— from Ken Speck —
Orcas Island residents are in a quandary about medical care again. This time the University of Washington – UW Clinics thinks they can solve the problem and absorb huge indebtedness. It has been stated they need to have $750,000 to proceed and another $300,000 per year beyond that amount. This is a huge financial burden which I cannot imagine has any logic. This has not worked before with Island Hospital and they left, and came back only to leave again.
For the past ten years I have served as President of the Board of the Orcas Family Health Center (OFHC) as we try to fulfill our mission to provide medical care for all who need it regardless of their ability to pay or any insurance they may or may not have. We provide 24/7 care for residents and visitors and have never turned anyone away. This is a daunting and expensive endeavor. We have done everything we can do to assist the process and still fall short of the costs. We have offered to merge with other medical practices many times over the past years and have always been rejected when it seems only logical that a combined medical center would benefit the entire community.
OFHC is a 501C3 nonprofit with rural health clinic status as opposed to a private practice. We provide a majority of medical care for over 45% of islanders and visitors. Our patient load is handled by three medical staff, two registered nurses and an office staff who go above and beyond because they believe in our mission.
We are subsidized only by volunteers who raise funds with projects that bring in relatively small amounts of support money.
I think the answer to the problem is to unify all the medical care into the Orcas Medical Center as it was originally intended and would encourage total community support.
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I agree. When the med center was built that was the understanding, no? We were so happy then about it — how very weirdly it’s turned out (so far). Let’s get sustainable & cooperative.
Well said, Ken. Thank you. It’s not up to UW to fix our problems. It’s up to all of the practices to work together – something the OMC people have repeatedly failed to do.
Well said, Ken.
One question: Is “our” medical building paid for or does it have a mortgage?
Might it not be time for all interested and invested parties to gather and forge a consensus on how to resolve this challenge?
Another important question is whether the MC could be run as an FQHC, which–until Paul Ryan has his way with Medicare and Medicaid–would provide some financial advantages.
I note the OIMF statement also posted today; it mentions our other two island physicians retiring. Wouldn’t it make sense to have them in the OIMC to allow their patients a reasonable transition if and when they do choose to retire?
*run as a rural health center (not FQHC)
For those of us who haven’t been on Orcas for a long time (five years for us), there seems to be some information missing from the discussion about the new proposal for Orcas Medical Center. According to Ken Speck, the other doctors on the island are willing to be part of a unified medical center. But the medical center does not seem to be interested in this. Obviously, if the other doctors are not included, there is no motivation for the patients of the other doctors to vote for a hospital taxing district. So in the interest of full disclosure, would those of you who know the missing details be willing to provide them here?
Thank you.
It would help me and others tremendously to hear why Drs Shindstrom and Russel left OMC in the first place.
Why do they want to go back to OMC when they chose to leave previously? Some of this isn’t any of our business BUT most of it is when we are asked to support financially the way we have been asked to do. Especially when letters are written to the public and statements are made that breed more mistrust.
In a perfect world, in my eyes anyway, it would be fabulous if the doctors could all work together. But I think there are many reasons the rest of us do not know and we choose to believe many comments that have been stated without questioning the “why” of them. We believe them because someone we know said it! Another bandwagon to jump on.
Until we have full disclosure about more details, people will be afraid to support anything. How tragic, indeed!
So, as some others have stated, can someone please clarify the reasons for some of these concerns? Perhaps Drs Shindstrom and Russel could begin since they wrote the first letters. Why should the community support “The Merger” when we were asked to support your leaving OMC? And please know, I am asking in a loving way. So many of us are so confused! Only you and OMC can help clarify all this. Many of us hope you will.
Thanks!
Maggie
Dr. Russell, in another offering to Orcas Issues authored by Michelle Russell, has said that unless the circumstances were indeed remarkable or there was a disruption in the excellent working relationship he has with Dr. Shinstrom and Orcas Family Health Center, that he is not interested in changing his present circumstances.
