Wednesday, September 23, 2009

Carey, St. Lukeís face off over clinic

Discussions about opening satellite office donít get far

Express Staff Writer

St. Lukeís is building an $11.4 million clinic in Hailey. The two-level, 30,000-square-foot building is scheduled to open in November. Photo by Willy Cook

Representatives from St. Luke's Wood River Medical Center drove into Carey Thursday night to discuss opening a clinic there, but the townspeople didn't want to hear one word of it—not until the bitter taste of past experiences with St. Luke's was washed from their mouths.

"A lot of people in Carey feel betrayed by St. Luke's," said City Councilman Craig Adamson.

The meeting between the City Council, residents and all three Blaine County commissioners was organized to begin talks of opening a clinic in the rural town. The closest health service is St. Luke's Wood River Medical Center, about an hour's drive north near Ketchum.

Many Carey residents at the meeting talked of feeling "abandoned" by St. Luke's and said they didn't want to partner with a company they couldn't trust to keep its word. The townspeople still are unhappy that St. Luke's closed its Carey clinic in fall 2007, and that the town never received the urgent care clinic that they said St. Luke's promised years ago.

Referring to the location of the hospital, Mayor Rick Baird said St. Luke's "left Carey behind."

"The hospital is far north of the population center in Hailey," he said. "The only thing it isn't north of is the money center."

Bruce Jensen, CEO of St. Luke's Wood River Medical Center, said no promise to build an urgent care clinic was ever made.

"We all have memories," he said. "Yours is over here. Mine is over there, and somewhere in between is the truth. What has happened, happened. Right or wrong. Decisions were made in the past, but right now we're making a great investment."

Devan Johnson, rural clinic planner for St. Luke's, agreed.

"Here we are today," he said. "Where does Carey want to go from here? Is there interest, and if there is, how do we move forward?

"I'm not going to argue about the past," Baird responded. "But to go into the future, you have to look into the past."

And the townspeople at the meeting wanted answers before even thinking of partnering with St. Luke's again. Jensen gave them some answers, but apparently not the ones they were looking for, especially those having to do with Carey's clinic that St. Luke's took over in fall 2006 and closed a year later.

Jensen said the clinic was opened half a day a week during that last year with only three patients visiting per week, on average. He said the clinic was operating at a loss, but St. Luke's was putting money away for an expansion, seeing that Carey's population was expected to double in the next few years.

"Then, two things happened," he said. "Carey lost its provider, and the economy went south."

He said St. Luke's placed ads in newspapers and tried to lure another provider to take over the Carey clinic, but no one came.

Johnson said Idaho ranks 48th in the number of primary-care physicians per capita. He said the situation is worst in rural communities such as Carey, where doctors often don't want to work. He said providers want to be busy and have amenities—such as in cities.

Baird said Carey needs some sort of health service and would like to work with St. Luke's if its past practices aren't repeated.

"That's the spilt milk," he said. "Now, as you say, where do we go from here?"

Johnson explained the process, using clinics he'd established in Stanley and Challis as examples. He emphasized that "every community pays for their health care."

He said St. Luke's helps with the planning, but after the doors open, the town is on its own to keep it going.

"And St. Luke's doesn't skim off the top," he said. "All the money stays in the community. The clinic is wholly owned by the community."

That scenario doesn't apply to Hailey's $11.4 million clinic set to open in November. The two-level, 30,000-square-foot building is being paid for by St. Luke's and will be owned and operated by St. Luke's.

However, rural clinics like that in Stanley are independent. Johnson said he opened that clinic three years ago and the town had to charge taxes just to keep it going. Stanley wanted a clinic open six days a week in the summer and three in the winter. But not enough people visited to pay the bills.

For that reason, patients paid $50 per visit with the town shelling out $400 per visit through taxes when the clinic first opened. Three years later, that's leveled off to patients' paying $100 per visit and the town putting out $150.

"This city is OK with that," Johnson said, adding that Carey needs to decide what's suitable for itself.

Townspeople seem not to know what kind of service they want. At the meeting, Baird acknowledged that the town of 700 couldn't afford a full-time clinic but may need a doctor to come through every winter to administer flu shots.

"Living in a rural community, you accept certain things," he said. "But there's got to be something between a six-day-a-week clinic and what we have now."

Which is nothing.

The meeting came to an end with no agreement made between St. Luke's and Carey. But those attending did agree to a meeting among key St. Luke's staff members and town representatives to decide on what kind of health service fits the town's population and budget.

When that will be is uncertain.

Trevon Milliard:

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