ST. IGNATIUS — Maps and photographs, framed posters and a Christmas tree. The building’s beige walls and its wooden ceiling create a warm, soft light that makes you feel at ease. With racks of colorful books and childrens’ games lined up along the floor, the Mission Valley Heath Clinic felt more like a friends’ house than a medical building. Perhaps it helped that with a small, loyal and local staff of three, the clinic was actually a place to visit with friends as well as to see the doctor.

Randy J. Trudeau, PA-C, has worked in the town of St. Ignatius for 15 years, first with another clinic, and as of 2006, as a private practice family physician’s assistant. He’s seen generations of patients come through his doors in that time.

The children he once saw now bring their own children to see him, or at least they did, until the doctor was forced to close his doors at the end of this year.

“It’s difficult to close a practice and say goodbye to your patients,” he said.

But, it hasn’t been an easy road bringing in business in a small town with four clinics all drawing from the same small pool of clients.

“The competition is very keen, but it seemed like once we obtained a patient, we didn’t lose them,” Trudeau said. “We’re small, but we care.”

He added that things have gotten worse for his private practice as the struggling economy has left more people out of work.

“When somebody loses their job, they lose their insurance,” he said. “People stop going to the doctors because they can’t afford even the co-pay.”

For a while, Trudeau held on to the hope that his clinic would be adopted as a satellite facility for hospitals outside the Mission Valley, but despite several promising leads, Trudeau thinks local politics may have severed any forward progress in that direction.

Also a part of the equation, Trudeau has recently stumbled into his own health problems. Potentially requiring significant time away from the clinic, he said it would be very difficult, at least at first, for him to commit the necessary time to the clinic in order to maintain its daily operations. With just three staff members, including himself, Trudeau can’t just hand off his duties to an understudy or share responsibility with a partner.

“I just wanted to do the medical,” he said. “But unfortunately, I’m also the janitor and the gardener.”

Trudeau’s clinic was actually a house before he decided to gut it and rebuild, all done during a transitional year where he stepped back from family practice and worked in emergency care around the state for five days in a row with 10 days off in between.

His loyal nurse, Bev Haflinger, LPN, has been by his side since day one at the other clinic in Mission and she even returned to the valley after working a year on the coast when Trudeau was ready to open his own clinic in 2006. As the doctor’s right hand woman, Trudeau said she’s seen the full spectrum of patients and tackled some pretty unique injuries along the way.

“Some of the patients are just like family to you,” she said. “You call them the next day to see how they’re doing.”

One of the most memorable patients, Haflinger said, was working with a young boy who was in an accident and needed very special care with removing the gravel that had lodged itself into his skin.

“I got to pick all the gravel out of his face, then I got to see him graduate from high school without a scar,” she said.

Then there was the time that another patient shot a nail through four fingers. The list goes on.

“It’s always been great working with Randy,” she said. “He was always there to get my back.”

For Trudeau, the feeling is mutual. His receptionist, Sabrina Castor, is a Mission Valley native, originally from Charlo. Trudeau said she also wears multiple hats.

“The girls are always on top of it,” he said. “They are two people that do the work of three each and I am very thankful for them.”

“Emotionally overwhelming” is the way Castor described the recent months and the task at hand.

“I’m really going to miss seeing the patients everyday and interacting with them,” she said.

“You don’t realize how much your patients are really counting on you and are going to miss you when you’re gone,” Haflinger said. “Thank you for trusting us with your care, you will all be missed very much.”

The clinic will be open for the first week in January for patients to call, stop by, get their charts and transfer files.