Interim, rental doctors have negative financial impact on district

Last week, Terri Cody wrote concerning the imminent departure of the Coast-to-Coast contract doctor that “it is a sad day for the other people of Ritzville who thought maybe we might have a choice in our health care system.”

I – and, I am certain, both EARH and Hometown – regret that Ms. Cody now feels that she will have to obtain her primary healthcare in “Cheney, Spokane, or in Davenport;” but some context is wanted.

In the half-year period running through July of 2012 (the most recent for which data are available), the “visiting doctors” had between them all a total of 299 “patient encounters.” For comparison, during the same six months of 2010, Doctors Eckley and Sackmann between them had 1,861 patient encounters. If one calculates encounters per clinic day, the Coast-to-Coast physicians have been seeing, between them all, barely over one patient per clinic day (1.075 to be exact). Moreover, when the now-Hometown doctors were at the District, only 46 percent of clinic patients (1,160) chose to see a PA; in 2012, 80 percent (1,567) have chosen to see a PA rather than any of the Coast-to-Coast physicians.

None of that is any judgment on Dr. Jenkins; I have myself twice been treated by her in the ER, and found her both competent and personable. But clearly the great mass of the District’s population prefers to see either one of the physicians at Hometown or a PA. (And, speaking of “choice,” just how much choice does a patient of the District have right now when wanting to see a physician at the District?)

EARH is a small district serving a small community – fewer than 4,000 population. It is impossible for such a facility to keep a physician whose patient base is so minuscule, especially when that physician would not be a salaried employee of the District, but rather would be on the extremely costly Coast-to-Coast contract. The District has been obliged, by the loss of the Hometown physicians, to spend well over a million dollars a year on a Coast-to-Coast physician staff that is seeing an average of one patient a day; and that million-plus has a lot to do with the fact that the District is now losing one-and-one-third million dollars a year ($794,024 for 2012 through July), a bleed rate that, if not stopped very, very soon, will mean that the District will be unable to continue operations.

Nor will simply ending that hugely draining contract with Coast-to-Coast suffice to fix matters, because the District still needs physicians, and especially because Medicare and Medicaid – over 60 percent of the District’s business – pay the District on a cost-plus basis, so that the expense saving also means an almost-equal income cut. The very day Doctors Eckley and Sackmann left the District, patient traffic dropped by over 60 percent, and it has only gotten worse since. The only thing that can preserve the District’s future is some sort of negotiated return of the Hometown physicians to the District; without the huge number of patients who followed their preferred doctors, it’s pretty much all over but the (doubtless extensive) shouting.

Ms. Cody states that, “I did not care to see the PAs there nor did I like for feel confident [sic] in the care of either of the doctors.”

That is absolutely, positively her right. But it is less clear that she is in a sound position to cast implied aspersions at the District for not continuing to retain, at a huge cost, a physician whose patient base is so tiny.

Eric & Lynn Walker, Ritzville