From India to North Dakota

Dr. Ravindra Joshi has treated more than 110,000 patients in the course of a career spanning 30 years across three continents.

Now he is at the heart of an effort to create a network of orthopedic services across rural North Dakota, including Tioga.

“The goal of that program is to bring all the rural health clinics and critical access hospitals around here, bring them together under a common flag and help patients,” said Sam Perry, Director of Operations for McKenzie County Healthcare Systems, Joshi’s employer.

The rural network is called CROSS, which stands for Comprehensive Rural Orthopedic Surgical Services.

Joshi plans to visit Tioga the second Friday of every month, beginning April 12. Another provider, Dr. Leah Brewster, FNP, will assist.

“I think there is a lot of opportunity here,” said Randall Pederson, chief executive officer for Tioga Medical Center. “We encourage our patients to use his services.”

A new concept

Tioga Medical Center has spent the last several months announcing a series of programs aimed at returning services to the area that left decades ago.

Cardiology, surgery and orthopedic services are now available at the medical center after nearly two decades of absence.

“We used to have some orthopedic services many, many years ago,” said Pederson. “We did have a physician out of Minot who would come out and do some orthopedic work. I have to say that was at least 20 years ago.”

The goal of bringing these services back to the Tioga area, often through visiting physicians, is to prevent local patients from having to spend hours on the road to receive their medical care.

“All of these patients that are local are having to travel out of town for these services” including consultations, procedures and follow-ups, said Shelby Dean, clinic manager in Tioga. “Instead they will be able to be referred right here in Tioga.”

Joshi’s presence in Tioga will offer more opportunities for orthopedic care than Tioga has thopedic care than Tioga has ever had.

“This is a little different concept,” said Pederson.

Joshi is an expert in multiple areas of the orthopedic field and is qualified to treat everything from arthritis to sports injuries to total joint replacements.

Pederson said that he hopes Joshi will even be able to perform the procedures themselves in Tioga’s new operating room.

India to North Dakota

Joshi has lived in North Dakota for nearly 20 years, but his journey began in India, his native country.

“I always wanted to become a doctor,” said Joshi. “I decided to go to school for medicine because you can see the healing in the patient.”

Medicine in India, which had been controlled by Great Britain for nearly a century prior to independence in 1947, was heavily influenced by the English.

“I wanted to go to England because most of our teachers at the time were from England, our books were written in England, discoveries were done in England,” said Joshi.

In England he began a six-year residency, which in the medical field is a structured on-thejob training after completion of medical school.

“I worked with one of the best people there,” said Joshi. However “when I was in my fourth year I decided to come to America.”

He secured a position at Columbia Presbyterian, a renowned hospital in New York City, where he worked with the world famous orthopedic surgeon Dr. Nas Eftekhar.

“I was really, really lucky to get that spot,” said Joshi. Eftekhar had trained under Dr. John Charnley, the British orthopedic surgeon who had invented total joint replacements.

He honed his skills under the expert before returning to Cambridge, England. He wasn’t gone from the United States for long. He was working with a doctor at the time who had just returned from living in Minot for nearly 20 years.

“I said, why did you try Minot, North Dakota? You must be crazy!” said Joshi. “At the same time I got a call from a recruiter in North Dakota, Minot. I said wow, here is the calling, I should follow that.”

In the time since, he has made North Dakota his home.

“The first thing I liked was the people here,” said Joshi. “They are the best people in the world. The nicest, kindest people in the world.”

For nearly 20 years he has worked in Minot, Williston and now Watford City.

“I was received by the community like a family,” said Joshi. “It was just amazing.”

Now he is embarking on his grandest adventure yet.

CROSS

In recent years specialized medical care has become concentrated in hospitals supported by larger cities such as Minot, Bismarck and Fargo. Perry and Joshi envision a network of care to return orthopedic care to rural areas left out in the cold by the current system.

“I decided the best thing I should do is create a rural network of orthopedic surgery where I could provide that service,” said Joshi. “Nobody has done that before.”

When he worked in Minot and Williston, many of his patients were driving from small towns.

“They used to come from small towns like Grenora, Fairview, Crosby, Powers Lake, New Town, you name it,” said Joshi.

Another advantage of the network is the ease of access according to Perry.

“Their orthopedic care is sometimes delayed to a three or four-month wait” in Billings or Fargo, Perry said. “Our patients here we can get in usually the same day if they’re in Watford.”

Joshi’s versatility will allow him to use his expertise on a wide variety of patients, allowing them to skip the days off work they would otherwise have to take.

“They usually focus on just joints or just sports medicine, just spine, just hand, whatever it may be,” said Perry, referring to orthopedic specialists. “We are pretty lucky to have Dr. Joshi who is trained in and comfortable with multiple aspects of his specialty.”

Joshi began visiting Stanley last month and plans to attend to patients there every Thursday.

“The beauty of Tioga is they also have an operating room,” said Joshi. “I can provide not only office practice, I may be able to provide some surgical treatment on an outpatient basis.”

There are plans to expand the CROSS network beyond Tioga and Stanley.

“Those sites have not been selected yet but we are in talks with other organizations in the area,” said Perry. “They are supportive.”

Joshi likens his travel to where the patients are as returning to the roots of medicine in rural America.

“The doctor used to do the home visit,” said Joshi. “This is like going to somebody’s home and taking care of them.”

It’s an extension of the approach the doctor likes to take with patients.

“I call it personalized care,” said Joshi. “It’s not a patient here. I consider them to be a person in my office. I listen to them.”

He hopes that the CROSS network will give the hospitals and clinics in smaller communities a larger voice.

“All the critical access hospitals can come together and have a voice,” said Joshi. “Sometimes I feel the critical access hospitals are on their own.”

To schedule an appointment with Dr. Joshi in Tioga, call (701) 444-8730. No referral is necessary.