— by Lin McNulty —
The curious and concerned gathered in the Madrona Room at Orcas Center Wednesday afternoon to hear Catherine Henderson, Orcas Medical Foundation (OMF) president, and Debra Gussin, Executive Director of University of Washington Neighborhood Clinics, outline a proposed plan to continue medical services at Orcas Medical Center in 2017 and beyond. Island Hospital’s contract with OMF is set to expire on December 31, 2016, although Island Hospital has since agreed to continue the contract through June 30, 2017 [See Orcas Issues story].
OMF began talks with UW in August following the Island Hospital announcement that providing services to Orcas Island was no longer financially viable.
Technology would be an enormous part of the new relationship with University of Washington Neighborhood Clinics, beginning with digitized medical records that would be available not only system-wide to providers, but also to patients. Technology would also facilitate virtual tele-medicine, eliminating an often-inconvenient trip to the mainland for a 10-minute follow-up with a medical provider.
The UW/OMC partnership is predicated on an initial sum of $700,000 to 750,000, which includes $300,00 – $350,000 for translating medical records to the UW system. The partnership would also require an annual outlay of $250,00 to $300,000 a year. OMC is “ten times smaller” than a normal UW Clinic.
There is a lot of behind-the-scenes work to be done to ensure this partnership goes forward. Solutions under current consideration include a tax levy for a local Hospital District. The earliest that could be on the ballot is November 2017. OMF is also setting up a fund at Key Bank to raise $750,000 by January 1 so that the partnership can go forward. The account current contains $200,000.
I have been curious for many years as to the lack of cooperation of the medical professionals on Orcas to work together for the benefit of the community.
Would it not seem logical that everyone involved in providing medical services to us all to coordinate efforts collectively? Apparently the Orcas Medical Center, during this time of transition, reached out to Doctors Russell and Shinstrom and were rebuffed. I don’t understand !! It would surely seem that three Doctors (or more) working in concert with OIFR could provide great 24/7 coverage of those vital services that are so important to those of us who are getting older and more vulnerable every year.
I encourage and support everyone who is working on the UW transition to continue a dialog with ALL medical professionals on the island to craft a comprehensive program that will be beneficial to everyone. The community needs to get behind this effort including consideration of a hospital district.
Dear Mr. Sutton,
Several years ago prior to Island Hospital resuming management of the Orcas Medical Center, Peace Health was somehow in the mix for this task as well. PH took it upon themselves to speak with the other physicians on-island to determine their receptivity to a PH presence on-island, as well as to ensure viability of their proposed endeavor. For whatever reasons, it was not to be, however by their pre-emptive communication they demonstrated a desire to work with all involved. Island Hospital undertook no such effort, and I must presume UW similarly has not spoken with the other physician offices, since Dr. Russell has not heard from them. Peace Health showed a level of respect for the other offices by involving them in their pre-negotiation discovery. Their example has been what we have looked to since then.
Similarly, your claim that the OMC reached out to Dr. Russell and was rebuffed met Dr. Russell with surprise. He was not contacted by anyone, so was therefore unable to rebuff them! He might certainly have said, “No, thank you,” but I believe that the vast majority of people who have the acquaintance of Dr. Russell would agree that he would be unlikely to “rebuff” anyone (rebuff, df as to “reject in an abrupt or ungracious manner”).
To even begin to solve the problem (which problem may or may not exist) of collectively coordinating efforts, it seems that first the rhetoric and charged-language must be dialed down. Then in an atmosphere of mutual respect, the right questions must be asked and the answers should be listened to – whether the answers are what one wants to hear or not. This is incredibly challenging in itself, but certainly cannot be done within the current conditions which have only fostered disrespect and distrust among many of the key players, as well as those whom they serve.
Thank you.
Ed,
Dr. Shinstrom has verified that he did in fact reach out to Orcas medical and received a negative reply (just the opposite of your assumption). That was shortly after Orcas Medical was notified that the contract with Island Hospital would not be renewed. Michelle Russell has verified above that Dr. Russell has not been contacted by Orcas Medical. Better to not suggest that “apparently” something as important as this has happened without being sure of the facts.
Mrs. Russell has very nicely summarized our historical experience with Peace Health at Orcas Family Health Center as well. Dr. Russell and Dr. Shinstrom, along with our local female Physician Assistant providers, Karen Orr and Jennifer Utter, have enjoyed a very supportive relationship working together to do what is best for the patients and visitors in this community by putting aside any competitive obstacles, sharing call, and providing support services to each other (i.e. we perform x rays and lab draws as needed and Dr. Russell has been a tremendous help to us when we have needed it).
