PeaceHealth Ketchikan Reps Present to AARP

2/1/2012

​Reprinted from Ketchikan Daily News,
By TOM MILLER Staff Writer

 
Ketchikan Medical Center representatives answered questions and talked about construction plans for the hospital at Friday’s AARP monthly meeting.
 
Pat Branco, chief executive officer, along with Penny Pedersen, executive director of the Ketchikan Medical Center Foundation, Dr. Peter Rice, medical director of the PeaceHealth Medical Group, representing the Southeast Alaska region, and Dan Jardine, an architect working on the hospital’s $75 million expansion plan, spoke to about 20 AARP members at The Plaza mall.
 
The AARP group had a list of questions and concerns. Its top issues were the ability to obtain a primary care doctor, obtaining a doctor’s appointment in a reasonable time, and how to avoid being referred to the emergency room for minor problems.
 
The group also asked for suggestions for how to keep costs down, whether the hospital plans to establish a nurse-practitioner clinic, and about the hospital’s proposed construction project.
 
Rice tackled the question about primary-care doctors and efforts to recruit more doctors. He said the hospital has been working to recruit one internal medicine doctor and is talking with two family doctors.
 
Regarding the question of timely access to care, Rice said: “We monitor days to the next appointment available for new and established patients. We monitor the number of referrals to the emergency room, because I know that’s rough thing for the community, to be told, ‘We have no space to see you today or tomorrow. You have to go to the ER.’”
 
The medical center has an average of about 700 primary care visits a month, Rice said.
 
“In September, we had five referrals to the ER,” Rice said. “October, we really scored, and had two. We had five in November, and we jumped up to 11 in December, I think because of vacations.
 
“We want it to be zero, but for 700 visits, if we can keep it to five referrals to the ER a month, that’s better than it (might) be.” Rice said the nature of primary care is changing.
“There is a nationwide dearth of primary care doctors,” he said. “No one wants to do what I do anymore, frankly.”
 
Young doctors are not interested in a career of seeing patients who come to hospitals for care, and are not interested in being on call nights and weekends, Rice said. “Interestingly, they want to have a 40-hour week and have a balance in their life.
 
“The future model for primary care is going to, by necessity, evolve to be more of a team approach,” Rice said, “including nurse-practitioners and other people who are not doctors, (who) sort of help with the care, and the doctor being a little bit more of a quarterback, so you might not see the doctor every time.”
 
The hospital has hired a nurse-practitioner who will work as a “chronic disease coordinator,” Rice said. She will help patients handle the myriad of necessary details when caring for complex diseases, such as diabetes or congestive heart failure, Rice said.
 
The hospital’s plans to enlarge and enhance the center, if and when fulfilled, very likely will help when it seeks to recruit talented doctors, Rice said. Recently, he said, a doctor who was considering a move to Ketchikan, who liked everything about Ketchikan, the hospital and the PeaceHealth system, balked after looking at the clinic spaces. She remarked that she would be surprised if the center could recruit anyone to work there, Rice said.
 
“It’s not easy to bring somebody to Ketchikan,” Rice said. “With the weather, you know — we like it here, but not everybody does. So you really have to have the other elements of the package be pretty competitive, and the work environment is one of them.”
 
Pedersen continued that argument: “What we’re limited by is infrastructure,” she said. The hospital’s situation is similar to that of a homeowner who had put off remodeling the kitchen and bathroom because they are the most expensive rooms to work on, Pedersen said.
 
“We’ve gotten to the point where we have band-aided and band-aided, and shoehorned here, and shoehorned there, to get space for our primary care physicians, and still be able to perform the surgeries that we need to have here,” she said. “We cannot recruit our surgeons anymore with the facilities that we have. They’re 50 years old. Think of what your kitchen would look like without a remodel after 50 years.”
 
Jardine handed out a six-page graphic description of the medical center’s remodel plans. It included layout diagrams and artistic renderings of new construction and remodeled spaces at the site. Two new floors would be added above the current main parking area, according to the drawings. Also shown are relocated main entry and ambulance areas, an enlarged emergency area, new surgery preparation and clinic spaces, new operating rooms and new clinic spaces.
Although the hospital as a business is owned by PeaceHealth, the nonprofit corporation originally founded by the Sisters of St. Joseph of Peace, its buildings are owned by the City of Ketchikan.
 
While $75 million is a lot of money, Pedersen said, the completed project would be an important benefit to Ketchikan residents and patients, who would be able to get good care here, without having to travel.
 
“It is going to be the city’s responsibility to help us figure out how we’re going to do that,” Pedersen said. “(City Mayor) Lew Williams has come out strong on that, and we are working diligently with the city and with the state to try and see what we can do to come up with the funding that’s needed.”
 
Federal money would help, but likely will not be available unless state and local governments contribute, Pedersen said. Pedersen added that the hospital is an important part of the local economy with an annual payroll of $28 million. The hospital spends $65 million a year for operating expenses, she said.
 
At the end of the meeting, AARP member Rebecca Valentine expressed her support for the entire hospital staff and for the proposed construction project. “I think all of us should try to give them a decent place to work in,” Valentine said.