Meeker business community — and the overall well-being of the town.

“We all went to school with Kevin. He could have chosen to go anywhere after his training. But he chose to come back here. It is just a really cool kind of small-town thing,” she said. “It is interesting to have something so prestigious in our community now.”

Dr. Borchard practiced in Boston and in the U.S. Air Force before returning to his hometown of Meeker. (Hugh Carey, The Colorado Sun)

The clinic is growing, but Borchard doesn’t want outposts 

Leslie Boyd, a Grand Junction retiree, found out about the Meeker orthopedic clinic from a paid-for Pioneers-generated article in the Grand Junction Daily Sentinel. She took it to her physical therapist to ask for his advice. He recommended she go to Borchard. She said he told her Borchard was the only surgeon he would recommend for her crippling knee problems.

She arrived in Meeker with a touch of trepidation.

“It was interesting because there is nothing much there, but this hospital stands out. It is state-of-the-art. It stands out in a town with a lot of older-looking buildings,” she said.

 She returned to Grand Junction the day after the surgery and two weeks later, was doing everything she was involved in before the surgery, including singing on stage with the Sweet Adelines.

“I’m a happy girl,” she said.

DiPaola went to Meeker on the advice of a retired-police-officer friend who had a knee replacement at Pioneers. He said he found an atmosphere that convinced him he had made a good choice. For him, it was the combination of top-notch care with a staff that made him feel well cared for.

“There was this hometown atmosphere around the hospital. They treat you like a neighbor, not a client,” DiPaola said.

He was happy enough with his first hip replacement in July that he went back to Meeker in September for his other hip. He is now walking 3 miles every other day.

He tells others about Meeker’s newest reason for being on the map, besides a massacre and highly-skilled border collies.

“I say that I am very happy that I went to little Meeker,” he said.

Dr. Borchard said he is also happy he decided to come home to practice in Meeker. As the Pioneers’ orthopedic clinic patient load increases — growing 65% last year — he doesn’t foresee the Pioneers clinic ever becoming anything like the well-established, gold-standard Steadman Clinic orthopedic practice that started in Vail 34 years ago and has branched out around the state.

The only branching-out Borchard has put in place is sending a physician assistant to Grand Junction every other week for after-surgery care so patients won’t have to make repeat drives to Meeker. At some point, he said he may add a small clinic in Craig to take care of the many patients Pioneers serves from that area and from Baggs, Wyoming.

“We have a different focus on our culture,” he said. That means growing and adding more surgeons in the future but not changing the patient-comfort focus.

Meeker is a place where he can show up for his first surgery of the day in camo and blaze orange after an early morning hunt. He can head to his brewpub after work. He can bump into a relative at every turn. And he can send patients out of Meeker on new joints that give them a new lease on life — and a new appreciation for Meeker.

“I have a hard time imagining being anywhere else,” he said.

After an early morning hunting session, Dr. Borchard enters the locker room to swap into surgical gear as his brother, Kristofer Borchard, the medical center’s surgery director, awaits for their first operations of the day inside the Pioneer Medical Center. (Hugh Carey, The Colorado Sun)

CORRECTION: This story was updated Nov. 29, 2022, at 11:34 a.m. to reflect that Dr. Kevin Borchard served in the U.S. Air Force. Rachel Gates’ work was also updated. She is marketing director for Pioneers Medical Center and director of its foundation.

Nancy Lofholm

Special to The Colorado Sun Email: nlofholm35@gmail.com Twitter: @nlofholm