Updated Sept. 8 at 11 p.m.
— by Margie Doyle —
After years of losing money and physicians, this month Orcas Medical Center will come under management by UW Medicine to meet the challenges of 21st-century rural medicine. UW Medicine will formally begin its oversight on Monday, Sept. 11 as UW Medicine Orcas Island Clinic.
Dr. Mike Alperin has contracted at the medical clinic as a full-time physician; he will also serve as Clinic Chief for Orcas and Lopez Island clinics. Dr. David Russell and Kirsten Pickard, nurse practitioner, will bring the staff to 2.8 FTE (full-time equivalents), according to Jay Priebe, Director of Rural Primary Care and Operations for UW Medicine. In recent years, the clinic was down to one full-time physician, Dr. Anthony Giefer, who observed that that wasn’t enough to provide medical care services in the winter months, let alone the busy summer season. Priebe clarified that there will be a physician at UW Medicine Orcas Clinic six days a week, through staggered staffing.
Staff will be supplemented by tele-medicine, with a 24/7 community-care nurse call line and with “virtual” care visits, similar to internet FaceTime or Skype. UW Medicine has also developed a provider call group on Orcas and Lopez with all the UW Medicine providers sharing after-hours calls, so, if necessary, the nurse care line can refer the patient to the medical provider on call. The after-hours service thereby will document the care offered which the medical provider can review the next day for follow-up.
Day-to-day clinic management will continue under Jennifer Taylor, with current staff — all Orcas Island residents — remaining under the new management, said Priebe. As Director of Rural Primary Care and Operations, he will oversee the Orcas Clinic/Orcas Medical Center operations and services.
In response to questions about “integrative” or alternative practices such as T’ai Chi, yoga, biofeedback), Priebe said, “Our providers are open to having conversations with patients regarding their interest in the direction in which they’d like to receive care; it’s between the patient and the provider and what they feel is the best for their care.”
UW Medicine is responsible for contracting and staffing at Orcas Clinic. Clients insured by Kaiser-Permanente (formerly Group Health clients) will be covered for primary care services at the Orcas and Lopez clinics. The Orcas Clinic website will provide documentation regarding the insurance coverage that will be accepted by UW Medicine. “We encourage patients to contact the clinic with any questions about coverage,” said Priebe.
Orcas Medical Center/UW Medicine Orcas Clinic’s recent history involves the Orcas Medical Foundation and Island Hospital in Anacortes. Orcas Medical Foundation (OMF) a 501(c)3 non-profit founded in 1991, owns the building and land on Mt. Baker Road, according to Leslie Murdock, OMF President. It also engages in fund-raising for the Center.
In 2011 Island Hospital took over the medical practice, but declined to renew its contract with OMC after 2016. (Island Hospital formally ceased operations at OMC on July 1, 2017). UW Medicine affiliated with Orcas Medical Center following Island Hospital’s decision not to renew its contract with OMC. This year, Orcas citizens raised $750,000 required to complete contract negotiations with UW Medicine for contracting and staffing of the rural health clinic.
“It’s important to note that primary care is not a revenue-generating service; it’s expensive,” said Priebe. The clinic’s financial shortfall takes into account staffing models, expense management and current indebtedness. Analysis of the current state of financial operations shows an annual loss of $526,000. To address that indebtedness, Priebe says, “Expense management allows UW Medicine to use contracts to reduce expenses; and to expand access which increases revenue for the clinic. There will be financial shortfalls that remain with the clinic because of rural health center Medicare financial reimbursement that no longer exists, close to $250-300,000.”
Priebe emphasized UW Medicine’s “Significant operational efficiencies” and the access to “virtual medicine” as factors in reducing the Orcas Clinic’s expenses. “Our goal is to provide resources to our patients to allow them to make the right decisions about their care, through increased staffing, the 24/7 nurse line, and the virtual care clinic,” Priebe said.
Collaboration among UW Medicine and the other two island physician practices, at Orcas Family Health Center, and at Orcas Island Family Medicine is still a topic of discussion. Dr. David Shinstrom of Orcas Family Health Center says, “Over the years I have advocated for unification of medical practices. This critical meeting will determine so much for the future.”
Coalition for Orcas Health Care — a diverse group of Orcas citizens, who first formed in Dec. 2016 — ‘is committed to providing primary and urgent care for all the members of our community in a financially sustainable way into the future,” according to Art Lange communications lead for the Coalition for Orcas Health Care (COHC).
Leslie Murdock, OMF Board President, said last week of the COHC, “We are two different organizations…[and] we are delighted that COHC, is working to form a taxing district.”
COHC is now collecting signatures for a petition for forming a Public Hospital District. COHC member JoEllen Moldoff said, “There is a lot of work to be accomplished before we can ask members of our community to vote on whether or not to approve a Public Hospital District. Signing a petition is a way of beginning a process of educating, informing and above all, listening with respect, to questions and concerns. Signing this petition does not signify approval.”
Art Lange clarifies: “There is no intent to build a hospital on Orcas. “By state law, the definition of a Public Hospital District means a public health services district. Our focus is on health services for everyone.”
Should voters decide on a Public Hospital District, Preibe says that publicly-elected commissioners would then “assume existing agreements” and contract with UW Medicine for health care services. “We would become partners in assuring successful delivery of medical services.”
The community meeting introducing UW Medicine Orcas Clinic was held on Thursday, Sept. 7 from 5 to 7 p.m. at Orcas Center.