At Bear Lake Memorial Hospital, a patient probably grew up with the nurses providing care. And the physical therapist. And the surgical technician, the X-ray and ultrasound supervisor, the lab supervisor and the administrator.
"I'm a local boy myself and have the philosophy that people born in Bear Lake are as good as anyone anywhere else," administrator Rod Jacobson said."Rather than find people with education and get them to move here, we get people already here and pay for their education."
The grow-your-own-workers strategy has helped Bear Lake Memorial become one of the area's most financially stable hospitals.
Jeff Cochran's story is typical.
The 39-year-old Bear Lake Valley native worked with quarterhorses in Texas and California after receiving his master's degree in equine physiology. In 1988, he decided to move back.
"Our kids were getting older and it looked like the horse business was going to mean more moving around. So we came back to Bear Lake."
There wasn't a big demand for experts in race horse reproduction in the valley, so Cochran supported his wife and five children by driving trucks and working on a car lot.
That's where Jacobson found him.
"Rod (Jacobson) approached me when I was selling cars," Cochran said. "He wanted to know if I would be interested in becoming an ultrasound technician."
Jacobson said the hospital would pay for Cochran's training at Weber State University in Ogden, Utah. He also had to become certified as an X-ray technician before learning ultrasound.
Cochran began the X-ray program in August 1990. He was certified in March 1992. He then began the ultrasound program.
With certification, the hospital had a present waiting: a $90,000 ultrasound machine.
The hospital's motives aren't altruistic.
Having a qualified, reliable support team helps the community's doctors, said Jeffrey Bartlome, rural health specialist at Idaho State University. And doctors are crucial to keep patients, and money, flowing to a hospital.
"A lot of discussion is given to doctor and nursing supply but very little to vocational health professions" such as therapists and lab and X-ray technicians, he said.
"A hospital has to have an adequate infrastructure, meaning they've got to have a team."
Jacobson said keeping pace with available technology, such as ultrasound, is a vital part of the overall team concept.
"We knew three years ago there was demand for the ultrasound," he said. "But we needed someone to run it."
Rather than pay a recruiting company $10,000 to $20,000 to find an ultrasound technician to move to Montpelier, Jacobson said the hospital decided to put the $10,000 into educating Cochran. Locals are more likely to stay in the community and patients are more comfortable with them.
"We get instant credibility by putting a kid to work who grew up here," Jacobson said. "People say, `He was a good kid when I knew him, so he's probably good at what he does here.' "
For Cochran, Bear Lake's home-grown philosophy means a satisfying job in the community he grew up in.
"I've found ultrasound to be one of the more challenging things I've ever undertaken," he said. "I don't suppose I'll ever run up to a time in my career when I'll have seen everything, and that's a little frightening."
Cochran and physical therapist Bruce Wallentine have received the most extensive scholarships to date from the hospital. But hospital board chairman Timm Toland doesn't rule out bigger possibilities.
"If we get a kid who does four years of college and decides he wants to go to medical school," Toland said, "I think we'd take that very seriously."