Past efforts to do the same with OMC have always been met with push back– with the exception of the nursing staff who has come to our rescue when we have needed an odd supply. Several years ago, OMF board members (no longer currently on the board) met with me and Dr. Shinstrom to see if the providers could somehow work in the same building to share administrative costs. Among a few others, there were two major issues that couldn’t be resolved: 1. All of the support staff, clinical and clerical, would be let go and then would have to apply for new positions—we have spent a lot of time cultivating and training a staff that works together symbiotically with the same goal in mind “it is all about providing the best experience for the patient” therefore this wasn’t something we could do; 2. We are a Rural Health Clinic which entitles the clinic to enhanced reimbursement rates (at the time OMC was not a RHC and only is now because of Island Hospital) changing the address dictates the clinic loses the designation and then requires re-applying, which wasn’t feasible at that time due to Health Professional Shortage Designations. In the end, the group ran out of possible solutions.
Within the past several weeks, Dr. Shinstrom contacted the OMF board directly to at least have a conversation about the current events. He was declined. I can’t imagine that Dr. Russell would ever be ungracious to anyone; throughout the past 12 years he has been very kind and caring to our patients and to our staff, which trickles down to how his staff treats us and our patients.
Sadly, I agree with Mrs. Russell that there is a climate of disrespect and distrust that has been exacerbated over the past 13 years. I appreciated Art Lange’s comment at the UW/OMF meeting that healing needs to happen. I had a few questions and comments that I wanted to ask and share, however due to the energy in the room, it didn’t feel safe to do so.
In short, there is very positive collaboration going on between at least two of the medical practices on Orcas.
One thing I wanted to bring up is that at this time, Virtual Tele Medicine will be an out of pocket cost for Medicare patients or a write off for UW, depending on how they handle patient accounts. It was asked at the UW/OMF meeting if OMC would be able to keep the Rural Health Clinic designation under UW management, Debra Gussin said she thought so; however, it is important to be aware that under current Rural Health billing rules, telemedicine is not a reimbursable service—Medicare requires an in person face-to-face encounter between the provider (MD, PA, NP) and the patient. This may change if RHC advocates can convince congress and Medicare.
Dear Mr. Sutton.
I will refer you to a letter posted today in Orcas Issues by Dr. David Shinstrom. You will note that he suggests the merging of practices.
It is interesting that you say the Orcas Medical Foundation has contacted both Drs. Russell and Shinstrom about joining together. I see by Shelly Russell’s response that this is not the case for Dr. Russell – he was not contacted and this is also the case for Dr. Shinstrom, in fact, it is the total opposite. Dr. Shinstrom contacted Catherine Henderson, the president of the Orcas Medical Foundation, a few months ago, to suggest that the practices merge. Within the hour he received a response refusing his offer. The OMC was built to sustain medical care for ALL Orcas residents not just a minority. The OMC under its current situation, and the proposed situation with UW, is not able to, and will not be able to, provide care for any more patients than it already has. The OMF and UW proposal is to not provide after hour care. This leaves a majority of patients having to seek care elsewhere and yet OMF want to propose a hospital taxing district that would only benefit the OMC. If the practices combined, as Dr. Shinstrom has offered, the community built building and a hospital taxing district could benefit the majority of Orcas residents and not just a minority. The OMF’s self serving pursuit of outside support, including UW, instead of working together and openly communicating with all of the other medical facilities on the island is difficult to comprehend.
For your information, some Orcas residents have approached Dr. Shinstrom asking him if he would merge and he has said yes, but qualified it with him having already being rejected by the Board president. However, despite the rejection, he is still pursuing this goal, but he needs the residents of Orcas to come together and then maybe the Orcas Medical Foundation will listen.
Also of note, at the recent meeting hosted by the Orcas Medical Foundation with UW as the guest, an Orcas resident suggested that the practices on the island merge. This was met with some applause. However, with many of the OMF board members present the issue was ignored. Dr. Shinstrom was more than ready to discuss that possibility but the undercurrent of hostility lurked. The biased behavior that has somehow perpetuated as the OMF board members change, is, without a doubt, damming what could be a free flowing river to a wonderful resolution.
Jill Bates DVM
My apologies. Michelle Russell not Shelly.
What more can be said. Politics is interfering with the Medical practices on our Island. It is sad that an agreement cannot be reached. I know that both Dr. Shinstrom and Dr.
Russell would be receptive to merging with the Medical Clinic but this can never happen until people realize that the health of our islanders is more important than their little
kingdom
I request that all those concerned, doctors, staff, and patients alike, read the comment I’ve attached to “Guest Opinion: OMF Not Serving All Orcas Residents.”
It contains a suggestion which may present a solution to the problem.