Merging the two practices, OFHC & OMC, and continuing the relationship with Dr. Russell, would serve 100% of the primary medical care for Orcas Island. I spent 42 years not getting all done I wanted to because of the “politics and culture” of the beast and don’t really care about what did or did not take place 25 years ago. What I do know is that all three doctors are excellent primary care physicians deeply dedicated to their profession. All three have tended to my medical needs – more than once in the middle of the night. The Orcas Medical Foundation Board is up to their armpits of themselves and need to step back and act like a landlord, not a doctor. To do otherwise is going to put 60 years of service to this community in danger of going down the gurgle.
In response to Ron and Maggie Schuler, I did not leave the medical center voluntarily. The medical center board forced me out for trumped (like that word?) up reasons not related to my quality of care. I would be happy to share the details. Call me at 376-7778.
Dr. Shindstrom,
With all due respect, if you were “forced out” especially if it had nothing to do with quality of care, please tell ALL of us why so we can make educated decisions. If you were “forced out” unfairly of a building the community built it is in the community’s best interest (and only fair)for us to know why.
This is so serious for our community! People will become more and more divided over this issue and we won’t get anywhere with solving the problem because no one wants to talk about THE problem(and honest, I do NOT know what it is but there obviously is one!)
This is like putting a Band-Aid on an infection. It’s festering bigtime and can’t heal until it is opened up and aired out and treated appropriately. And the longer information is kept in the dark, the more the infection grows. And as you know, Dr. Shindstrom, some infections, when left unattended leave horrible, permanent scars.
Talk to us please! ALL of us. We need to hear your side of the story.
Thanks for considering it.
Maggie
Comments in the Guest Columns of Orcas Issues about the future of medical care on Orcas have been both discouraging and heartening. I am discouraged to realize there are some misconceptions going around, but am heartened and grateful that so many of us care about this issue and are deeply concerned about the future. It sounds like many of us would like to see a merger of practices, improvement in relations, and reduction of waste. Quite so!
As a former employee of the OMC who had a lot of contact with the Orcas Medical Foundation (OMF) board of directors, I hope to clear up a few misconceptions here. In a future column, I hope to discuss the quandary we face in health care, and my thoughts about a possible solution. My intent here is to be unbiased, with respect for all concerned. (And with my thanks to Aaimee, who has answered a complicated question about Medicare billing in Rural Health Clinics, above.) Here’s a bit of history, as I understand it that I hope will answer some questions:
The OMF is a 501(c)3 non-profit that was founded 60 years ago with the mission to support medical services for all on Orcas Island. That mission has not changed. Board members serve a term of three years, and up to three partial or complete terms. OMF (under its prior name, Orcas Island Medical Building Association) raised the funds to construct the medical center building, which was completed in 1992. There is no mortgage; OMF owns the building outright. From 1993 – 2003 (roughly) Island Hospital had a contract with OMF to operate the practice. During that time, the Hospital contracted with Dr. Shinstrom and a few other practitioners to provide medical services. The practice lost money and in 2003, the hospital ended its contract. There may also have been an issue with some doctors leaving for other pursuits, but I don’t know much about that aspect. The OMF board sought the help of a consulting firm for guidance. I don’t know the nature of the conversations that took place, only that OMF and Dr. Shinstrom did not renew their contract. Subsequently, Dr. Shinstrom established Orcas Family Health Center, a Rural Health Clinic and 501(c)3 non-profit. Around 2004(?), OMF contracted with Dr. Russell to establish a private practice at OMC. In 2005, Dr. Giefer was hired by OMF to be the second physician at OMC. At the end of 2005, Dr. Russell decided to leave and establish his own private practice. Then OMF asked Dr. Giefer to establish a private practice at OMC, which he did from Jan. 2006 to Aug. 2011. For a variety of very legitimate reasons, OMC still struggled to make ends meet and the OMF board sought a larger, outside partner. Peace Health was considered but – take note – they said the three island practices would have to be joined, and Orcas Island would need a hospital district before they would get involved. Then Island Hospital stepped in and negotiated with OMF to administer the practice at OMC. In Aug. 2011, OMC staff and practitioners became employees of Island Hospital. In 2012, OMC obtained RHC status. Around 2011 – I believe at Dr. Shinstrom’s request – the Dept. of Health sent a representative to determine the feasibility of setting up a Federally Qualified Health Center (FQHC) on Orcas. The conclusion was that an FQHC needs a minimum of 4,000 patients to operate successfully and only functions well when the whole community is behind it. With its disparate medical practices, Orcas did not qualify. Currently, the contract between OMF and Island Hospital ends on 6/30/2017.
