‘It has been an honor to serve you’

Published 1:30 am Tuesday, June 30, 2026

When Dr. Jennifer Simpson-Manske stood before a packed Orcas Island Health Care District Board meeting at the Orcas Island Library to address her sudden termination from Island Primary Care, the room went silent.

What followed was raw, emotional testimony from Orcas Island residents and former patients who felt not just abandoned by their health care system, but betrayed by it. Her firing has drawn 466 petition signatures, 42 formal written statements and an outpouring of public grief that has rattled many on Orcas Island.

The words that came up again and again during public testimony at the meeting were simple: she listened and took the time needed.

Martha Kramer, present at the meeting, prepared a written statement that her husband addressed to the board: “Dr. Manske’s sudden departure has shaken this community. And that longer appointments with Dr. Manske resulted in significantly improved health care for Orcas residents of all ages. That certainly includes me. While we do not know the reason for Dr. Manske’s termination, the community is fairly united in the belief that it has to do with the length of her appointments versus Island Hospital’s profit-motivated directives. We, as the community, have demonstrated our very strong support, most recently in 2025, with the passage of a 10-year levy lift that promised, in your words, long-term stability in clinic operations and expanded primary care services. Terminating Dr. Manske’s overnight, without clear compatibility of care, does not provide us with either of those stated goals.”

Susan Mustard gave emotional testimony addressing the crowd from all directions as she described learning she had a brain tumor only after Simpson-Manske ordered a scan that other doctors had never considered.

“She saved my life,” Mustard exclaimed. “I was ambulanced to the UW surgical neurosurgical unit, where I had brain surgery to remove a tumor the size of a nectarine.”

Victoria Smith, who has lived across the United States and called Simpson-Manske the best doctor she has ever seen in this country, was furious. Discovering her yearly checkup had been canceled — and her doctor gone — without a word of warning, she invoked the Patient Bill of Rights and turned directly to the commissioners.

“I would argue that that is abuse. That is a violation of the social contract. You have violated our right not to be abused by a healthcare provider. They abused us by just single-handedly, arrogantly, unilaterally terminating my patient services. And you owe me that,” she said.

Rebecca Cohen called the termination “medically dangerous,” pointing out that many of Simpson-Manske’s patients were complex and fragile, now left without continuity of care and referred to physician assistants who, in some cases, lacked the authority to even prescribe their existing medications.

When Simpson-Manske herself rose to speak, the room was still. She began with gratitude.

“Thank you for sitting across from me in face-to-face visits. This is where I am most comfortable. It has been a true honor to be trusted with your health care,” she said.

Simpson-Manske described arriving on Orcas as a complete stranger who had never even known there were islands here.

“I came for the challenge — for what it would mean to practice in a place smaller and more remote than I had ever imagined. And you were overwhelmingly welcome. You let me slow down and listen and take the time in a real unhurried way.” She paused. “Time is the most valuable tool a doctor can offer a patient.”

Simpson-Manske continued with an apology: “I was working on the concerns that Island Hospital had identified one year ago, including patient wait times, timely results, length of visits and my relationships with the medical assistants. I took those challenges very seriously and improved. So if there were additional concerns, I would have worked on those as well. I feel a sense of failure in that I was not able to identify those concerns myself and prevent this outcome. I am so sorry for this.”

She did not close the door: “I would welcome the opportunity again to work for Island Health because what I care about the most is that patients here have equal access to care, regardless of whether they’re insured, uninsured, Medicare, or paying out of pocket. Time is how we get it right.”

Beneath the grief and anger ran a harder, structural question: Why did this happen?

Council member Justin Paulsen offered sobering testimony near the end of the meeting on Simpson-Manske’s termination.

“This is an acute issue. This is a very small issue in the overall discussion, which is healthcare priorities, and how insurance governs the care that we all receive,” he said. “There’s a whole group of people that can’t see Dr. Manske because they have no coverage. They have no access. They have zero ability to meet their needs. And those are the folks who are really suffering. All of us are suffering from Dr. Manske’s [dismissal], but there’s a whole group of the population that’s suffering even more. So I applaud your work in pushing that forward. I have all the expectation that you guys [commissioners] are going to take these voices and amplify them [to Island Health], as it has been said. But I hope this conversation is leading to a bigger discussion.”

Commissioner Diane Boteler, MD, a physician who moved to Orcas in 1997 and practiced medicine here before joining the board, urged the community not to lose sight of the larger picture. She knew firsthand what it meant to lose a doctor. “I was someone whose patients had to find another doctor when I chose to resign in a very tumultuous time in the clinic. I’ve also lost my doctor personally. I really appreciate the emotion, the fear of being abandoned in your health care.”

She defended the partnership with Island Health — the only institution that responded when the district issued its request for proposal — and warned of turbulence ahead. “Because of the so-called Big Beautiful Bill, we are all staring in the face of really dramatic potential losses in healthcare, particularly with Medicaid and Medicare.”

Board President Mark Salierno pledged to channel community feedback to Island Health, though he was candid that the district holds no authority over personnel decisions. For many in the room, that was not enough.

As Simpson-Manske finished her remarks, tears ran down the faces of many former patients.

“It has been an honor to serve you,” she said, “and I hope to continue.”