SARATOGA – Memorial Hospital of Carbon County leadership made a second unannounced and unadvertised visit on Tuesday to the Saratoga Town Council.
Hospital board trustees and the CEO came to pitch their solution to Saratoga’s struggle to attract a doctor to their clinic. Their Interim CEO, Robert Quist, was not even on the agenda, but spoke for nearly an hour.
“(The Platte Valley Medical Clinic) has been without a doctor for a year now,” Quist said. “We have a general practice medical doctor ready to move to Saratoga as soon as we establish a clinic here.”
According to Quist, the unidentified doctor is now practicing in Colorado.
“He and his wife have visited Saratoga and like the town and area and would like to live here,” Quist said.
However, he wants to work for a hospital-attached clinic and not a stand-alone clinic, Quist added.
In a hospital-attached clinic, the potential doctor could be relieved by another doctor when he wants a day off or plans to go on vacation. He would have regular hours in Saratoga, either five eight-hour days or four ten-hour days “so he could have a long weekend,” said Quist.
Saratoga could have a doctor here “in 60 to 90 days after a hospital clinic is established,” said Quist.
General practice doctors are in high demand across America, according to Quist.
“They cost $300,000 to $320,000 a year with benefits,” he said.
A regular clinic cannot support this high cost with a fee for service business model, said Quist. To support this high cost of operation, a different business model, like a Critical Access Hospital, is needed to generate the needed cash.
Memorial Hospital is already a (CAH) and can collect fees at the higher rates allowed by the government funding model.
To establish a new CAH in Saratoga, with all the planning, government red tape, land acquisition and the need to build a new hospital “will take three years, and it will be very expensive, requiring at least 20% local money,” said Quist.
Having previously discussed the solid financial condition of Memorial Hospital, Quist said, “We can provide you a doctor and we can afford that doctor.”
Quist said if the medical clinic property becomes available in November, they would either lease the building or make the town a cash offer for it. Memorial Hospital could open Saratoga’s existing clinic as a hospital clinic shortly after taking it over, according to Quist.
Some remodeling would probably be necessary to meet current federal standards for that building to qualify as a government-approved rural hospital clinic.
If extensive remodeling were necessary, then it would be cheaper to build new, said Quist.
“Our plan to build a clinic here (in Saratoga) is not a threat but a strategy,” said Quist.
He also said it’s to provide convenient medical care for all the Platte Valley residents who now travel to Rawlins for care.
An earlier study suggested the best strategy for medical care in Wyoming is the hub and spoke model. With Rawlins as the hub, the surrounding towns like Saratoga that have clinics become the spokes that feed patients to the hub.
After making his presentation, Quist fielded questions from both council and audience members.
From the audience came the inquiry about the hours of the hospital’s clinic in Hanna.
Memorial Hospital has operated the clinic in Hanna for years. That facility is the closest medical facility for everyone living in the northeast corner of the county, as well as the towns of Medicine Bow, Elk Mountain and Hanna. Quist’s response was “it is open two days a week.”
The lack of after-hours care at the Saratoga clinic was discussed. Historically, residents and visitors could access medical care after 5 p.m., during the night and on weekends, by calling 911. The on-call staff person would open the clinic to provide medical assistance.
Under the current management, Saratoga’s clinic hours are 8 a.m. to 5 p.m. Monday through Friday, with no after hours, nighttime or weekend access to medical assistance.
In past conversations Karl Rude, the current operator of the facility, he has said the clinic is not an emergency room and he has no plans for it to become one.
A call to 911 will bring an ambulance and EMTs to your door. If transport to a medical facility is required, then the ambulance must go to Memorial Hospital in Rawlins or some other hospital if required or requested.
According to John Zeiger, Saratoga mayor and a frequent driver for the SCHWIMS ambulance service, once someone is loaded in the ambulance it “may not stop here at the Saratoga clinic for patient stabilization or any other reason but must go directly to Memorial Hospital. “
With Memorial Hospital operating the Saratoga clinic, it will be open for regular business hours Monday through Friday.
As for after-hours medical service availability at night and on weekends, only Tele-medical services will be provided, according to Quist.
Twenty four/seven emergency room services are just too expensive, Quist added.
“We (Memorial Hospital) pay 3.5 million dollars a year to run our ER,” he said.
Carol Beach, who lives in Ryan Park, expressed concerns about the lack of any “stabilization care being offered in Saratoga before going on to Rawlins. Tele-med after hours offers no effective intervention for someone in need.”
The fate of the Nursing Home was briefly touched on during Quist’s long presentation.
In past statements, Quist has said the Memorial Hospital has no interest in operating the nursing home or saving it from closure. In this presentation Quist said a hospital-operated clinic would “offer more support to the nursing home by providing more services at their clinic” without discussing who would operate the facility.
Quist further stated, “The nursing home is being used as a wedge issue to keep us out of Saratoga.”
The financial difficulties of the Saratoga Care Center are public knowledge. The possibility of closing the nursing home has been openly discussed.
The plan of the Platte Valley Healthcare Sustainability Project (PVHSP) committee has always been to incorporate the residents of the nursing home into the 25-bed Critical Access Hospital, with its higher cost reimbursement model, thus saving it from closure, while providing better medical care to the general population in the Valley.
A final area of concern not touched on by Quist’s presentation, but raised by Councilman Steve Wilcoxson and members of the audience, is the quick access to care.
The long time delays and considerable distance from Saratoga to Memorial Hospital in Rawlins with even greater time and distance problems from Ryan Park, Riverside and Encampment and the surrounding national forests are a common concern to Valley residents.
The risk of road closures, some 50 times last winter, due to weather was also discussed.
Wilcoxson discussed the importance of the “Golden Hour” of treatment: That first hour after the health emergency when the success of intervention is most critical.
“And we are going to spend most of the hour or more traveling to Rawlins, before we can reach the high-tech care at the hospital?” said Wilcoxson. “We need a hospital here.”
Jeb Steward, local resident and former State Legislator, suggested a public meeting or workshop that would include the other towns and general public, where both entities could lay out their plan for healthcare in the Valley with a goal of getting the two competing organizations to work together.
When asked if they were in communication, Quist said, “they had talked” and Rude said, ‘It fell flat.’”
Rude, when invited to speak, was brief.
“The Clinic continues to move forward in its goal to provide healthcare to the Valley,” he said. “The Golden Hour problem will not be solved by Memorial Hospital in Rawlins.
He disagreed with some of Quist’s statements and agreed with others.
He invited everyone to come to the next healthcare meeting on Aug. 14 at 5:30 p.m. at the Platte Valley Community Center to hear the results of the study conducted over the last several months as to the feasibility of establishing a Critical Access Hospital in Saratoga with Federal government loans and support.