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The Interim Sunshine Medical Director Talks About the Dispensary and After-Hours Coverage

by Phillip Manning ~ October 15th, 2013

After the contract of the Sunshine Clinic’s Medical Director, Dr. Mary Loeb, was not renewed, a search began to fill the position.  Last month, the Sunshine Community Health Center hired Dr. Philip Hess on an interim basis to fill the spot.

Dr. Hess has worked for community health centers in Cordova and Anchorage.  Dr. Hess says he was brought on to address policies and procedures as well as to help prepare for the site visit by the federal Health Resource Services Administration, or HRSA in September.  In addition to looking at Clinic policy, Dr. Hess says he provides day-to-day support for clinical questions and is listed as the collaborative physician for the Clinic’s PAs.

Among the policy issues being considered are the Clinic’s dispensary and its after-hours policy.  At the last Clinic Board meeting, community members expressed concern that these services could be changing.

Dr. Hess acknowledges that controlled substances have not been available at the dispensary since July, when Dr. Loeb’s contract was not renewed.  He says that there is currently not a plan to change the dispensary from its current state.  According to Dr. Hess, Sunshine had expanded beyond what is normal for a dispensary of its size, and that while the rules and regulations on dispensaries are intentionally vague to allow communities to adapt to their own needs, he believes that there are other solutions, namely mail-ordering prescribed controlled substances.  Dr. Hess also says that expanding to a full-scale pharmacy is an option but would be costly, as a licensed pharmacist would be required.  He says that whatever path is taken, consultation with the Board and discussion within the community is important.

The other major policy change being looked at is the Clinic’s after-hours policy.  According to Dr. Hess, the handling of after-hours calls has been nebulous, and depends largely on which provider is on call.  He adds that HRSA identified the current practice as one of the Clinic’s highest-risk policies, since it often leads to providers meeting patients without any other staff present.

Dr. Hess says that the decision has been made to scale back the service, and that going forward, twenty-four hour “phone triage” will be provided.  He says that continuing to provide the previous model of after-hours care is definitely desirable, but that it would require a nurse to be on staff at all times to assist in seeing after-hours patients, which he says is cost-prohibitive right now.  Dr. Hess says that could change if funding were extended in the future.

1 Response to The Interim Sunshine Medical Director Talks About the Dispensary and After-Hours Coverage

  1. mary gunderson

    SORT

    Mc Gunderson
    Dr. Hess’s interview on KTNA was disheartening. The dispensary situation is tragic and will undoubtedly take a lot of work to get back up and running to the level that Dr. Mary provided. The clinic board may have a difficult time finding providers, let alone someone willing to take on the dispensary duties, due to the mismanagement at the hand’s of the ED. Undoubtedly the clinic is facing reduced revenue due to patients pulling their records and seeking medical care in Wasilla or Anchorage , so the idea of hiring a pharmacist could be financially problematic.

    Dr. Hess’s suggestion that after-hours care be reduced to a phone triage indicates that he does not understand how vulnerable that leaves the community. It is incredibly scary to think that if a child broke his/her leg that the only care available is a “phone triage” and mail order pain meds. The community continues to get the message that they need to head south for treatment. The thought of transporting a young child in pain, without benefit of pain meds, to Wasilla is horrific.

    The board beginning a search for an ED now, would give the staff and community a sign that they are heading in the right direction. It may send potential provider applicants the message that an end to the clinic dysfunction is in sight and the re-building process has begun. Hunkering down, waiting for the ED’s contract to run out while the clinic crumbles around them is not a solution. It takes months to advertise and vet new applicants, so it is not too early to begin the process.

    In the meantime we, the community, can not give up on the clinic. We need to show up at the board meetings to keep the pressure on the ED, hoping that he will decide to leave now, so we can start re-building. There is an upcoming board meeting at the end of the month. The date and time will be posted as soon as we get the info. Please come.

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