— from Tony Giefer, M.D. —
Much of what has been written or placed online recently about the medical issues facing Orcas Island has been misinformed or plainly false. As Senator Daniel Patrick Moynihan said “Everyone is entitled to his own opinion, but not to his own facts”.
Instead of attempting to correct or rebut, I wish to point out some important truths about our current choices.
University of Washington Neighborhood Clinics (UWNC) has offered to start a NEW clinic on Orcas Island. This is not a time limited management contract of Orcas Medical Center (OMC) like the arrangement with Island Hospital (IH). The new clinic would be located in the existing building that was built as a medical facility.
There has been much talk of “unifying the existing medical practices.” Right now, that is not possible even if everyone wants to do it. All of the OMC staff are employees of IH until June 30, 2017. There is no way IH would hire a physician – any physician—for OMC at this time. As of July 1, 2017, the hope is that there will be a new entity on the island – UWNC – and OMC will cease to exist. If that comes about, anyone UWNC hires will have to apply for employment. That goes for all the staff including me – the OMC physician. UWNC has said there is no reason, and it is not their policy, to exclude anyone from applying. It is their policy to thoroughly vet all applicants and make their own hiring decisions. Even I don’t know if I’ll have a job as of July 1, 2017. The Orcas Medical Foundation has recently restated their long-held position that they support integrating any and all Orcas practices.
UWNC certainly does not want to establish a new clinic in a place they are not wanted. Discussion of a tax district may be appropriate in the future, but right now it is premature. If UWNC does not establish a new clinic here, there is no sense discussing a tax district for the foreseeable future.
If we residents of Orcas Island want to have long term, sustainable, quality medical care, we should all come together and show UWNC that they are welcome here. MaryAnn and I have made a contribution to the fund and I encourage all islanders to support the effort as well.
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I find your unwillingness to rebut what you say are “misinformed or plainly false” statements frankly curious. It does nothing to move any conversation forward when one party makes accusations, yet presents no evidence to support such accusations. Makes me think of using rhetorical tricks when sound arguments fail; i.e. Argument By Dismissal: an idea is rejected without saying why.
or perhaps; Argument From Authority: the claim that the speaker is an expert, and so should be trusted.
I can’t make an informed decision if I don’t understand what was falsely put forth, and what the truth is.
I agree with Dr Feuer and wonder what your reasons could be? Both for not wishing to be clear and for wanting Islanders to want UWNC here….
Thank you Dr. Giefer for providing your voice of reason in this whole discussion. And thank you for clearing up some of the misinformation that’s been put forth on this topic. I, too, hope that the island can come together and show UWNC that they are welcome here. And I hope that the dissension surrounding this issue does not cause UWNC to back off from establishing a clinic here.
Here is a most welcome, clear description of this extremely fortunate offer of an opportunity for longterm, sustained, high quality, well managed, medical care for our Orcas community through the establishment of a NEW University of Washington Neighborhood Clinic as of July 1, 2017. It is my great hope that everyone who is able to envision this logical and viable solution to our current, unsustainable medical care crisis on Orcas, will join Steve and me in helping to make it a reality by donating a check in any amount to: “OMF/UW Medicine Fund”, Orcas Medical Foundation, P.O. Box 515, Eastsound WA 98245, or stop by Key Bank and deposit your donation into that account.
The community has been presented only fragmented information about the status quo from three or four different perspectives, but is expected to make decisions about (and substantial financial commitments to) the island’s long-term future plans that exclude two major physician practices. We’ve seen no true data about demand, supply, costs, or charges ACROSS the community. I’ve been in healthcare for 40 years and every time I read a piece here, I have more questions, not fewer. Committing $750,000 and $300,000 a year, even if that amount could be raised, guarantees nothing for the future. If a “hospital” district were established, its taxes would be applied by the elected district commissioners, and not necessarily to a closed medical staff at the OMC. This is a complicated subject and is about to get much more challenging. For example, the rural health clinic category created by Medicare could disappear if Medicare is eliminated, as discussed.
In my view, it makes more sense to have an independent third party come collect information from all the practices, look at demographic trends, analyze the benefits and limits of a taxing district, and propose recommendations.
As a new resident…i know almost nothing about this important issue But i am learning and i am somewhat alarmed. I arrived here in December 2014 and my aliment (TN) exploded in pain and i found my way to OMC and found a completely efficient and professional operation…I was very happy…Now…are we in REAL danger of medical care on Orcas…vanishing????
