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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (July 21, 2018)
8A | SATURDAY, JULY 21, 2018 | SIUSLAW NEWS “If the care I’m providing is go- ing down, then maybe I have to She continued, “Did you trip? see less than 250 people,” she said. Are you heavy? Do we need to While these clinics do provide work on weight loss?” a better quality of care, they are And the visits are not limited. not intended to be the sole medi- Patients can see Gitnes as many cal facility for their patients. They times as they need. still do not cover actual lab work, “I don’t flatter myself to think surgeries or specialists, though people really want to spend a they are looking into expanding large amount of time with me in their offerings. my office, unless they have a re- Again, patients to these clinics ally good reason to be there,” Dr. still need to hold onto their insur- John Egar joked. ance. Egar is the owner of the newly “We don’t encourage anybody formed Siuslaw to change their Medical Clinic, “Every provider wants to have more time with their insurance,” Dou- another con- da said. “We had patients and have a better relationship. But it’s frus- cierge clinic in one business trating because they have to do what they’re being who signed up the area, which follows a simi- told to do. ... A lot of the providers, myself included, five people and lar format. As of just said ‘enough.’ We can still provide care, but we can say, ‘Maybe we right now, he is do it differently.” should go back — Melinda Gitnes, Northwest Reflections to this.’ We told the sole doctor at the clinic, but them to wait. he’s looking to The problem is, bring on others. what they went into medicine for. insurance is built for big, cata- The long-time local physician They’re not coming into the pro- strophic events more than it is for was inspired by Gitnes’ use of the fession to fill out paperwork.” everyday living.” model after becoming frustrated And then there’s dealing with Beyond emergency needs, in- with the experiences he had as a insurance companies. surance will still be needed to physician in the medical system. “When I worked in Springfield, cover the costs of medications, “You don’t really have time to there was a group of physicians blood work and referrals to spe- see a patient,” he explained. “And who just said, ‘That’s it, we’re cialists. then there’s the amount of red done,’” said Gitnes. “The insur- While concierge is a supple- tape you have to go through to ance companies were dictating ment to insurance and not a even get the prior authorization to the clinics who you would see, replacement, Douda has found for each and every visit, each and how many you would see and some in the community who just every test, each and every refer- what you would see them for. You don’t have access to health insur- ral.” were spending your whole time ance at all. By getting rid of the red tape of filling out documentation and “In my mind, I thought we insurance and overhead, Egar and submitting them to the insurance would have a particular popula- Gitnes believe that they can give companies. And then they would tion of Florence that’s going to use patients something that many in kick it back to you, saying you us because they have the money,” the region feel they lack: access. didn’t put something in the right she said. “Then we realized there’s “Say you moved into Florence section.” a majority of people in Florence and you’re now on the waiting The publication The Hill re- that are living and working in list for a primary care doctor,” ported in August 2017 that 24 a town they can hardly afford, Egar said. “Maybe waiting in the percent of patients were denied and so they aren’t insured. That’s walk-in clinic for one prescrip- medical treatment by insurance something that slapped me in the tion isn’t good enough for you. companies. In 70 percent of those face.” Or maybe you need responsive- cases, the denied treatment was She spoke of one business own- ness right away, and a phone tree for an illness or condition de- er who couldn’t afford health in- in a different state won’t help you. scribed as “serious.” surance for themselves and were I would be able to provide these Most consumers reported wait- relying solely on the emergency things the same day, with all the ing more than a month to even room for care. services that we normally provide hear whether their claim was “We’re at least affordable,” Dou- in a primary healthcare clinic like denied, the report said. And 29 da said. “It’s enough so they can at PeaceHealth. And having the percent said their condition wors- start getting care.” security may be worth it for those ened while they waited for a de- Gitnes and Douda hope that who could afford to pay it.” cision. Thirty-four percent had to the majority of people do get The clinics are not intended put off or forgo treatment entirely proper insurance, using their to be a complete replacement for because their insurance provider clinic as a way to gain better ac- hospitals, and patients are still refused to pay for it. cess to healthcare. But better ac- strongly encouraged to keep their All told, the report stated an cess has raised issues about the health insurance. estimated $471 billion was spent fundamental fairness of concierge “We’re not everybody’s pri- annually just on billing and in- medicine. mary care,” Douda said. “A lot of surance-related administrative Does paying separately for our patients have primary care costs alone, regardless of the final an off ramp from the long wait through PeaceHealth.” outcome. lines and short visits of tradition- Gitnes added, “It’s nothing “It’s just become such a night- al medicine create a disparity in against PeaceHealth. It’s a num- mare for the medical side to pro- who receives the best medical bers game. There’s so many pa- vide the type of healthcare they services? tients here, and there’s only so want to provide,” Gitnes said. “A lot of people are here on many providers. They are trying “Every provider wants to have fixed incomes,” Egar said. “They to get through all the patients, but more time with their patients and expect their Medicare to suffice. there’s not enough providers.” have a better relationship. But it’s For us to say, ‘No, we’re going to Attracting and retaining clini- frustrating because they have to charge you extra for being a pa- cians has always been a difficult do what they’re being told to do. task in a small, rural community That’s how it is in most places. like Florence, which is constantly A lot of the providers, myself in- in competition with larger cities cluded, just said ‘enough.’ We can with higher pay and more ame- still provide care, but we can do it nities. This tends to create longer differently.” wait times for doctors to see a pa- Gitnes and Egar see concierge tient. health as a way to help counteract But the entire healthcare sys- these issues. By not having to deal tem, and how clinician/patient with insurance companies direct- relations are organized, also con- ly, they are able to give direct care tributes to wait times. And it’s in a timelier manner and save those trends that Egar and Gitnes costs by not having to hire addi- are trying to buck. tional staff to just to work with “At a clinic I worked at in insurance. Springfield, on my first day they Because the overhead is small- said my first roster was 3,000 pa- er, and the paperwork is less, they tients,” Gitnes said. “I thought, are able to spend more time with ‘My gosh, how am I going to get patients, and limit the number of to know my people?’ You don’t. patients they see in a year. You have patients every 15 min- “I will limit my patients to 300 utes, five days a week. You come so that I will guarantee the pa- in, you have one ailment that tients the care they expect,” Egar you’re allowed to treat. Someone said. “If I have time on my hands had diabetes and hypertension, and I’m twiddling my thumbs, I you don’t get to treat both. You may take on more patients, but get to pick one. What kind of care by and large I will be happy with is that?” those 300 patients.” The reasons for the 15-minute Gitnes is topping her panel at wait time are many. 250 patients per year. CLINICS from page 1A A September 2016 article by Forbes found that for every one hour a physician sees a patient, they are required to spend two hours on paperwork. There are multiple forms from administra- tion officials and lawyers seeking information, beyond the typical paperwork that is needed to keep track of patient care. The study found that only 27 percent of a physician’s time is actually spent face to face with a patient. “The providers are getting very fed up,” Douda said. “This is not tient at this clinic, and if you’re not a member, then you don’t get in,’ that feels unfair to them. And it is. The system of payment that I’m operating is not fair, and it grieves me. I will try and reas- sess in the future, but for now, it’s a simple set price a month for all comers.” Neither of the clinics believe the concierge clinics are the an- swer to all the problems with healthcare. “I think the funding model in this country with all the com- plexities and regulations is just a patchwork of Band-Aids that doesn’t deserve to hang around,” Egar said. “I think both people on both sides of the aisle would say it’s broken. You have to start and imagine what’s the best and most efficient situation, and then plan your solution from there.” What that solution could be is anybody’s guess. “If I had the answer to fix healthcare, I would be a bizzil- ionaire and have the Nobel Peace Prize,” Gitnes said. “I try and keep it simple because I’m a bit of a simpleton. I don’t know how to change the world, but I know how to change the world I live in.” For more information on Siu- slaw Medical Clinic, 1845 High- way 126, visit siuslawmedical. com or call 541-999-6599. For more information on Northwest Reflections, 5292 Harvard Ave., visit nwrhealthandwellness.com or call 541-590-3906. Hillside A NATURAL FIT FOR YOUR RETIREMENT Set on 57 acres in the heart of Oregon wine country, you’ll find Hillside. With luxury accommodations, a full calendar of activities and beautiful surroundings complete with walking trails, gardens and wildlife, our senior living community is designed for your needs and your zest for life. Call 1-844-388-5640 today to attend our Live Well workshop at 11 a.m. Monday, August 13. A Life Care* Community 300 NW Hillside Park Way | McMinnville, Oregon 97128 brookdalelifecare.com *Life Care plan/guarantee is subject to the terms of the Residency Contract. ©2018 Brookdale Senior Living Inc. All rights reserved. BROOKDALE SENIOR LIVING and BRINGING NEW LIFE TO SENIOR LIVING are the registered trademarks of Brookdale Senior Living Inc. 160256-2 SR Bringing New Life to Senior Living® FLORENCE AIR ACADEMY AND THE BOYS & GIRLS CLUB Take to the Skies July 30th – August 10th • For Teens 6th – 12th Grade Now, It’s Even Easier to Donate to Food Backpack for Kids Visit our website at foodbackpackforkids.com Click on “Donate” It will take your right to Paypal to complete your donation. You will receive by mail a copy of your tax deductible donation. Your generosity has impact and will continue to do so in the lives of many of our yougnsters. Th ank you. Oregon Pacifi c Bank - Sponsor-paid advertisement The Boys & Girls Clubs of Western Lane County is partnering with Aero Legends for the 2nd Annual Florence Air Academy. The Florence Air Academy, led by COLs (Retired) T.F. “Sam” Spayd and Terry Tomeny, will be a two-week course teaching Boys & Girls Club members the principles of aviation and information on careers in the aviation industry. Classes will include a tour of the Coast Guard ' N!O ' N ! O Helicopter, flying Remote Controlled planes, piloting drones, and the chance to fly one-on-one with an instructor pilot! The Academy activities will be a combination of classroom study, interspersed with hands-on activities and flight operations. There is no cost to Boys & Girls Club of Western Lane County GREAT FUTURES START HERE. members. All expenses for members are paid by Aero Legends Biplane Rides. Teens not already a CLUB member can join for a $25 member- ship fee and $50 OF WESTERN LANE COUNTY HELP US, HELP THEM www.bgcwlc.org