January 16, 2019

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My Roots and My Passion Have Always Been with Rural Medicine

Dr. Ronald Holmgren, ACMC

Ronald Holmgren, MD, President & CEO, ACMC-Willmar

A native of Litchfield, MN, Dr. Ronald Holmgren’s first experiences with Willmar Clinic (now known as ACMC) were as a third year medical student participating in the Rural Physicians Associate Program (RPAP).  In 1977, Dr. Holmgren returned to Willmar to start his practice and today is currently the President and CEO of Affiliated Community Medical Centers.  We asked Dr. Holmgren to talk about his experiences with ACMC over the years and what it is like working for one of the largest multi-specialty medical practices in the area.

Dr. Holmgren, what attracted you to the Willmar Community and what was then the Willmar Medical Clinic?

Holmgren: I joined the Willmar Medical Clinic in 1977 after residency.  I grew up in Litchfield, MN and my wife Etta was from the Paynesville area.  I spent one year in the area as a third year medical student under the RPAP program and was working at the clinic in Clara City under Dr. Lyle Munneke and Dr. Milton Gaebe.  At the time, they drove to Willmar every day to hospitalize patients, so I was here on a daily basis and got to know the physicians really well.  I was a third year resident when the opportunity became available to practice at what was known as the Willmar Clinic (now ACMC).

Most people that get recruited don’t always know a lot about what they are getting into, but I had a really good idea. I knew that I always wanted to be in a small town in rural Minnesota similar to the size of Litchfield or slightly larger. After looking into a couple other options, my wife and I chose to settle in Willmar.

What do you like about living in the Willmar area?

Holmgren: I like the lakes, the school system and I feel at home here with the cornfields because I grew up with them.  Over the years I have been involved in many recreational sports such as softball and basketball and with the many open spaces and lakes I have become an avid hunter and fisherman.  So, when not working, I have spent the years hunting, fishing and with my family as my children were involved in many activities through their school years.  It has really been a great place to live.

I like the multi-specialty group that I am a part of.  Family doctors at ACMC are able to practice all spheres of medicine such as OB, hospital and clinic medicine. So we are able to use all of our skills and still have support from the sub-specialties within our system.  At the time that I joined the clinic (six of us joined in 1977) we went from 28 to 34 doctors and now we have about 102 doctors practicing in our eleven clinics!

You have been a part of the administrative team serving as President and CEO since 2000; what has this experience has been like?

Holmgren: I have really enjoyed being in a leadership role at ACMC.  I have been a part of the leadership team in one way or another for almost all of my years here and really can’t see myself as not being a part of the decision-making process.  I felt that I was well prepared for my role as President and CEO (since May 2000) as I have been involved in the governance over the years, so I look forward to the challenges and enjoy it!  My style is more collaborative than authoritarian and it seems to work well with Administrator Terry Tone and the other medical directors.  We all have a very collaborative style and that’s where I think we are most effective.

In the business world, there are always ups and downs and challenges; in corporate medicine we also face those same challenges.  At ACMC, we govern ourselves and have a Board or Directors that gives us direction, we are able to be much more reactive to changes that occur in medicine and make decisions we feel are best for the organization. We are able to implement those changes and have been effective because we can adapt and change quickly rather than being burdened by a city government or hospital process that may have other agendas.  We can focus on what’s best for the patient and for the organization.  We really do value the physician group as a whole as having input into the decision-making process.  We are different than many of the medical organizations out there.

I have really enjoyed being in a leadership role at ACMC.  I have been a part of the leadership team in one way or another for almost all of my years here and really can’t see myself as not being a part of the decision-making process.

Do you still practice medicine as well as lead the ACMC organization?

Holmgren: Yes, I practice about 1/3 of the time seeing patients in the clinic.  Recently I gave up my hospital time to the Hospitalist’s which was a huge change. The change was good as it allowed for me to have more clinic and administrative time.  Many times these two jobs (administration and patient care) add up to more than 100%, but I really enjoy the clinical part and would never give it up completely!

What are some of the challenges you face as an ACMC leader?

Holmgren: One of the biggest challenges that we see is that we are about 50% government programs so about half of our revenue is fixed and paid for by the state and federal governments.  To give you a perspective, metro clinics are usually in the area of 7-20% government programs compared to our 50%.  So, we become somewhat at the whim of the government for changes they bring that affect how we run our organization.  That means that we have to be even more efficient as to how we run our organization and have to have other sources of revenue; we have been successful in doing so through ownership and joint ventures in imaging and physical therapy services and also joint ventures with hospitals including our surgery center.  We also need to have solid long-term contracts with third party payers.

We’ve always put a really high value on recruiting quality physicians and have a very good process for screening and interviewing candidates.  We have been quite successful the past couple of years, but that does vary from year to year.  We are limited in the number of candidates that are willing to come to a rural environment to practice medicine.  Right off the top only about 20% of medical students and residents are interested in rural medicine with the other 80% going to metro locations.  Out of that 20% we have a lot of competition across the United States.  We like to think that we are very competitive though in that we are a different type of organization than most.  We are physician owned and run and that gives us some uniqueness so we attract people who want to be a part of that.

What do you think are benefits of being a part of the ACMC system?

Holmgren: We have been an organization that is known for quality and new recruits see that we have a market compensation which is good; but we also have an excellent retirement program that isn’t just for physicians, but is for all employees.  Once here for 10-15 years you really start to see the value and our retirement program is really our “golden egg”.

As physicians, we have a style here in that we are a group practice that allows individual physicians to practice quality medicine.  We have spent a lot of time working on best practice initiatives that have kept ACMC very high on the list of eighteen different community measurements that are brought out and published by the Minnesota Community Measurements organization.

What advice would you give your children, who are also physicians, as they continue to practice as well as those seeking an interest in becoming a physician?

Holmgren: I do have two children that practice medicine within the ACMC system. My daughter, Dr. Amber Vick, Family Medicine, New London Clinic and my son, Dr. Aaron Holmgren, Centra Care Clinic (who also does In-reach here at ACMC-Willmar). My other daughter, Britt, is in HR/Consulting.  I am proud of them all because they have worked hard over the years to be successful.

I was always positive about becoming a physician myself, recognizing that it was a lot of work.  With my own children, I didn’t really have to tell them because they knew what they were getting into.  I am very encouraging with them as I have also been to my nephew that is starting medical school this fall.  Everything is always changing and the key is to adapt to the change.  You need to work hard!  There are lots of people out there that have the intelligence and background to become physicians.  You need to be dedicated and be able to work with people and help people and put in the hours; if you have these skills, you can be successful.

The hardest hurdle is really making the decision to become a physician, next is getting into medical school.  It’s not always easy to get into medical school but once you are there, the process keeps you there and keeps you interested.

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