Dr. Charles Frankum said he is 鈥渏ust a physician like any other,鈥� aside from the fact that his daily four-hour commute includes piloting himself between some of Colorado and Kansas鈥� most remote hospitals.
鈥淚 have patients that I鈥檝e seen for 20 years, and we used to go to 4H auctions together and buy cows, and stuff like that 鈥� that鈥檚 just part of being a physician. You鈥檙e going to build relationships because you see people over and over again,鈥� said Frankum.
Frankum, a surgeon whose flights can be followed , assumed the role of pilot-doctor around 2003. Over the last 20-plus years, he has flown and worked in Eastern Colorado towns including Burlington, Springfield and Yuma, as well as a few spots in Kansas, providing care ranging from general surgery to colorectal screenings.
Frankum鈥檚 efforts, as well as those by other medical professionals, offer locals of small-town Colorado the opportunity to receive critical medical care closer to home, in turn developing close-knit relationships in rural health care systems frequently threatened by limited funding.
While there is little information about how many doctors and nurses fly or are flown between hospitals, may see significant hourly rates. , healthcare providers who fill gaps in understaffed hospitals and clinics, may spend anywhere from in one location, while doctors like Frankum may travel between a handful of locations each week.
Heather Burdick, Springfield鈥檚 chief nursing officer and nursing home administrator, said the hospital relies on traveling physicians like Frankum, in order to provide the care patients need without breaking the bank on a full-time employee.
鈥淸Frankum] comes in once a month, and just since I鈥檝e been here the last couple of years, I know numerous people he has found cancers on or snipped polyps off of,鈥� said Burdick.
鈥淪o just the preventative services he鈥檚 able to offer us alone is phenomenal.鈥�
Access to medical services can be limited for people living in remote towns such as Springfield, especially for patients who need specialized care.
Springfield (with a population of about ) is one of Colorado鈥檚 farthest southeast towns. It sits about 30 miles from the border of Kansas to the east and Oklahoma to the south, and included among the few buildings surrounding Main Street are a couple of restaurants, one post office and a small movie theater, as well as the hospital.
Springfield is also the county seat of Baca County, one of the in the state.
When tragedy strikes in these areas, such as a high-speed car crash along the highway or an illness requiring specialized care (about of the county is over the age of 65), a patient鈥檚 best chance at survival may be at a , which are designated rural hospitals that provide 24/7 emergency care services to isolated communities. These hospitals stabilize patients in critical condition before transporting them to treatment centers in cities with the appropriate facilities, like Denver or Colorado Springs.
鈥淭he goal for these critical access hospitals is to do as much as they can with the limited resources they have,鈥� said Udo Foreman, a physician assistant who occasionally works at the Southeast Colorado Hospital in Springfield.
Foreman said that these 鈥渕om-and-pop鈥� hospitals often operate on that limit staff sizes and require administrators to turn to outside help to continue providing services.
As much as of independent rural hospitals nationwide are operating at a loss, according to a 2024 report from Chartis, a health analytics firm. In Colorado, the Center for Healthcare Quality found that in the state had losses exceeding assets.
Frankum comes from a farming family. His grandfather plowed fields in Tennessee while Frankum鈥檚 father and uncle trained to be surgeons. Both succeeded, affording the family the chance to move to Memphis, where Frankum was born.
Frankum studied medicine at the University of Tennessee and completed his residency in general surgery at the Atlanta Medical Center in Georgia. He earned his pilot鈥檚 license during his residency, originally as a means to travel with his family to fishing destinations in the Bahamas.
He moved to Denver in 2001, and after a couple of years working as a surgeon specializing in colon and rectal surgery on the Front Range, and took over making the long-distance visit to Springfield from his partner, who had tired of traveling the route.
Because Frankum already owned his own plane, he decided to fly himself instead of driving the four-plus hours. He flies a Socata , a single engine turboprop with enough seating for about six people, including the pilot. Frankum said that the margins for air travel are slim, but flying allows him access to multiple rural hospitals in a day as well as the ability to return home each evening.
Frankum enjoyed the visit, as well as his next rural hospital visit in Burlington, a town of just a people in Kit Carson County. These trips, matched with his family history in small-town America, inspired Frankum to focus his work in rural Colorado.
By 2004, Frankum was visiting more than a dozen different rural hospitals across the Colorado and Kansas plains, as well as a few in Denver. He specialized in colorectal surgeries (intestines, colon, rectum) but performed an array of surgical procedures as needed and as possible in the locations he visited.
