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Prairie Lakes Healthcare System Physician Recruitment Model

  • Need: Localized specialty and surgery services for residents in rural northeastern South Dakota and western Minnesota.
  • Intervention: Prairie Lakes Healthcare System expanded their services by recruiting specialty physicians and networking with regional community hospitals to increase patient referrals.
  • Results: Patients receive surgery and specialized care closer to home through Prairie Lakes' specialty medical providers and specialty services.


Based in Watertown, South Dakota, Prairie Lakes Healthcare System operates within a 10-county region in northeastern South Dakota and western Minnesota. The nonprofit aims to meet the more complicated medical needs of patients by offering surgery and specialized services, eliminating the need to travel long distances to receive treatments.

Prairie Lakes Healthcare System logo

Up until 2003, this region had only a traditional community hospital, a cancer center, and a rural dialysis outreach. With the idea of expansion brewing, Prairie Lakes completed a Medical Staff Development Plan to determine medical specialty needs in the market. The plan established how many subspecialty physicians were needed for services such as cardiology; nephrology; urology; pulmonology; ear, nose and throat (ENT); and general surgery.

Initially, the rural location of Watertown, South Dakota made physician recruitment a challenge, so Prairie Lakes hired a full-time recruiter to accelerate the process and establish new referral relationships. Their incentives caught the attention of specialty physicians across the nation, and new physicians built credibility with referring physicians in the market.

Prairie Lakes currently has working relationships with larger medical centers such as The Avera Health System and Sanford Health, as well as partnerships with Critical Access Hospitals (CAH) in the region, including:

Hear how Prairie Lakes medical staff worked with Randy to treat his sinuses:

Services offered

Since 1998, Prairie Lakes has expanded their services to include the following:

General services:

  • Cardiac Catheterization
  • Infusion Therapy
  • Radiology
  • Cardiology
  • Nephrology
  • Kidney dialysis
  • Pulmonology
  • ENT
  • Cancer care
  • Radiation Therapy
  • Wound Care
  • Vascular
  • Oncology Clinical Trials
  • Dermatology
  • Home care
  • Hospice
  • Obstetrics
  • Rehabilitation & Therapy
  • Acid Reflux Center
  • Cardiac and Pulmonary Rehab
  • Emergency
  • Pharmacy
  • Sleep Studies
  • Urology
  • Lab

Surgical Services:

  • Pediatric
  • Vascular
  • General
  • Orthopedic


Since 2003, Prairie Lakes Healthcare System has succeeded in the following:

  • Established a total of 23 outreach clinics
  • Increased the number of referrals coming from regional primary care physicians (PCPs)
  • Grew employed, specialty physician medical staff from only 1 to 23 physicians and 9 nurse practitioners.
  • Recruited 3 general surgeons
  • Established a new radiology services contract with 70-80 fellowship-trained radiologists
  • Achieves a 5% to 6% operating margin, compared to most hospitals' 3% average margin
  • Built a sustainable structure where specialists work together with referring physicians in order to provide each patient continuity of care
  • Has become a "show site" for patient care technology and diagnostic equipment
  • Opened a specialty clinic to centralize services in the fall of 2018.

The Prairie Lakes Healthcare website lists additional achievements and awards and more patient success stories.

Prairie Lakes Healthcare System Gerrish
Dr. Greg Gerrish, a General Surgery specialist, meets with a patient at Prairie Lakes Healthcare System.


  • Finding and recruiting physicians is an ongoing challenge
  • Competition with established, large health systems
  • PCPs have concerns about losing the patient if they refer them to specialty services, often making it difficult to secure a partnership
  • Having physicians on staff adds to higher fixed costs
  • Low numbers and volume factor that can make it difficult to be as profitable on physician services as large health systems
  • Overcoming old mindsets such as the negativity surrounding itinerant surgery and the idea that being independent is unsustainable
  • Lack of backup physicians for key specialty services


Prairie Lakes has built a successful physician recruitment model through marketing the positive aspects of practice in an independent community hospital:

  • With many large medical infrastructures buying out smaller practices, the independent, non-corporate system was appealing to mid-career specialists seeking a change in environment.
  • Recruiting specialists to help develop and build a program was incentive to semi-retired specialists looking to use their services in this way.
  • Prairie's advanced technology and equipment, healthy work-life balance, and not requiring physicians to be on call 24/7, helped to draw interest from specialists.

Much of Prairie Lakes' success is due to their commitment to the viability of community hospitals and referring PCPs. While growing a medical system, they suggest keeping the following principles in mind while working together with established medical facilities that surround you:

  • If you think there is a demand, validate it by assessing the market and the needs of your community.
  • Cater your services to meet the medical needs of your community.
  • Calculate how many physicians your community could support before you start recruiting.
  • Acquire ownership interest in local, privately owned surgery centers.
  • Stick to your medical plan and cut services that are not in line with that plan.
  • Put the patient first: work with their area medical provider to help the patient access services as close to home as possible.
Prairie Lakes Healthcare System building

Contact Information

K.C. DeBoer, President & CEO
Prairie Lakes Healthcare System

Networking and collaboration
Recruitment and retention of health professionals
Specialty care

States served
Minnesota, South Dakota

Date added
December 9, 2015

Date updated or reviewed
February 24, 2021

Suggested citation: Rural Health Information Hub, 2021. Prairie Lakes Healthcare System Physician Recruitment Model [online]. Rural Health Information Hub. Available at: [Accessed 22 February 2024]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.