Hospital District Superintendent revisits the past to reinforce how we create a sustainable future

||| FROM ANNE PRESSON, HOSPITAL DISTRICT SUPERINTENDENT |||

Early last month the District Office moved to a new location. While packing up my files I came across an article from the August 13, 2003 issue of The Islands’ Sounder, which was a Q&A with Dr. Roger Rosenblatt, Associate Professor at the University of WA,
Department of Family Medicine. Dr. Rosenblatt had a lifelong commitment to providing care to rural areas, and he helped form the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Rural Health Research Center. The WWAMI program remains today as the ultimate training ground for rural medicine.

It is sad for many reasons that Dr. Rosenblatt passed away in 2015. I would have loved to bring him back, almost 20 years later, to revisit that interview. As I read what he observed so many years ago, I was not surprised that those same principles hold true
today.

As health care on Orcas has undergone a significant change, it feels timely to revisit Dr. Rosenblatt’s insights. Specifically, what he describes as the way to bring stability to delivery of health care on Orcas.

1. You can always attract physicians, but you need to attract the right ones. Compensation must include incentives on productivity.”
2. “You need one organization providing the services, and everybody working together. You can’t split it up among competing organization or doctors.”
3. “Orcas cannot devise a system that won’t have to be subsidized. It just can’t be done. It’s not even remotely possible in terms of what the people of Orcas expect.”
4. “The model that will work has all providers working well with each other, as a team. This is about building a stable system that works long-term, not about one doctor.”

The insights from this interview are consistent with what we heard through our years of research and reinforce that defining the problem to be solved wasn’t the issue. Until now, finding a way to actually solve for the complexity of care delivery, adequate
staffing, and financial challenges has been the problem. For almost 20 years, we have known that the way forward is through a single clinic that provides the infrastructure to address all of our unique needs. This includes accommodating urgent care visits during clinic hours, a workable system to support after-hours care that doesn’t burn out the providers, an adequate staffing model that allows everyone to have a reasonable workload, and a close collaboration with community partners. We now have the ability to
solve these challenges in establishing the new Island Primary Care – Orcas Clinic in partnership with Island Hospital.

Health care is essential – it is emotional – it is complex. Establishing the right balance between care delivery and the business side of health care within which we must operate is necessary to create a sustainable model. Leaning too far to one side or the other will cause the model to fail. The Island Primary Care – Orcas Clinic has been constructed to strike the right balance by delivering care in the most efficient and effective way while maintaining an equal focus on the patient and care team experience.

Island Hospital’s culture and One Team Model is committed to delivering quality care and creating a positive work environment to support and value the providers and staff. While we are experiencing another period of disruption, I suggest that this time we have
the tools and partnership in place to ensure all members of our community have access to a stable health care system that provides quality, island-appropriate health care now and into the future. We take our responsibility to care for all members of our community
very seriously, and there is still more work to do to prepare for the future needs of our community. We remain committed to continue working on your behalf to create a strong and stable health care system.