Letter from Mark and Heather

In the SJ Update mailbag this morning, we find this letter to you from Mark Fishaut and Heather Christensen…

Recently a letter was sent to patients of San Juan health Care that Dr. Burk Gossom is retiring as of the end of November, 2019. This is without question a significant change and will have a seismic effect on the choices and the delivery of care available for our community. We both appreciate the opportunity he provided us to serve the families of this beautiful island.

Many have already approached us about our futures as providers and the impact that will have for their care. There have been obvious misunderstandings about our status that require clarification:

Neither of us intend to stop practicing medicine!

Between us, we care for more than 50% of the children and teens on the island, a significant proportion of whom have complex physical, behavioral, emotional, and academic problems. Heather has a substantial adult following of her own, independent of Dr. Gossom’s long established panel. Thus we recognize that there are profound implications for the healthcare of many.

For us, the practice of rural medicine is both rewarding and challenging. We are both committed long term to our work and to our community. However, in the absence of a dramatic change, it is not realistic for us to maintain the current office.

That being said, be assured that we are making every effort to find a solution and “land on our feet” in order to serve those who have entrusted their care and that of their children to us. In the meantime, it will be “business as usual” at our present location. We hope you will be patient and support us as this all plays itself out to a happy ending.

Mark Fishaut MD FAAP
Heather Christensen PA-C

PS – Here are links to three papers that summarize the sate of pediatric care in rural America to provide you some additional background. Some of the data is relatively old but the situation is now worse than at the time of publication:




Posted on May 15, 2019 at 12:00 pm by

Categories: Health & Wellness, Letters, People
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