It’s been no secret that the hospital and clinic affiliation of Cheshire Medical and Dartmouth-Hitchcock Health, which is the principal health-care provider for Keene and Cheshire County, has struggled with shortages of primary care providers. Indeed, stories are not uncommon of patients receiving announcements that their doctor or other provider is leaving the practice and later learning the assigned replacement has also moved on, sometimes before having had an initial appointment with the replacement.
With the predominant health-care model typically requiring that access to many specialty care and other services be channeled through a patient’s primary care provider, the difficulty the local Dartmouth-Hitchcock affiliate has experienced in recruiting and retaining primary care providers has strained its staffing resources and can frustrate patients seeking an ongoing relationship with a primary care professional.
Encouraging, then, is the news of Cheshire Medical’s plans to launch a family medicine residency program in Keene. According to hospital officials, the program would provide post-graduate training to medical professionals while also offering health services to local residents. The potential benefits for area health care are significant. As envisioned by Cheshire Medical, a residency training program would attract new primary care physicians to Keene. Further, while primary care residents complete their training, the program would give them — and in many cases, their spouses relocating with them — the chance to get settled into the area as well as experience the community-based professional opportunities here.
That should bode well for retaining family medicine practitioners after their residency, as national studies cited by hospital officials show that physicians are more likely to remain in practice near where they’ve received residency training. An additional, more immediate benefit of a residency program to the area is that, officials say, it will require the development of a family medicine clinic where both program faculty will practice and program residents will receive clinical training.
To meet the physical space needs of the program, Cheshire Medical plans to purchase the former Peerless Insurance headquarters on Maple Avenue. The facility seems well-suited for the hospital’s needs. It’s conveniently sited near Route 12 and the bypass system and has substantial parking. And, with hospital officials concerned about overcrowding at the main health-care campus on Court Street and the limited room for expanded services there, the former Peerless building would also enable Cheshire Medical to relocate some other medical practices and administrative functions and to expand some of the other existing services at the Court Street campus.
Despite the potential benefits of the plan, there are some considerations that should be addressed. Chief among them is the potential loss of property tax revenue from the Maple Avenue property, which, municipal records indicate, might have been more than $362,000 at last year’s tax rate. That certainly would be a significant gulp for city residents to swallow annually if, because of the hospital’s nonprofit status, the property were to go completely off the tax rolls. If it were, an increase would certainly seem called for in the amount the city receives under its payment in lieu of taxes agreement with Cheshire Medical.
Another issue that may deserve a look is whether establishing the family medicine practice and residency program in the former Peerless headquarters and relocating other services and hospital functions there raise any traffic concerns for Maple Avenue, which in recent, non-pandemic times has seen increased volume from the new Keene Middle School. That will presumably be considered by Keene’s zoning board in deciding whether to grant a special exception, which is the next step in the approval process before Cheshire Medical can proceed with the purchase.
Assuming such considerations are satisfactorily addressed, Cheshire Medical’s plan to establish a family medicine residency program is an inspired one and offers much promise to help the long-vexing challenges of meeting the area’s primary-care professional staffing needs and expanding family medicine capacity.