Joey Wahler (Host): It's a unique challenge, so we're discussing providing medical imaging in a rural area. Our guests are Sean Driscoll and Jon Salmon. Both are imaging supervisors. This is Valley Vitals, the pulse of healthy living in our community, brought to you by Carson Valley Health. We're going beyond the checkup to bring you real conversations with the experts you trust. Thanks so much for joining us. I'm Joey Wahler. Hi there, Sean, Jon. Welcome.

Jon Salmon: Good morning.

Sean Driscoll: Thank you.

Host: Good morning to both of you. We appreciate the time. So, first, Sean, can you please remind us to get started here, some of the most common types of imaging you provide?

Sean Driscoll: So at our hospital, we offer CAT scan, MRI, ultrasound, echocardiogram, diagnostic x-ray, mammography. We also do procedures, such as PICC lines, port insertions, barium swallows, nuclear medicine studies. And then, recently, we've also added on a cath lab, an outpatient cath lab, so we can do imaging of the heart as well, which is new to our area. We started that when the expansion opened on December 9th in 2024.

Host: And, Jon, we touched on it at the top, but what are indeed some of the unique challenges of providing imaging in a rural area?

Jon Salmon: Some of the unique challenges with providing imaging in a rural area are just getting the information and the communication with the patients so that we could be able to provide the quality care that they need. Also, some of the challenges in the area that we are in is weather. Like, this week, we had a bad week where it was very snowy and we had to switch things around and we've been working with our patients so that we could get them their needs met so that they could get diagnosed and move on with their healthcare.

Host: And picking up on that, Sean, oftentimes one thing that gets overlooked when it comes to healthcare in general is what a challenge it is for many patients to get to and from the services they need, right? And that becomes really exacerbated in a rural area, doesn't it?

Sean Driscoll: Yeah. Probably the hardest part, probably the most unique challenge that we have being in a rural area is a lot of people work the lands. We have a lot of ranches, a lot of agriculture, and just a lot of distance in general. We serve more than just Douglas County. We have Story County, we have Lyon County. Parts of California still come to us. Even people from the lake, they come to us. So, it's hard to get people to, you know, have to shut down for a day and travel to Reno. Anytime you travel to Reno, what could be a six-hour trip for us turns into almost like having to stay the night in Reno. So, finding lodging, finding someone to cover your animals or cover watering or whatever they're doing on their land.

And also, just in general, they're just tough-built people out here. So, it's hard enough to get someone that works the land to come in and get seen for something, let alone have them stay the night for something. So, very strong people in the area. That's kind of part of just being a rural nevadan, is we don't have a lot of the amenities that you have in the bigger metropolitan areas of Nevada, the two major ones we have where things are a little bit more easily accessible at all times. We have to do a lot of planning to make sure that everything's taken care of to get yourself taken care of.

Host: And picking up on that, Jon, what about the fact that many patients, of course, are simply not in the best of health when they need imaging done? And so, that adds to the aspect of transportation, how and with whom they're going to travel, et cetera, right?

Jon Salmon: Yes, we have an older community here in Douglas County, especially in the Gardnerville and Minden area. So, we have to coordinate with family members, we have to coordinate with community transportation, and try to get those patients here so that they be seen, taken care of. It takes several people to get someone taken care of here. And we work very well with the community as well as companies that provide those services so that we could take care of them.

Host: We're going to talk about those services in just a moment. But first, just to kind of close out the portion of our chat concerning getting people to and from and the big challenge of that, Sean, how important is it for you two, like, right now, to get that message across that, yes, we'll work with you and yours to make sure that you're able to get here and get back, and that that doesn't add to your stress?

Sean Driscoll: One of the ways that we're doing that is we're actually offering a lot of weekend appointments. So, we do CAT scan on the weekend. We do MRI on the weekend. We do ultrasound on the weekends. So, a lot of other facilities, they may not have that outpatient availability, but we've recognized that getting people here is the first challenge, and then getting them here at a time when it's available to them is the second challenge of course.

So, weekends tend to be wide open for people. So, we started offering that service. And once we started offering that we've noticed an increase in our volumes and patient retention and patient's willingness to come in. Not everybody's available at 11 o'clock during the week, but 11 o'clock on Saturday is a little easier to manage for a lot of our community.

Host: Yeah, absolutely. So Jon, that being said, what are the new advancements, or at least some of the key ones at Carson Valley Health's Medical Imaging Suite, and why are they significant right now?

Jon Salmon: The significant updates that we've made since we've moved over in December of 2024 are we've added several comfort levels for the patient so that like we have scenery on the ceiling. So when they get into an MRI scanner or CT scanner, they have something to look at. We have mood lighting, which is provided by PDC image carrying suite. So, we're able to change the lighting, make it a little bit dimmer for them, change the color, something that makes them feel more comfortable in it. MRI as well, we now provide music so that they could listen to something to make them more relaxed. We have a wider bore with our MRI so that they feel more comfortable if they have some claustrophobic challenges. We also have live image scenery behind on a monitor so that they could look at things like balloons or a sunset or aquariums just so that it makes them more relaxed, makes them feel more comfortable. Also, with our new MRI technology, it makes the exams a little bit faster. And so, that's some of the changes that we've made with that.

