Volume 5, Number 3 - April 14, 2005
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Clinic, EMS dilemma remain for RHCB
In a marathon meeting on Monday, April 11, the Sublette County Rural Health Care District Board covered a number of subjects, beginning with a report from the Physician Search Committee. Joan Mitchell reported that they have three doctors and three support persons to consider for temporary coverage as well as a number of applicants for permanent positions in both areas. They have selected six physicians and eight mid-level personnel for further consideration and interviews.
The board agreed to schedule an emergency meeting to make a decision on hiring when all cost and timing information is assembled, with the goal of having people in place by April 15.
A public comment period followed, with Donna Dickson of Pinedale presenting the board with a petition with 60 signatures requesting action to retain Dr. Alex Constantinides, whose contract will not be renewed by Dr. Judy Boyle at the Pinedale Medical Clinic.
Several in attendance spoke in support of Constantinides and asked if anyone knew why his services were being terminated. No board member could offer an answer. Chairman Jerry Jensen advised the group that Boyle is the contracting physician and can hire and fire as she sees fit.
Newly hired Director Randy Johnson reported that he had spoken with all parties involved but could not comment on reasons. Constantinides told Johnson that he has several options and that he will take his time to consult and consider, with no options excluded. A suggestion that the board hire Constantinides to replace Boyle drew some applause from those attending.
Board Member Bill Barney advised that the board needed to depend on the physician as contracted and that the contract runs through July of 2006. While there is a provision in the contract to cancel it by either party with 90 days notice, as was done by Dr. David Burnett recently, there would need to be compelling cause for the board to take such action.
Burnett commented that Boyle was within her rights to make that decision and would be wise not to comment on reasons for her action. Board Member Garry Eiden, referring to Director Randy Johnson, said "Unless our high dollar man can say 'Abracadabra' and solve this, we're stuck where we are."
At the urging of Burnett, the board agreed to offer positions to two Marbleton clinic staff members who are not going with Burnett in his new practice. Barney added: "The board will add people at Marbleton one at a time until it works. We can't get a full staff at once."
Regarding the final inventory of equipment and supplies at Marbleton, Burnett reminded the board that it needs to be completed by this Friday, but had not yet been scheduled.
Andy McGinnis of the Pinedale Emergency Medical Service presented a letter to the board regarding EMS concerns about the anticipated increased flow of patients during the summer season with only Boyle remaining as a physician. The EMS letter recommended the board retain Dr. Doug Schmitz of Jackson or Dr. Brent Sherard of Cheyenne as medical director for the EMS to replace Constantinides, who had been handling that position. Schmitz is the Wyoming State Trauma Program director and Sherard is the Wyoming State Interim Medical director.
Johnson advised that he had discussed this matter with Boyle and she concurred that the board should contract with another physician for that position. Jerry Jensen suggested that there should be one director for both the Pinedale and Marbleton services. Burnett inquired if the decision of who would be the director lies with the board or with the EMS, suggesting that a state statute gives that decision to the EMS.
Burnett commented: "The situation is murky. Do we have a paid service, a volunteer service or a hybrid?" Burnett recommended the board consult all members of the Marbleton EMS before making a decision.
Board Member Mary Lynn Worl urged the board to have their attorney check that statute before contracting with a medical director.
Dr. Darcy Turner then addressed the board concerning his offer to provide after-hours emergency service after April 15. Turner advised the board that he needed to give staff answers and they needed to have someone in place by midnight Friday. The board then went into executive session to discuss terms with Turner.
The board reviewed architectural drawings of the Pinedale Medical Clinic property and agreed to move forward on two projects there. A 24' x 56' manufactured home will be purchased and set up for a cost of $27,000 to provide needed office space, subject to zoning approval. The new ambulance barn project will be contracted to Chambers Design-Build of Pinedale, subject to approval of the Sublette County Commissioners.
Regarding clinic construction, Jensen said, "We need to actively start going somewhere with the one clinic or two clinic plan." Johnson reported that he had promised the county commissioners that they would have an answer within five weeks. Johnson will compile citizen input to see what the county wants, but did not specify how this information would be gathered.
Eiden recommended emphasis be placed on hiring physicians and staff rather than on clinic construction, commenting, "We have to have doctors and staff or we don't need clinics."
Johnson asked the board to approve hiring a person to serve as his secretary half-time and as billing clerk half-time. The board approved the hiring at a starting wage of $14 per hour. Eiden objected to the staff addition as unnecessary, commenting, "My opinion is no, we donít need it."
In other business, the board approved a budget change request from Boyle for equipment. Contracts for clinic cleaning and medical transcription services at Marbleton were approved.
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