I deeply appreciate the conversation about health care on Orcas! Some folks seem to believe it’s possible to operate a fiscally solvent medical practice for all islanders on Orcas. Dr. Shinstrom himself has acknowledged it’s not possible in a recent comment in Orcas Issues. He generously takes no salary to make his practice solvent, but if he (or any doctor) attempted to set up a practice for all Orcas, he’d have to hire more physicians and they would not work for free.

The expenses of a medical practice are very high. Supplies are costly. For example, to operate legally, you must discard any medical and pharmaceutical supplies that are outdated and purchase fresh ones. To be legal, a practice can’t use pharmaceuticals ordered from Canada. But by far the largest expense is personnel. If we really want good doctors and staff to stay, we must recognize the challenges of working here and ensure that salaries plus health and retirement benefits are sufficient to retain them over the long term. Please remember the shortage of primary care physicians. Doctors will not be tempted to work here for a skimpy compensation package. Doctors work hard and long hours. They sacrifice a great deal in their personal lives to make our lives better. They deserve to work in conditions that compensate them appropriately and protect their personal time.

I’m confident the folks from the UW know quite well the fiscal requirements of running a clinic here. Their policy is to ensure stability by ensuring physicians don’t get burned out. The up-front cost is indeed high, but remember that the cost includes transferring patient records to a world-class, fully integrated medical record system, EPIC, AND covers operating costs for the first several months while waiting for insurance revenues to start coming in.

I strongly support the UWNC because of its long-term sustainability and superior reputation. AND I strongly support the idea of a future taxing district to close the gap between clinical revenues and expenses. Remember, our taxes are a form of INSURANCE that services will be there when we need them.

Alison Shaw

Orcas Island