Dr. Robert Hoyer spends four days each month living in a Holiday Inn Express while his UCHealth team brings oncology care to southeastern Colorado, reducing what would otherwise be multi-hour trips to Pueblo or Colorado Springs for many patients.
The outreach team leaves Colorado Springs at dawn on Mondays, visits Mt. San Rafael Hospital in Trinidad on Monday and uses space at Prowers Medical Center in Lamar on Tuesday through Friday, then returns home around noon on Fridays. In a typical five-day trip the team sees about 130 patients for new diagnoses, test-result reviews and chemotherapy.
There is not a single oncologist permanently based in the southeastern quadrant of the state. Many counties on the Eastern Plains lack specialists of any kind; the Colorado Rural Health Center reports one physician for every 995 residents in the region, compared with one per 295 residents in urban Colorado.
Hoyer, who trained at Georgetown and worked at the Mayo Clinic before becoming medical director of oncology at UCHealth Memorial in Colorado Springs, began traveling to southeastern Colorado in 2011. What started as a single-day outreach has expanded to a full week as demand has grown and as word spread among small towns from Lamar to Springfield, Walsh, Eads, Holly and Cheyenne Wells.
Patients say the outreach makes life-changing care possible close to home. Michelle Cooper of Springfield, diagnosed with ovarian cancer two years ago, receives infusions in Lamar and has avoided repeated long drives. She credits the local care with allowing her to continue attending her daughter’s sporting events during treatment.
Dennis Leathers of Holly receives a monthly injection for multiple myeloma in Lamar. He and his wife say the short drive spares them the hotel, meal and transit expenses that sometimes accompany trips to Colorado Springs. “Without this treatment, I don’t have any hope,” Leathers said.
Smaller hospitals often cannot prepare chemotherapy because of the specialized ventilation and safety protocols required for handling hazardous medications. Prowers Medical Center in Lamar has a pharmacy that compounds chemo on site; for Trinidad, chemotherapy is prepared in Colorado Springs and transported under strict timing constraints so patients receive it within hours of production.
UCHealth’s electronic medical records system supports the outreach clinic by tailoring dosages and running drug-interaction and organ-function checks. “These are very, very complex calculations that have to happen,” said Dr. Wells Messersmith, chief medical officer for oncology services at UCHealth, noting the same safety checks used at larger hospitals apply to rural infusions.
The shortage of local specialists extends beyond oncology. Shelby Casper, a family nurse practitioner who opened a clinic in Wiley in 2022, carries a patient panel of about 1,900 and works long days to meet demand. Casper said she has been trying for months to recruit another provider but is “maxed out,” and many patients have nowhere to go for specialty care.
UCHealth also sends cardiologists and other specialists to southern Colorado communities, and Rocky Mountain Cancer Centers provides oncologists to Burlington and La Junta. Still, roughly 90 oncologists with active licenses practice in Colorado, concentrated along the Interstate 25 corridor, leaving large rural areas underserved.
Telehealth and local coordination are key components of the program. Hoyer successfully petitioned Medicare to maintain coverage for virtual visits from patients’ homes, arguing that removing that option would force rural patients to travel to the hospital simply to connect by video. Telehealth, local labs, imaging and infusions allow patients to stay close to family and community while receiving care from a major health system.
Nurse practitioner Rose Gates, who returned from retirement to join the outreach team, said rural patients frequently lack internet access or smartphones and need in-person explanation of results. “A lot of patients don’t have cellphones,” she said. “They appreciate the fact that we’re coming out here.”
Hoyer, 49, has considered shifting his focus to lifestyle and longevity medicine but continues the monthly travel because of the impact on patients. He predicts advances in targeted therapies and artificial intelligence will further improve outcomes in the coming decade.
Rural patients and clinicians alike describe the outreach as essential, saying it fills a gap that would otherwise force some people to forgo treatment or endure costly, exhausting travel for care.
Leave a Reply