CRESWELL — It was a good seven years, Dr. Damon Armitage said.
Camas Swale, a community-based family medicine clinic at 117 Melton Road, closed its doors on July 18, leaving Creswell without a family care practitioner for the first time since October 2017.
Above, practitioners and community members celebrate the ribbon cutting of Camas Swale Medical Clinic at 117 Melton Road in 2017. The clinic closed its doors in July, citing economic challenges at the root cause. CHRONICLE ARCHIVE PHOTO
Before Dr. Damon Armitage planted his flag in Creswell, he practiced five years at the Veneta Medical Clinic. Before that, he has had a long career in medicine and active duty.
Armitage has 23 years of combined federal service with the Air Force and Air National Guard and has been in the medical field for over 18 years. He also serves as the Oregon State Air Surgeon.
Now, Dr. Armitage is practicing out of the Eugene VA on Chad Drive — fitting for a veteran medicine man.
What led to the closure came down to an amalgamation of “economic infeasibilities,” Armitage said.
In a nutshell, the clinic could not keep up with increasing costs while also receiving flat or declining reimbursements from third-party insurance companies.
That, and staffing issues due to pandemic-related workforce changes, unaffordable childcare, and difficulty finding and keeping qualified providers, all contributed to the clinic’s closure, Armitage said.
“A lot of factors are making it difficult to survive as an independent practitioner,” Armitage said, starting with the issues persistent within the state’s healthcare industry.
“After Oregon Medical Group was bought out by the big conglomerate back east, it made a lot of changes that many of the providers were unhappy with,” Armitage said.
Armitage is referring to an April report by Lane County Medical Society, in which 32 doctors were cited to have left Oregon Medical Group since March 2022. The exodus came after the group was purchased during the pandemic by Optum, the largest employer of physicians in the U.S.
The buyout led to changes in the system, industry dissatisfaction, and now those ripple effects are being felt in our communities, he said.
“Oregon Medical Group recently lost so many primary care providers that they actually released several thousand patients back to the community and told them that they wouldn’t be able to absorb them into their practice,” Armitage said. “For a lot of the practices here in Eugene, the wait can be up to 12 months right now to get a new primary care provider.”
No increases in third-party reimbursement rates from insurance companies has also clobbered the clinic, he said.
Third-party reimbursement rates are the negotiated rates that insurance companies — including Medicare and Medicaid — pay to healthcare providers like Armitage for services. These reimbursement rates are significantly discounted from the actual fees charged by the practice.
Over time, he said, as the practice’s costs have consistently increased due to inflation and the rising cost of living, the reimbursement rates have remained flat. He said that some services they provided were actually reimbursed at less than the practice’s costs, making it impossible to continue offering those services to patients on government insurance plans.
This mismatch between rising costs and stagnant reimbursement rates is a widespread issue affecting many medical practices, especially independent and rural practices like the one in Creswell, Armitage said.
Additionally, many people in the medical and service sectors stopped working during the COVID-19 pandemic, and did not return to the workforce afterwards, Armitage said.
Armitage noted that when the cost of childcare is considered; it may not be worth it for some employees to continue working, leading them to decide to stay home with their families instead.
The data speaks volumes.
According to the most recent information provided by Annie E. Casey Foundation’s Kids Count Data Book, in 2023, the average annual cost of center-based infant care in Oregon was $14,400, and the average annual cost of center-based care for a four-year-old in Oregon was $10,800.
This means that the annual cost of childcare in Oregon is nearly the cost of in-state tuition at a four-year university. The University of Oregon’s 2024-25 school year tuition and fees rack up to $16,137, for example.
“Our business model also somewhat depended on growth, and not being able to retain staff – especially physician assistants or other providers – contributed to it,” Armitage said.
The clinic’s location in Creswell was not necessarily a deterrent. By the time the clinic closed, Armitage said that Camas Swale had over 3,500 patients enrolled — for comparison, that’s over half of the Creswell population — and had loyal patients from neighboring communities, too, like Cottage Grove and Pleasant Hill.
“Dr. Armitage was kind and friendly. He never seemed rushed during your appointment and always listened to my concerns,” said Ken Parramore, Creswell resident and former Camas Swale patient.
Armitage said that he gave it his all. He hung on by his fingernails and put himself in considerable debt in an attempt to hold out until the tides turned.
They didn’t. But the community remains thankful for his service, nonetheless.
Patients are able to access their medical information at MorganRecordsManagement.com, or by calling 833-888-0061.
