Evergreen Family Medicine: Some Historical Context and Philosophy

As I begin my new role as CEO at Evergreen Family Medicine, my community should know who we are, how we got here, and where we are going.

During the mid-1990s, hospitals, large HMO groups, and insurance companies were forming or acquiring primary care practices to manage patient care.  Individual practices were being absorbed by these entities all over the country.

In 1995, a group of local physicians had the foresight and courage to form Evergreen Family Medicine and take a different path forward.  They merged traditional primary care practices with urgent care services into a physician-governed care model.  In 1996, I finished my Family Medicine residency in Arizona and recognized how unique an opportunity Evergreen represented.  So, I joined my brother and his physician colleagues, and we never looked back.

We operated as a physician group “without walls” for many years with offices throughout the Roseburg area.  In 2004, four physician-owners took out second mortgages on their homes and contributed capital to finance the first Edenbower Clinic. I remember receiving the bank’s “second notice” in August 2005 to pay the entire principal balance on the construction loan until our final financing was complete.  I have saved that notice as a reminder that we were “all in.”

From 2005 to 2010, we continued to operate the Edenbower clinic, meet our financial obligations, recruit a few new physicians, and deliver quality primary care, which included our independent laboratory and X-ray services.  However, it was difficult to attract new physicians to the area who were willing to accept personal financial risk, especially with a local payer mix that relied heavily on Medicaid and Medicare payments (approximately 70%).  Evergreen Family Medicine has been, and continues to be, committed to seeing everyone, regardless of insurance type.

In 2010, the CEO of Mercy Medical Center approached Evergreen with a proposal that aligned incentives. The hospital recognized that our area was still significantly underserved by primary care physicians, and Evergreen’s actions demonstrated our commitment to addressing this need.  A community partnership was born, based on the understanding that the relationship was built on trust, not control. Evergreen Family Medicine was not for sale, but we welcomed a joint venture to improve access to care.

The concept has worked well.  Since then, we have grown from about 10 physicians and advanced practice providers to over 60. Physician partners contributed capital and secured financing totaling over $30 million to build or renovate clinics and expand services into Sutherlin and Myrtle Creek. Mercy Medical Center, with financial backing from CommonSpirit, assisted with recruiting efforts to compete for professional talent nationally.  Our shared effort and resources helped to grow medical services in Douglas County.

In 2026, Evergreen Family Medicine aims to continue and expand its services to include internal medicine, family medicine, pediatrics, endocrinology (adult and pediatric), behavioral health, urgent care, women’s health (including obstetrics), occupational medicine, hospital medicine, endoscopy, integrated wellness medicine, palliative care, and third-party administration of our certified federal drug and alcohol testing program, reflecting our commitment to comprehensive community care.

Diagnostic services (laboratory and X-ray) at Evergreen Family Medicine clinic sites have expanded since its inception to include ultrasound, Zio monitoring, mammography, and echocardiography to address community gaps in access to these services.

I have enjoyed participating in the evolution of Evergreen Family Medicine, but there is still much to do.  The delivery of medical care, institutional reputations, and resource allocation are broken in many ways, so changes will be welcomed but will require active engagement.

Many are aware of the Peter Principle in management theory, which states that in a hierarchical organization, employees tend to be promoted until they reach their "level of incompetence." On the other hand, over the last 5 years, I have also witnessed the Dunning-Kruger effect among many experts and leadership classes. This phenomenon is a cognitive bias in which people with limited knowledge or competence in a domain vastly overestimate their own knowledge or skills. When this occurred, I often observed a lack of humility, or even hubris, but the worst offenses were not to allow the right questions to be heard or even asked. Evergreen will do the opposite.

This is why our organization's structure is “flat,” and prioritizes listening to those closest to the problem.  We remain committed to maintaining control over our operations, identifying service gaps, and innovating to deliver tomorrow’s solutions that improve medical care for our community. 

I look forward to our journey together.

John Powell, M.D.