Collaboration: it has been asked why OMF made no effort to collaborate with the other island practices. It did. In 2010-2011, extensive efforts were made by the OMF board to make it possible for Drs. Shinstrom and Russell to relocate to the OMC building and operate as separate practices under one roof while administrative, billing, and nursing services would be provided for a fee. Those efforts did not bear fruit. More recently, Dr. Fleming met with Drs. Shinstrom and Russell to explore ways the practices could work together. And I believe the most recent efforts by OMF board members, to collaborate on after-hours call, have also been rejected. It’s important to note: any practice’s rejections of offers to collaborate are not simply a blanket unwillingness to cooperate. It generally means that some of the conditions posed by one party are not tolerable to the other. So far, it seems no one has been able to get beyond this point, but it’s not for lack of trying!
The statement that OMC only cares for 25% of the island’s population is questionable. I ran those data for OMC back in 2011 and again in 2013, using a specific set of parameters. I would estimate that the percentage was closer to 40% of the island’s population, after correcting for visitors, etc. Those numbers fluctuate from year to year, and some patients tend to use more than one doctor depending on the type of visit. It can get complicated. Unless all practices use the same parameters and time period for their data queries, it’s really difficult to pin those numbers down with any accuracy.
Regarding Group Health – yes this is a problem if you want to go you the UW hospital. Generally, Group Health refers its members to Virginia Mason for tertiary care. However, the Group Health primary care network includes contracts with many primary care clinics and the UW representative, Ms. Gussin, was confident that a UWNC clinic on Orcas would also be able to contract with Group Health.
Ms. Shaw,
THANK YOU!!! Your letter clears up many misconceptions and I hope everyone reads it. Several times.
I, too, am hoping we can work with UW for many very obvious reasons. UW has been around long enough to know how to successfully run a medical business and in doing so, give us the best healthcare possible. And for that reason they should be allowed to hire the folks who will abide by their working parameters so all goes as smoothly as possible. We need to support them and then get out of their way and let them do what they do best to help ALL islanders!
Thanks again. You have helped this islander(and I am sure a multitude of others) to “get off the fence” and support this needed merger.
Maggie
WOW; having lived here for over 42 years, it is hard to remember these many changes that have occurred at “The Clinic”. Old timers remember when the Clinic was in the current Lower Tavern building, and the REALLY old timers remember when Dr. Barber was the only physician. My all-time favorite Doctor was Stan Williams. He administered to my many needs over the years and was a friend, as well.
My angst with this current situation is not the dedication of the medical professionals on the Island so much as it is the governance of the medical center facility. We are reminded that the community built the OMC, allowing its former location to become a roost for Seahawk fans on Sundays.
So, how do various individuals come to be on the OMC Board. There is ONE person listed as the nominating committee. I suspect that those folks who are convinced to participate simply take a seat at the table. I know, for certain, that I never voted for anyone to represent my concerns.
What then would happen if the OMC Board could not find any qualified physicians to staff the facility. Would the building remain empty? Could it be converted to a restaurant? Who would make such a decision? Does, in fact, the community own the land, the building and everything in it?
This arrangement is very strange from my perspective. Frankly, I don’t find it to be very comforting or reassuring with respect to my need for services. There are many, many questions that beg for answers and we all need to participate finding them. What is the next step??