UO Magazine > MI's Upper Peninsula

Community Profile — UPper peninsula of michigan

Call of the Wild...

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“It was like a pressure cooker,” he remembers. “The downside was that it was very challenging. The upside was that you were doing a truly broad range of services and you were really needed.”

Today there are 38 doctors on the active medical staff. “I’m one of the few not employed by the hospital,” he reports, citing several advantages: “If you are employed, you are going to use the services of the hospital, such as physical therapy, and especially outpatient care. (For instance), I have a lab that turns (tests) around in half an hour. At the hospital it’s six hours.” Best of all, in his opinion, “I’m not beholden to anyone else except my patients. They can call anytime, and I make house calls. I try to be what patients want as a doctor.

“The fun of being an internist is taking care of the tough stuff and knowing where the edges are and that the patients will trust you. What makes life interesting as a practitioner is the variety of cases.”

He does admit to an occasional “complication,” though. A favorite anecdote: “Blue Cross & Blue Shield once sent me a note that it would drop me as a provider. I didn’t match up with other servers they could find. They didn’t realize that I was saving them money.”

For Terry Kinzel, MD, Janners’ partner for several years, freedom means he can choose an “unusual” lifestyle. Now limiting his practice to about half-time, he has found other satisfying activities, although he and his wife still enjoy biking, hiking, walking in the woods, and skiing.

Echoing some of the more extreme baby boomer trends, he admits that “my wife and I are pretty left of the midline. One of the things that concerns us is how we feed ourselves,” such as inordinate amounts of corn fed to cows and the great distances to transport food items. “We raise geese and chickens and mostly trade for meat and eggs. We had some sheep, but that didn’t work out so well. I couldn’t slaughter them, so they’re pets now.”

His wife volunteers with the Network in Solidarity with the People of Guatemala (NISGUA) and makes frequent trips to the Central American country, an interest sparked when she traveled there in 1976 to help earthquake victims.

You could say Kinzel inherited a “relationship” with the UP. His grandparents lived there but relocated to Detroit for work when the UP copper mines began closing. Decades later, Kinzel graduated from Michigan Tech. After medical school at the University of Michigan and residency at Michigan State University-affiliated hospitals, he rediscovered Keweenaw’s beauty.

He, too, winces as he remembers the dearth of practitioners in 1978 when he arrived. The expectation was that he and Janners would refer “tough cases” to a bigger hospital. “We received complicated patients and took turns on call for emergencies,” Kinzel recalls. “There was no emergency room then. The practice was really quite, quite consuming.”

Kinzel’s eventual “salvation” was to move into geriatrics and community mental health. He’s also medical director for the hospital’s long-term care facility and, most recently, has been working with the Veterans Administration Hospital in Iron Mountain.

Kinzel does lament the fairly recent arrival of “civilization.” He says, “Now we’re on a strip complete with Wal-Mart and other big box stores in an area southwest of Houghton and Hancock. If you were transported blindfolded you would think you were almost anywhere, except for the cheaper construction.” But area tourism people are proud of their designation by National Geographic magazine as one of the top 10 outdoor adventure spots in the United States. There are hundreds of miles of hike/bike trails, lakes and harbors for boaters, many trails or loops for snowmobiling, and—almost unique to the area—scores of shipwrecks for SCUBA divers to explore.

In fact, Sean Ley at the Great Lakes Shipwreck Museum says victims of Lake Superior’s all-too-frequent “temper tantrums” now number 550. At least 200 wrecks have happened near Whitefish Point, today’s museum site and one of the UP’s most treacherous areas. Over the years, professional divers have salvaged several of them.

Although practitioners like Janners and Kinzel have maintained their independence, they have by no means shunned the vast array of new patient tests and treatments. Neither have the UP’s five acute care and 15 critical access hospitals. While small, with less than 25 beds each, the 15 handle a multitude of outpatient cases.

Hospital care in the UP dates back to a time when the area’s reputation for “healthful air” attracted tuberculosis and hay fever sufferers. Early “care centers” were private homes, but today’s Marquette General Health System, the UP’s largest hospital, dates to 1896, a time when, among other lacks, there was no elevator. The superintendent carried patients upstairs on his back. Today’s large complex offers many specialties, and a number of its doctors act as consultants in other UP hospitals.

The modern face of UP medicine includes an exponential number of doctors, state-of-the-art diagnostic and other technology, available help from organizations such as the Michigan Office of Rural Health, the Upper Peninsula Health Care Network and the Telehealth Center, with 42 sites. It links local internists with specialists around the world, allows physicians to “attend” professional conferences and tune in on pharmacy and therapeutic health committee meetings without leaving home. “This builds efficiency like crazy,” says Telehealth’s program director Sally Davis.

Thanks also to the State Office of Rural Health, “the hospitals have gone from isolated to a complete network,” says Angie Emge, the hospital programs manager. The organization oversees group purchases of supplies, facilitates rural health clinics, monitors legislative activities, and advises on strategic opportunities for rural health improvement.

