Orcas medical care, lessons learned

For the last 30 years Orcas residents have received their primary medical care from multiple small local MD practices. What lessons has the Orcas community learned?

We have learned that public and private medical revenues available to this community are limited. Orcas MD practices compete for the same patients and revenues. Multiple practices bring redundant overhead costs, especially for facilities and insurance processing.

While small MD practices can handle most daytime urgent care needs, they have proven deficient at delivering after-hours care on Orcas, resulting in misuse of our EMS and over-reliance on expensive airlifts. We have come to understand that community urgent care really requires a team of participating doctors, mid-level staff, calendar integration, EMS coordination, and medical records management. Every year contains 365 nights and 104 days which lie outside of weekday office hours. Orcas urgent care is just too heavy a lift for our disjointed small MD weekday practices.

Accommodating to these lessons may well be hard for us and our doctors. There may still be a niche for small weekday MD practices in places near Emergency Rooms, but that isn’t Orcas. Our Commissioners know that those weekday practices don’t meet this community’s needs, and we didn’t pass a tax levy just to support such practices. Orcas health care today isn’t just a popularity contest for doctors and hospitals. It entails affiliating with the only hospital which maximizes our Medicare revenue, and supporting those doctors who will pull their weight in the team effort required for urgent care, including after-hours care.

The OIHCD Commissioners have studied these lessons and charted a new course to sustainable primary and urgent care in this community. The tax levy resources which they manage will no longer be dispersed across multiple small practices, but concentrated in a single practice at OMC. To maximize Medicare revenue they have contracted with Island Hospital, which has offered OMC positions to all Orcas MDs who choose to participate.

The Commissioners have charted exactly the right course for this community’s future health care and they should invest every single OIHCD tax dollar accordingly. It’s time for us all to embark on this new course, leaving the old dock behind — and probably also the old weekday-doc practice model. This isn’t just a choice for the doctors; it is ours as well.

Norm Zimlich

Deer Harbor