Frankum said that his schedule is mostly set to the end of 2025. He follows a standard visitation plan for 12 hospitals.
The surgeon typically spends Mondays in Hugo and Tuesdays in Burlington. On Wednesdays, he may fly between two different hospitals on the same day, starting in Oakley, Kansas, and finishing in Yuma, Colorado, before flying home to Denver.
Frankum owns and operates his own plane and coordinates with to travel between locations. He flies out of the Colorado Air and Space Port in Denver, a small airstrip a few miles southeast of DIA.
His days often start as early as 4 a.m. and finish well into the night. Weather can make air travel across the blustery, and occasionally blizzardy, Eastern Plains challenging. But Frankum said he has come to appreciate the hardworking, community-connected rural hospitals he serves, as well as the loyal patients that often prefer treatment somewhere near home.
鈥淚 probably go to three towns that have a McDonald鈥檚,鈥� said Frankum, of the small towns he serves.
鈥淏ut they鈥檙e great towns, and they鈥檙e full of great people that love and trust their nearby hospital.鈥�
Foreman, who drives (or is sometimes flown) between rural hospitals in Colorado, Kansas and Nebraska, originally planned on practicing in the city, but after building close personal relationships with the farmers and ranchers he served in critical access hospitals, he decided to keep his sights beyond the metro area.
鈥淭here鈥檚 the continuity of care, right,鈥� said Foreman. 鈥淚n the smaller towns, you go to the E.R. for something really bad, and lo and behold, it鈥檚 your primary care doctor.鈥�
鈥淎nd he knows you, and he knows not just your medical history, he also knows a little bit of your personal history, too.鈥�
Dr. Sacramento Pimentel, a family medicine specialist based in Burlington鈥檚 Kit Carson County Memorial Hospital (KCCMH), said that his long-time regulars feel the same way.
鈥淲e absolutely need help from people in Denver, they are essential to helping patients that we can鈥檛 necessarily serve out here,鈥� said Pimentel, who specializes in family medicine in Burlington.
鈥淏ut Denver can be intimidating. And small towns are doing more now, so patients tend to want to stay out there if possible just because of how personal and familiar it is.鈥�
Michelle Wright, a family nurse practitioner with the KCCMH, said she has had nervous patients ask that she 鈥減lease not send them to Denver.鈥�
鈥淭here is absolutely a different level of comfortability,鈥� said Wright. 鈥淢ost patients have known you forever, and you see them at the grocery store or at schools 鈥� and they trust that you are looking out for them.鈥�
Frankum, Foreman and Pimentel all underlined the connectedness between critical access hospitals as well. Rural healthcare networks often share resources when spread thin, and all three of these doctors regularly cross paths while traveling.
Foreman said that he and Pimentel have gone to concerts together, and Frankum and Pimentel have gone hunting in their spare time.
While rural hospitals such as the and are working to expand their services and facilities, employees like Wright and Burdick are concerned about across the state.
Nationwide, health clinics are facing potential from the Trump administration as well.
Colorado鈥檚 Department of Health Care Policy and Financing has support systems, including the , set to provide supplemental financial support through September of this year, yet a number of rural hospitals are still calling for further investment.
鈥淸A lot of these hospitals] are not owned by giant corporations, so they鈥檙e hanging on by a thread,鈥� said Foreman. 鈥淚t does happen where you have a hospital that collapses, their funds run out and they have to shut down.
"And then that town doesn鈥檛 have anything. No one wants that.鈥�
Burdick said that critical access hospitals are essential, and their absence could be the difference between life and death.
鈥淚f someone goes down with a heart attack, and there鈥檚 no stabilizing services, and the nearest place is an hour away 鈥� without stabilization to be able to happen as quickly as it can, people would definitely die,鈥� said Burdick.
Now in his mid-50s, Frankum plans on continuing his air travel commute as long as it is feasible and beneficial to the communities he serves.
鈥淢y work makes it so that only one person has to travel instead of all these other people having to travel,鈥� said Frankum, 鈥渁nd it allows some very rural hospitals to turn their wheels and do procedures in their town, and make money for their community.
鈥淭here are a million headaches that come with [the job], but you go home at the end of the day, and all you鈥檝e done is help a bunch of people throughout the day. That鈥檚 not really a bad way to go home.鈥