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

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.

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