— from David Shinstrom, M.D. —
I presume many of you have been following the numerous letters regarding the medical situation here on Orcas. To Paul Kamin, I really appreciate some of the points you have brought up. At the request of several community posts, I explained on 12/08/16 (Examining the Background to the Current Medical Quandary) how in 2003, the medical center board made it impossible for me to work in the community medical building even though I wanted to. I chose to stay on Orcas and continue to provide care to patients and visitors of Orcas.
Alison Shaw recently posted that I claimed I would be able to operate a fiscally sound practice for all islanders. I never made that statement. On reflection, I believe Ms. Shaw may have an excellent idea. Along with the feeling of many people who have commented to several posts, the sentiment seems to be the current medical practices should unify as one of the first steps moving forward to solve our medical dilemma. So, why not move Orcas Family Health Center to the Orcas Medical Center?
Orcas Family Health Center is a fully functional family medicine practice with all the necessary components, electronic medical records, billing and an excellent staff. Those of you that know us realize we are welcoming and efficient. We could move OFHC to the medical center, joining forces with current medical providers, and provide a sound practice for all islanders but there would need to be a subsidy. The deficit will be present regardless of whether we keep our management local or not. A taxing district would be a good future solution as long as it is to the benefit of every individual patient, not a select population. The cost of the transition would be minor, much less than the $750,000 proposed by UW Neighborhood Clinics. Our electronic medical record system and practice management system we use are transportable.
Those of you who have followed the proposal by Orcas Medical Foundation that an agreement be made with UW Neighborhood clinics to establish a practice at the medical center realize there have been countless questions raised, most recently in the excellent analysis by Paul Kamin. The deadline for affiliation with UWNC is only 4 weeks away. $750,000 must be raised by that date to proceed. Unifying the current practices and having Orcas Family Health Center practice at the medical center would slow the juggernaut and allow time to answer some of these questions.
The most serious question I have is what does the Orcas Medical Foundation have in mind should the $750,000 not be raised and there is no agreement with UWNC? Island Hospital has extended their management of the Orcas Medical Center practice through the end of June but it is my understanding that is contingent on an agreement with UWNC. So no agreement by January 15, 2017 would mean no medical practice at the medical center after January 15, 2017.
Let me summarize the advantages of moving the Orcas Family Health Center practice to Orcas Medical Center. Very importantly, there would be no $750,000 up front expense. The practice would require subsidization but likely that would be less than the $300,000 that would be required by UWNC but likely more for the first few months due to the complexity of transferring our rural health clinic status, re-credentialing and the annual decrease of insurance payments at the beginning of the year as patients need to make their deductible. The best estimate we can make is $40,000 for the first month and less over the next several months. The practice would be locally operated utilizing current local providers and staff potentially drawn from all practices. And, a huge benefit, we would provide 24/7 after hours coverage, something not part of the current UWNC proposal.
Such an arrangement would not preclude an agreement with UWNC in the future but that process could be undertaken with thoughtful analysis answering some of the questions that have been raised. I do not want to imply Orcas Family Health Center can be compared to UWNC, just that we will have a solution while evaluating options. I encourage the Orcas Medical Foundation to give serious consideration to this proposal.
Seems like an idea that provides stability at lower risk and lower cost.
From my perspective, the critical element would be the cooperation and coordination of ALL of the medical professionals on Orcas for the benefit of ALL of our neighbors. The physical location of any Doctor’s practice would not seem to be relevant to the importance of everyone working together.
In that context, what is it that UW Medicine, Island Hospital or St. Joe’s brings to the table. Other than providing the next level of care, the involvement of the regional hospitals would not seem to be important to the daily medical needs of our community.
If Dr. Shinstrom is willing to participate, what does Dr. Russell have to say?
finally – at last – some intelligent proposals for the return of the medical clinic to thoughtful management by those who live and work on Orcas. The intrusion of Anacortes Medical pros have been a local disaster.
Seems like we should use the money raised to combine the other fine practices and combine them in the existing OMC location…Seems unfair for residents to support UW with a Million dollar” present” to do what has already been done at the other clinics….they want us to pay upfront to have the privilege to operate a clinic on Orcas.
the fine folks at OMC could go about their business without worrying about the future employment….
Seems like the ideal situation…LET’S RAISE MONEY TO GET THIS DONE…KEEP OUR HEALTH CARE LOCAL. Just my uniformed opinion….