Host: So Sean, here again, we're talking about not just taking images and delivering results, but making people feel comfortable. How important is it that someone, while the procedure is going on, while the images are being taken, how important is it that they feel at home, relaxed and that there's nothing adding to their stress about the experience itself until it's all over with?

Sean Driscoll: Yeah. What we're doing is, at least with the expansion, our old facility, we had a little bit—like, no space. It was a lot smaller. Room size was basically machine, table, technologist, patient. So, our director, Patty Smith, when she was helping design this area, she got us as much square foot as we possibly can.

So, one of the first things that's changed from our old site is just the amount of room that you have. There's plenty of area to walk around. There's plenty of area for you to put your things down. You don't really feel like you're crammed in.

The other thing we've also done is just the change of the aesthetics of the area. So, it's very bright, it's very open. You don't feel closed in. As you're walking around, you get that sense of going to have a good time and a good experience in our department. We've also done a lot of training with our technologists and working on speaking with our patients and just accommodating those needs and recognizing for something is going on as opposed to that more proactive feeling than a reactive feeling.

Host: So Sean, one thing that you and yours offer are 3D mammograms. So for those unfamiliar, in a nutshell, how do they differ from 2D images?

Sean Driscoll: The 2D images are your classic radiograph that you would see. We've all kind of seen that picture of a bone, where you have a front view and a side view. So, the 2D image for mammography is you're going to take a picture of the tissue, top to bottom and side to side basically. When we do the 3D or tomo, it's a rolling picture through the tissue. So, you start at the top or and roll your way down, or you start from the inside and roll your way outside kind of issue.

What that does is the 2D image will show, if there's anything that is different, and then the 3D as it rolls through will help you localize that area that you've identified as possibly being abnormal. And then, we'd also follow it up with an ultrasound as well, just to see how the tissue reacts to the sonogram to kind of help with that diagnosis, to make sure the patient gets the best care and gets that best diagnosis, prognosis going on.

Host: Couple of other things for you two. First, Jon, imaging often is needed ASAP. No one knows that better than the two of you. It was touched on earlier, but what would you say to those joining us about the ease with which they can schedule an appointment at Carson Valley Health for imaging?

Jon Salmon: With our imaging department, there are some advantages to a rural department. If you go to bigger cities, you could wait up to a month, two months, just to schedule an MRI, even a CT and other imaging modalities. With our hospital, if we have an order and we're able to talk to the providers, we usually could get someone in within a reasonable amount of time—a week, two weeks, sometimes even quicker, depending on the circumstances. And if it's needed for a primary care provider and they would like it even sooner, we are able to get people in and out of here very fast and take care of them in a small community-oriented situation where they feel very comfortable.

A lot of our patients know us. They come in, and they smile. We see a lot of the same people. And we like to think that it's like coming to home or coming to a place where you're comfortable and being taken care of. And we do very well at that. And we hear good things every day about how the patients feel treated, the ease of setting an appointment, the ease of getting their information back to them so that they could get them to their providers.

And that's one of the big advantages to coming to a hospital like ours, a pri, we're able to take care of them very well and the communication, because they could even call myself or Sean and get that information back. And we could help them get their stuff so that they're taken care of and feel like they were taken care of well.

Host: So in summary here for you, Sean, is that what you and yours are most proud of about what you're able to deliver to patients that human touch that it seems has been a common thread during our conversation here? It's not just about taking images and delivering results.

Sean Driscoll: Yeah, absolutely. That's what keeps me in imaging. I was in a different field for a couple years after I became an x-ray technologist. And I didn't have as much patient interaction and I did not enjoy that. So, when I came back. I kept that same standard. Unfortunately, all those cliches are out there. You know, if it was your grandma, if it was your wife, it was your mother, your child kind of thing. But I take that to heart. If someone's walking through here and they need something taken care of, it's going to be me one of these days. And I really hope that when it's my turn to have a problem, that I'm given just an ounce of what I'm trying to give our patients.

No one's ever going to come into imaging because they're having a good day. Whether it's the first chest x-ray from a cough, or it's that last CT scan and they're in full remission, there's something that brought them to our department. And generally speaking, it's nothing good. Like, we don't have ice cream here. This isn't an ice cream parlor.

So, while they're in our care, we offer that extension family to them. It's a very scary thing. Not everybody has that medical knowledge of what's going on. Something that's very routine to us is scary to somebody else. And it's part of our job not just to press the button, take the picture, but to comfort them and get them through that. Because a lot of healing and a lot of going through stuff is that positive attitude towards it. We've seen people that have kind of lost that spark and it's part of our job to help try to get that spark back, try to reassure them that they are going to be okay, and that they got the best chance of a best outcome based on the imaging that we provided.

Host: Indeed. Treating people as people, not just as patients, right?

Sean Driscoll: Absolutely. Absolutely.

Host: I'm sure those joining us are comforted to hear that, to say the least. Well, folks, we trust you're now indeed more familiar with imaging in a rural area. Sean, Jon, keep up all your great work and that human touch, and thanks so much again.

Jon Salmon: Thank you so much and have a great day.

Host: Absolutely. Same to you too. And for more information, please do visit carsonvalleyhealth.org Also, please subscribe to our podcast and connect with us on social media. If you found this episode helpful, please do share it. And stay tuned for more engaging discussions right here. And thanks again for being part of Valley Vitals. Let's move mountains.