— from Coleen O’Brien —
I have been and remain a grateful supporter of forming a Hospital District for Orcas. However, I’ve had cause to be concerned that the policies of UW Medicine, as they stand, are not a good fit for rural health care. It’s bound to be a problem for the formation of a tax funded district, the district, the elected commissioners, and anyone who might be a patient.
I am an alum of the UW, and proud of it. However, the exclusive closed UW system of providing health care is troubling to me. Allow me to explain.
An Orcas friend had surgery in Seattle performed by a specialist she’d researched for her condition. For a month post-surgery, she needed her blood checked twice a week (pin pricks). When she asked to have it done at the UW Medicine Clinic, the same building she had gone to for the past 25 years, she was refused service with the statement that the clinic will not perform courtesy labs for doctors not affiliated with the UW. It was suggested she go to Peace Health Hospital in Friday Harbor or to Island Hospital in Anacortes or to a LabCorp location. That’s not right for a rural health clinic.
In a follow-up with the Clinic Director it was learned that the UW Medicine does lab work here on Orcas, but it operates as a closed system, and since my friend chose a surgeon not affiliated with the UW, the Orcas Clinic would not help her.
I hope UW Medicine announces a change to its policies before ballots are mailed out for the April election.
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1) It is crucial to distinguish between the hospital district and any specific provider on Orcas. We desperately need the hospital district. While I agree with you about UW’s closed system, its policies should have zero effect on the April election (for the hospital district).
2) “the same building she had gone to for the past 25 years”
Do you actually believe a building (physical structure) has anything to do with healthcare?
3) Orcas Family Health will take your (her) blood.
The UW policies–including declining to perform simple billable lab tests on orders by licensed WA physicians who happen not to be in UW’s panel–do indeed affect whether to vote in a hospital district at this time. UW has a contract that failed to address several service issues like these and the Hospital District is expected to assume the contract, paying UW large sums for unspecified services. And yes, Dr. Shinstrom’s office will do the lab tests and will serve the underserved, by why should his be the only practice to do so? Obviously, the writer didn’t think about the building as providing care but rather as representing the community’s investment in a facility that provided needed services.
Thank you for your letter. I also have this concern. I am also concerned that it is not financially viable to operate 2 separate clinics, especially if one is part of a large closed academic health center. Although “it is crucial to distinguish between the PHD and any specific provider on Orcas”, it is hard not to assume that going forward UW will continue to be supported no matter our concerns. That repeatedly has seemed to be the reason there is such urgency to pass this tax increase – to keep UW here. I agree that we need the PHD and the stable primary health care it will help support, but am skeptical about supporting 2 primary care clinics with our small population, especially when the one that we’ve already paid so much for is part of a large expensively run academic health system that is not small town friendly.
I am happy to finally hear that folks are looking hard at having UW run our health care here on the Island… I worked at UW,including the hospitals, and lived in Seattle for 20 years. Most folks I knew in Seattle went to UW for care as a last resort (or for very very specialized care unavailable elsewhere) so I wasn’t terribly excited about having them here! They are huge, they have their own ideas, and they do things the way they want… That’s why when you dial the clinic’s telephone number you get someone in Seattle. That isn’t what I want.
This is cuckoo — & why exactly wasn’t that patient directed to Dr. Shinstrom’s office for a blood draw? Such lack of cooperation & respect has been going on for years, I’d hoped that the PHD might blend & accommodate what’s best with both but no! It’s up to 6 individuals, & perhaps I missed what they said about: where are the guarantees that low income islanders, the uninsured and underinsured, will receive the health care they need? This is a dealbreaker, folks
None of the public hospital districts with which UW works has the authority to control UW’s policies. The PHDs do, however, have control over what services and the quality of services their Commissioners fund UW to provide.
Rather than policies, perhaps services are the real issue at hand. If the PHD contracts with UW as a vendor for primary care plus urgent/after-hours care, then the PHD can set the parameters for continuation of public funding. That is, the PHD would negotiate measures to evaluate the vendor’s performance regarding access, quality and cost. While not changing UW “policies,” the PHD could provide an incentive (i.e., continued funding or even performance bonuses) for service factors including: lab services / blood draws, new patient enrollment, length of time to schedule an appointment, same day appointments, clinic wait times, “thru put times”, % cancelled appointments, no-show rates, % referrals successfully completed, % billing errors, customer satisfaction, provider satisfaction, etc.
Additionally, the contracts for after-hours/urgent care could create a high advantage to sharing after-hours call between providers of the two existing practices. That could promote some sort of information (record) sharing and improved collaboration between two practices (e.g., X-rays, labs). In time, the two practices might co-operate or even grow together.
Some folks have debated that the island cannot afford two practices. Ironically, we actually may be at a moment when we cannot afford one practice. Consider this: with two practices on the island, the option exists to de-fund any practice that does not meet performance expectations and invest public resources in building capacity in the other one. If there were only one practice in the start-up phase of the PHD, that leverage would not exist.
Public hospital district candidates for commissioners……a point of clarification. The candidates now running for commissioner of the PHD were not “prepicked” by the Coalition for Orcas Healthcare, but have chosen to run because of their concerns about our rural health care dilemma here on Orcas and their desire to have a sustainable source of funding for our future healthcare needs. Anyone could apply to become a candidate provided that they were a registered voter in the precincts served by the proposed PHD. The Coalition for Orcas Healthcare has not endorsed any candidate, nor slate of candidates, preferring to introduce the candidates to the community by way of our Town Hall forums so that the voters can make informed decisions about who they would like to have serve as Commissioner. Dale Heisinger, COHC
Commissioners of the proposed Public Hospital District (PHD) would not be in a position to assume the contract between the Orcas Medical Foundation and UW Medical Center. Additionally, it is doubtful that a new but identical contract would be acceptable to County legal counsel.
PHD Commissioners must establish new contracts for specific services with every medical practice they fund. Public statements made by most candidates thus far reflect that understanding. The five Commissioners’ work is to be done in public sessions following the election and before November 2018. The contracts are public documents.
It is critical that levy funds are used in a prudent and reasonable manner. The Coalition (COHC) is advocating for public funds to support ALL currently practicing primary care and urgent care providers on Orcas. That funding must be accountable. Ongoing support of any medical practice should be contingent upon satisfactory delivery of services outlined in its contracts with the PHD.
The medical services purchased (“deliverables”) through new contracts with providers should support improved access, quality and cost of medical care. Such improvements (especially after hours/urgent care) could be achieved through collaboration outlined in the contracts and possible unification of services over time.
If the UW clinic or any other funded clinic fails to perform, then public funds should be redirected to medical practices that do perform well. Voters need to ask and learn the position of each Commissioner candidate on this important matter. Commissioner candidate e-mail addresses are posted online at: https://weiapplets.sos.wa.gov/elections/Candidates/WhoFiled?countyCode=sj
The PHD Commissioners you elect will have both the authority and responsibility to assure access to high quality, affordable medical care. As public officials, they will be publicly accountable for their actions.
Far more well-funded and sophisticated entities have tried to measure quality and failed.
“Assuring access” to high-quality, affordable health care is another goal that far more well-funded and sophisticated entities have sought for decades without success.
“Assuring access” for all residents and tourists is quite an expensive undertaking.
The notion that the Coalition has not selected or “endorsed” candidates is beyond disingenuous.