Dr. David Crimin is Director of the Long Term Care Track at RVUCOM-SU, Assistant Professor of Primary Care, and Medical Director for the Southern Utah Veterans Home.
A board-certified osteopathic physician in Family Medicine and Hospice and Palliative Medicine, Dr. Crimin is also certified as a Medical Director of Post-Acute and Long Term Care. Prior to his academic life at RVU, Dr. Crimin worked as a rural physician at Intermountain Healthcare Sevier Valley Hospital/Clinic, providing full-scope family medicine care in hospitals, skilled nursing facilities, hospices, and home care. He served as a member of the Board of Health in Central Utah for 20 years. He was also a Medical Director and “House Doc” for an Avalon Healthcare, Inc., a skilled nursing facility for 27 years in Richfield, Utah.
At Rocky Vista University:
Each year, Dr. Crimin accepts 10-15 students into the Long Term Care Track at RVUCOM-SU. In this track, students learn about the “Silver Tsunami” and the Baby Boomer generation—the largest and fastest-growing segment of the U.S. population.
“Elderhood consumes the largest portion of medical care and dollars as [people] live longer and with multi-system, life-limiting illnesses,” says Dr. Crimin. “People [who are] 65 years and older find themselves lost and neglected in the medical world: in the Emergency Department, hospitals, and long-term care facilities. There are not enough geriatricians or primary care physicians to provide care for this population.” With the Long Term Care Track at RVU, Dr. Crimin hopes to change that.
In addition to the track, he is also the Medical Director of the Southern Utah Veterans Home (SUVH), a 108-bed skilled nursing home facility managed by Avalon Healthcare Inc. The partnership between RVU and the SUVH was the vision of Dr. Clinton E. Adams, President of RVU and a veteran himself, to create a bond between veterans from all branches of the military and students at RVU’s College of Osteopathic Medicine. Under the shadow of the Red Mountain, “There isn’t a more beautiful setting for elderly veterans and medical students anywhere,” said Dr. Crimin.
At the Southern Utah Veterans Home:
RVU faculty physicians provide daily and comprehensive long-term care, end-of-life palliative/hospice care, and short-term rehab care to veterans and/or their spouses. “There is a two- to three-year waiting list for a long-term care bed at [SUVH], so we are always full,” said Dr. Crimin. “[Students] also have been part of Veterans Day and Patriot Day celebrations with the veterans and have been assigned early clinical experiences with the residents.”
Osteopathic Principles and Practice (OPP) Fellows, supervised by Dr. Jan Pryor, Vice-Chair of the Department of OPP, and Dr. Chris Edwards, Assistant Professor of OPP, also provide specialized osteopathic manipulative treatments for residents on consult.
In 2018, the SUVH was awarded the distinction of the “number one skilled nursing home facility in the nation” by the Centers for Medicare and Medicaid Services for achieving the lowest percentage of re-hospitalizations of residents. This year, the SUVH earned the American Healthcare Association and National Center for Assisted Living’s 2020 National Silver Award for “Achievement in Quality.”
Questions for Dr. Crimin:
Below, we asked Dr. Crimin to answer the questions he receives most often, as a physician and as an RVUer.
What do you like most about RVU?
“The faculty and staff provide a great teaching atmosphere for the students. I especially enjoy the family feeling and collegiality of the students, faculty, and staff.”
Why did you move to the St. George area?
“I became excited for the great opportunity to teach the new generation of osteopathic physicians in my own backyard and state. Learning about the plans to build the school made me excited about being more than a preceptor. I wanted to be part of this dream of [Dr. Thomas N. Told, Dean of RVUCOM]. Coming here rejuvenated me and gave back the great feeling of being a doctor again (and not just as a generic provider or caregiver for a large healthcare organization).”
What do you like most about being a family physician?
“The personal interaction with friends and neighbors and being able to provide excellent compassionate care when they and their family most need it.”
Isn’t it hard to take care of dying patients?
“Yes, it can take a toll. But it is also very rewarding to alleviate the pain, distress, and fear in the patient’s last chapter of life. As Sir William Ostler, MD, said: ‘To cure sometimes, To relieve often, To comfort always.’
“It is also said that the ‘healing physician always provides comfort care.’ I believe that nobody should ‘die alone, in fear, in pain, or in distress.’ Knowing that, as a team, we made a difference in a person’s last stage of life, and being with the patient at the bedside holding their hand with their family as they take their last breath peacefully is rewarding to me. The family never forgets this.”
When are you coming back to Richfield, because we still can’t find a doctor we like and trust?
“I tell them to hold on a few years for our new, bright, well-trained osteopathic physicians that we teach here at RVU.”
What do you like best: taking care of the veterans or teaching medical students?
“I enjoy the best of both worlds. The great staff and veterans of the SUVH and the bright, young students, faculty, and staff at RVU.”
What inspires you as a physician?
“I am inspired (and frustrated) by the opportunity of lifelong learning of becoming and being a physician.”
How has the pandemic affected the SUVH and how you overcome these challenges?
“The COVID-19 pandemic has certainly affected the patients and staff at SUVH. It has been a dynamic process. We are just starting to understand the nature of this virus. The measures of early lockdown to outside visitation and strict use of personal protective equipment (PPE), hand-washing, facility sanitizing, social distancing, and masks have been very effective in minimizing the risks of exposures. We know we can’t prevent this sneaky virus but we are prepared.
“The residents are either grateful for the precautions taken or have ‘pandemic burnout’ and long for a sense of normality where visitation and trips outside are free again.”
What is your advice to those treating the elderly?
“Be present. Most elderly are living longer with multiple health problems. Many are very frail with incurable, life-limiting (terminal) conditions. Most lack family support. These patients come in with long lists of complaints.
“You need to listen to and prioritize their health concerns. Then, address them or they risk going back to the emergency department/hospital, where they will receive more invasive diagnostics and treatments which may adversely affect their quality of life. Knowing your community resources can ease your burden of ‘caregiving.'”
What has been one of your most rewarding moments at SUVH and/or the Long Term Care Track?
“When a student discovers a new health condition from a thorough patient history and physical exam and can follow the diagnostic and treatment process for the benefit of their veteran. I had one student discover a symptomatic enlarging abdominal aortic aneurysm and was able to follow the patient’s care.”
What have you learned from working with veterans and their families?
“Most veterans are very appreciative and respectful of their doctors, but can also be very demanding and entitled. Family relationships can be supportive or toxic to their care. Some days, I only want to care for ‘unmarried orphans without kids.'”
Fun Facts about Dr. Crimin:
Every morning, Dr. Crimin swims a 2,500-yard workout in his endless pool and bikes to the SUVH and RVU. When not at work, Dr. Crimin loves to hit the slopes in the winter or take a boat out on Lake Powell with his family. He also enjoys hiking and photography.
In his personal life:
Dr. Crimin and his wife, Rochelle, currently reside in Ivins, Utah, and have four children—Bradley, Kevin, Steven, and Emily—and four grandchildren—Aidan, Caitlin, Alaina, and Mason.