Lucas County Health Department Closes………….

Clinic closed

Health Department Clinics Close

Lucas County Health Department in Toledo announced the closing of its family practice, women’s health and pediatric services as of June 30th, 2018.

Some services will move to another building.

This will affect over 6000 patients.

Patients were notified and given a list of other options.

According to The Blade in a February 2018 article.

The department faced a $100,000 shortfall by year’s end if nothing changed, Mr. Zgodzinski said.

“Public health really needs to focus on public health issues,” he said. “Clinics and individual health is not a part of public health … it’s not a central part of its duty, mission or need to protect the 435,000 individuals who live in this community.

This means it was never meant to be a place where people get regular medical services.  It’s meant as someplace to get vaccinations and take care of things that affect the public at large and not the individual.

The Doctor is not in

Have you ever been given a list of physicians or practices accepting new patients from your insurance company?

According to a patient that I saw a week ago and an HR manager in an engineering company, I was speaking to; Even if you have insurance, no one is taking new patients.

Why is this?  Could they be overwhelmed?

According to the Kaiser Family Foundation (KFF) in December of 2017, Ohio needed an additional 208 primary care providers to meet its quota.  This did not include any services by nurse practitioners or physicians assistants.  This is because Ohio law doesn’t permit us to practice without a “collaborating physician”.  Don’t get me started.

OK! Go out and hire some primary care doc.  Wait! There aren’t any.

According to the Ohio Physician Workforce Profile put out by the American Association of Medical Colleges, Ohio only has 93 Primary Care Physicians per 100,ooo population.  That would be over 1000 patients per physician.  Holy Shut The Door Batman!  

Over 27.5% of the active physicians in Ohio are over the age of 60.

There are only 18 (EIGHTEEN) family practice residents per 100,000 population in the state of Ohio currently.

Ohio retains about 67% of the residents who complete their training here.  Terrific! BUT

Promedica announced, in January 2017, that it was phasing out its Family Practice Residency.  It will be moved to Monroe, MI. The University of Toledo will open a few slots but will probably change them to internal medicine.

Is it a coincidence that the displaced 6000 patients at the Lucas County Health Department are the very people who are cared for by the residents in this program?

The AAFP (American Academy of Family Physicians) stated in January 2017:

Now the already disenfranchised community served by the W.W. Knight Family Medicine Residency will be further marginalized by corporate decisions that strategically shuffle residency program slots around the service area like pieces on a chess board. It has been reported that ProMedica will add new residency positions in Monroe, Mich., (roughly 25 miles north of the W.W. Knight facility) but that change would be of no value to the 5,000 patients already in need of more access to health care in Toledo.

They go on to say:

According to the Robert Graham Center for Policy Studies, Ohio will need an additional 681 primary care physicians by 2030 based upon changes in the number and age of the population of Ohio.

We know without a shadow of a doubt that a strong primary care-based health system leads to better health, better care, and lower costs. Evidence shows that access to primary care helps people lead longer, healthier lives. In areas of the country where there are more primary care physicians per person, death rates for cancer, heart disease, and stroke are lower and people are less likely to be hospitalized. Adults in the United States who have a primary care physician have 33% lower health care costs.

ProMedica’s claim that the decision was based on national trends shifting family medicine residency programs from large, tertiary care medical centers to community hospital settings seems disingenuous given their decision just over two years ago to close the family medicine residency at Flower Hospital, which is a smaller community hospital.  Read more here.

As 67% of our residents continue to live where they do their residency, we have just lost more family practice docs.

Solutions?  There are a couple.

The first rule in medical practice is to “do no harm”.   The large money mongering hospital corporations need to remember why they exist. To serve the people.  To care for and educate the population in regards to health.  Not to see 1 patient every 8.45 minutes.

BUT, not to place all of the blame there…………

There are many nurse practitioners who would love to have their own office.  Ohio law prohibits this without a collaborating physician. A physician employed by the major healthcare organizations cannot collaborate with an independent nurse practitioner.  Most doctors do not own their own practices anymore due to financial constraints.  I haven’t personally known my collaborating physician for 5 years.   I wouldn’t know him/her if I ran him/her over.  They review a percentage of my charts for a fee.  They do not see patients in the clinic where I work. In one instance, he/she lived accross the state. I refer and consult with local providers if I need to.

HOWEVER………….

We cannot place the blame entirely on the medical system.  The average patient does not know what meds he/she is on or why. They don’t always know what they are allergic to “the little pink pill:  REALLY?   The average American patient needs to take control of their health instead of relying on the medical community.  It is clear that there aren’t enough of them to go around.  But, that’s a discussion for another time.

In the mean time,

You Have A Choice. Choose Health

Terri Lohman DNP, FNP-BC, BC-NC

Board Certified in Family Practice and Health Coaching

 

 

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