— by Susan McBain, Orcas Issues reporter —
Few issues seem to work out simply for the Orcas Island Health Care District commissioners.
At their July 2 meeting they were faced with new wrinkles in several ongoing issues:
- Building maintenance. The District’s consultant on new roofing and HVAC systems, Hargis Engineers, recommended a thorough but expensive approach to upgrades for the clinic building, where the UW Neighborhood Clinic (UWNC) currently operates. The approach would include multiple steps, multiple reviews, and possibly additional engineering. As proposed, the upgrades would be done in four phases to minimize interruptions in clinic services. The commissioners will need to decide whether a simpler approach to construction and scheduling would be adequate, given their budget constraints.
- Budget revision for Orcas Family Health Center. OFHC has asked for an increase for its fourth fiscal quarter (July–September) from about $82,500 to $133,000 in order to bring staff compensation in line with industry standards and UWNC compensation. The commissioners felt that the proposed increases were a good basis for negotiations for the next fiscal year, but they were uncomfortable with the precedent of making changes during the current year. However, they recognize that OFHC does not have the base of resources available to the UW clinic, and they plan to continue talking with OFHC about how that practice’s need to recruit and retain staff could be met.
- Insurance changes. District Superintendent Anne Presson talked about the pending replacement of Kaiser insurance with LifeWise Health Plan of Washington. The plan proposed by LifeWise is affiliated with Providence Health & Services, which would mean the two Orcas clinics would be considered out-of-network providers. Presson has brought this to the attention of the Office of the Insurance Commissioner and has also asked San Juan County councilmembers Rick Hughes and Jamie Stephens to voice their concerns. She will work with the Lopez and San Juan public hospital districts to draft a letter from the three district presidents explaining the issue. She also wants to be sure that LifeWise’s plan does not include the same restrictions on emergency air transport that have caused problems for Kaiser patients.
Finally, the commissioners discussed the agenda for their special meeting on July 9, a longer meeting more like a retreat than their regular meetings. They will focus on what they want the District to accomplish over the long term; the options that need to be explored for sustainable medical services, and who will be responsible for each one; the information and contacts each commissioner already has; what the District’s prospectus document (a description of its services and needs) should contain; how to involve the community in considering options; and how to chart a clear path to reach decisions on the options.
The special meeting will take place Tuesday, July 9, from 9 a.m. to 3 p.m. at the West Sound Café. The next regular meeting is Tuesday, July 16, at 5 p.m. at the Eastsound Fire Hall.
There was is interesting new research [programinplacebostudies.org/] into the use of placebos at Harvard Medical School. One initial conclusion is that it is unnecessary for practitioners to behave unethically towards patients – mislead them – for them to experience significant treatment effects. The only requirement is that the recipient have a trusting relationship with the provider. So we’re talking sugar pills, not Primary Care, even.
We on Orcas, including especially those that lead our many public non-profit corporations need to seriously consider if our public discourse harms the health of our neighbors by inciting distrust. As we look to the future strategy of providing for community health, we are going to have to radically alter the tone from conflict to collaboration, putting the health of those we claim to serve above our own financial/ political health.
As I read it, having participated in the debates over what a PHD’s priorities should be, the initial commitment is to provide financial stability and administrative clarity to the existing provision of primary care on Orcas.
Full stop.
There was no promise of righting the wrongs of decades of conflict and uncertainty. IMHO every board member and officer of every clinic on Orcas should have road rash of the upper extremities from prostrating themselves at the threshold of the competing clinic on behalf of their patients whose health has been compromised by the long-running spat over control. Seriously.
Should we name names?
No. we should put this behind us with some Truth, Reconciliation and Humility. And start behaving like adults .. professionals, who have the honor of serving our neighbors as best we can without fear or favor.