Or degraded….I plan to donate as much as I can….It seems to me that there is not sufficient information that reaches the Public;…Being a newbie…an outsider, if you will, but a full time resident, a senior to boot..,.about our medical situation..
SURELY there are 5 or 6 hundred families (that use the facilities) that could donate $1000.00 or more…and insure some a continued quality health care on Orcas
Thank You.
Carroll,
I think your comments are a great example of the confusion surrounding this issue.
If OMC shut its doors tomorrow, there would be no significant drop in the level or availability of health care on the island. Simply, the two remaining practices would serve larger populations. An argument could be made that that may actually improve the quality of care on the island because of the resulting consolidation of costs.
As Peg has very adeptly stated, no one has put out enough information for a realistic analysis of the complete health care picture on Orcas Island (Patient loads, staffing loads/patient, revenue, uncompensated care, supplemental income to support operations, community donation support…..).
Ultimately, under the current structure, the decision of OMF to proceed in whatever direction they choose is a decision that they can make based on whatever information they have and for whatever reason they believe justifies their action.
It may in fact be that bringing UW to the island is the best solution to our healthcare situation, but I for one would like to see that decision driven by real analysis, not buy a perceived need to fill a building.
yes confusion and much conflicting information…I just want to know the best solution…Our Medical system (in total in U>S) is very fragile…I would personally support a practice by paying for some services myself… A physician’s knowledge and care are generally worth more than they are allowed to charge thru Medicare/private insurance..And public funding for only OMC is not right….I see now.
As a new arrival…my only experience has been at OMC…I would hate to see that clinic turned to a corporate environment…As I read and learn…My thought about supporting the UW proposal are changing…I am a member of the “don’t leave the Island” club….I surely want medical services on THIS ISLAND…
Justin,
“Simply, the two remaining practices would serve larger populations.”
That is not true in the long term. Dr Shinstrom doesn’t receive an income, and he is close to retirement. No one will step into that situation. We will be having this conversation again and with less solutions when he retires, if we don’t support the UWNC.
Heidi,
I agree that no one will step into that situation, but the fact remains, that if OMF were to decide tomorrow to shutter the operation, medical services would not cease to exist on Orcas Island. (please note, that that was the question that was the comment I was answering). There are 2 facilities, fully capable, and fully willing to meet the needs of this community in the immediacy.
I also did not say that we should not be and will not be having a conversation about this in search of a better solution. But I believe that it is critical that it be a conversation driven by bringing all parties to the table and should include discussions with additional regional providers as well. Thus far, the discussion to expend $1 million of community money is not being driven from the standpoint of what is best for the community, but instead by what the OMF board THINKS is best for this community. It is a planning approach that, quite likely, results in the continuation of three independent practices operating in a manner similar to what we have now. So for a million dollars we get what exactly? The same failed system we have now.
It may well be that affiliation with UWMC is the absolute best thing to do and if that is what is produced from a comprehensive analysis based on facts and meetings with every provider on the island, I will get behind it 100%, but that has not happened yet.
Greetings, From my perspective as a former clinic manager for Orcas Medical Center/Island Hospital, the possibility that the OMC building would close its doors is frightening. It would have a devastating effect on a lot of folks in the community. There would be an immediate shortage of appointments available at the other two practices, and it takes months to hire new doctors plus even more months to get them contracted with health insurers so they can start seeing patients. Bringing in an entity like UWNC would be a very smart move. In addition to their ability to provide superior care, they could also provide stability in the long run. The UW has an excellent record as a good employer and that will attract our future physicians and staff. The long term stability of our health care will make it possible for many of us to stay on Orcas and will attract future residents, thus impacting our community in a positive way. While we are all considering our health care needs for the future, PLEASE let’s think beyond only tomorrow.
That said, I agree we need to have a conversation with all health care providers and give the community the opportunity to shape what their health care services will look like, including urgent care. It’s my profound hope that Orcasians will realize we need to subsidize our health care the way other communities do with a taxing district. San Juan does it, why not Orcas? The small amount it would cost per household could ensure that services are there when we need them. I feel that choosing for the UWNC is a choice for stability. But I also think it should be made with a commitment to have the community conversation about what we need from our health care system and how WE are going to support it in the future.