Some communities are starting fresh with state-of-the-art replacement buildings. Exhibit One: Munising Memorial Hospital opened in March. All 11 homelike patient rooms have scenic views of Lake Superior. “It’s like a shopping mall,” says Velte, its CEO. “Once you’re inside you don’t have to leave the building,” a huge advantage, especially for elderly patients who will no longer have to cross—and cross back again—an often snowy, icy parking lot.

The new building is a special triumph for him. “(Other administrators) can’t believe that we built a 60,000-square-foot hospital for $9,200,000,” he says. Thinking toward the future, Velte also insisted on a wood-framed building so that interior walls could be quite easily reconfigured if the need arose.

Exhibit Two: Bell Hospital in Ishpeming, 15 miles west of Marquette, a Single-level, 102,427-square-foot building and the third incarnation of a 1917 structure built mainly with area iron miners in mind. The new facility focuses on patient convenience and staffing efficiency, and comes with an attached medical office building. With some 90 resident and consulting doctors, it can now handle many surgical procedures once farmed out to bigger hospitals.

Exhibit Three: War Memorial Hospital in Saul Sainte Marie, on the eastern end of the UP, bordering with Canadian sister city Saul Sainte Marie, Ontario. War Memorial just finished a new 30,000-square-foot rehabilitation center, helping the hospital double in size within the last eight years. The hospital’s wish list for specialty physicians includes OB/GYN, internal medicine, ENT, dermatology and urology.

Searching for Dr. Right

But even with an exponentially increased number of fellow professionals, state-of-the-art facilities and ultramodern communications capabilities, Wayne Seibert, human resources vice president at OSF St. Francis Healthcare System in Escanaba, worries about recruiting certain specialists. The hospital, on the warmer Lake Michigan side, is one of the UP’s five acute care facilities. Tiny-niche specialists seem reluctant to wear the generalist hats required at smaller hospitals, says Seibert. It does seem there are more than enough hospitalist wannabes but fewer internists, and recreational considerations are more prevalent than in the past.

“When we’ve had candidates here, they often are quite surprised at the level of our technology. But getting them here is the thing,” Seibert explains. Among recent arrivals, though, are an OB/GYN from Lower Michigan and an orthopedic surgeon. Seibert’s search for “outdoor-oriented, four-season-oriented” practitioners continues.

Mark Povich, DO, is a family practitioner rather than a tiny-niche specialist, but the UP was a very soft sell for him. “One of my classmates in medical school was from up here,” he reminisces. During an Air Force stint, he and his family frequently drove home from North Dakota to downstate Michigan, stopping to visit the old UP classmate. “When the time came for me to look for a practice, there happened to be an opening in Escanaba. While doing my residency in Lansing—not the worst part of town, but not the best, either—we’d be awakened at night by police helicopters shining big searchlights, looking for the person who had just robbed the convenience store up the road. This, I thought, is not the right kind of place for us, with its crime and heavy traffic.

“North Dakota had been a breath of fresh air. There are places in the world where there’s not much crime, a lot of outdoors and not much traffic. The UP had the taste of a different quality of life, which was on our criteria of places to go. We grew up in the Midwest, so the snow didn’t make a difference to us. If you are going to be up here your mindset is either that you’re a prisoner of winter or a participant in winter. Good snow makes winter all the more doable.”

That’s what the season has been for Povich, who enjoys cross country skiing and snowshoeing. His take on the cold season: “There’s hardly a day all winter long that I can’t dress appropriately for something outside.”

In a multi-specialty group practice, he says, “I think we are at an advantage because it’s part of the OSF corporation that has many resources we can tap into. A big part of that soon will be having electronic medical records integrated into the hospital system. Patients can flow from office to hospital to home and home health. Everything will be connected.” This, he adds, will be a first in the UP.

For Dickinson County Healthcare System in Iron Mountain, recruiting Michael Merig, MD, was also an easy sell. Growing up on the Gulf Coast, Merig, a pathologist, remembers “two snows, in 1972 and 1977” in Mobile. Two factors played a role in his UP arrival. “The older I got, the more I didn’t like heat in the 90s. The summers are pretty bad in the South, and the humidity is high. I had always wanted to come somewhere up north, and, the way this job happened, it worked out.”

After completing education and residency in the South, he decided this northern locale was his favorite place. In fact, “(my family and I) had all anticipated seeing snow so much that we just couldn’t wait.” Still, he adds, “I wanted to be involved in all four seasons.” Not only that; “the summers are very nice here.”

For recreation, he has switched from the deer hunting he loved as a boy to duck hunting. He’s done some skiing and enjoys snowmobiling. “When the temperature goes to zero or below, that’s not fun for any activity,” he groans, “but, honestly the winters haven’t been that bad. Just because the weather is 10 degrees outside, doesn’t mean you stay inside. It just means you add more clothes before you head out the door.” He’s been in the area for 10 years. In summer, he says, “I’m heavily involved with my youngest boy, who plays soccer and baseball.”

As for winter, he still pleads guilty laughingly to a first naïve snow removal effort — with a leaf blower. He still says it works when there’s a tiny dusting, but, in the meantime he’s prepared himself very well. He now owns a four-wheeler ATV—complete with plow on the front!

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Eileen Lockwood lives in St. Joseph, Michigan, and has vacationed in the Upper Peninsula several times. She is a frequent contributor to Unique Opportunities.