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Aggie advisors begin their mission

David Adlerstein
The Apalach Times
The Apalach Times

A trio of health care experts from Texas A & M, led by a former president of the American Medical Association, rolled into town this week to see how they can best assist in solving the challenges of rural health care in the county, where Weems Memorial Hospital serves as the linchpin.

Perhaps the most crucial thing former AMA president Dr. Nancy Dickey, who now serves as principal investigator for the university’s Center for Optimizing Rural Health, stressed is that she and her travel team, assisted by another dozen team members back in Texas, are here to help, but not to make the final choices for the future of Weems.

“At the end of the day, whatever decision the community makes, our goal is for access to care to be high quality, affordable and meeting as many of the needs as possible,” she told a community forum Tuesday evening in the courthouse annex, the audience a blend of Weems staffers and community members largely from the eastern end of the county, including County Commissioner Bert Boldt.

“The best we can do is hope to consult with, and share perspectives, with decision makers,” Dickey said. “We are not the decision makers.”

She said that the team will examine the Ascension Sacred Heart, and Alliant, proposals now on the table, and in response to a question from Carrabelle Mayor Brenda LaPaz, said they will look at the repercussions any decision would have on the existing interlocal sales tax agreements. She cautioned that the team does not have the legal expertise often required for this aspect of the discussion, and could only go so far.

“We’re not going to make that decision for you but our role as consultants we’ll say here’s the advantages of this one and here's the disadvantages and hopefully that will help,” she told Commission Chair Noah Lockley at Tuesday morning’s appearance. “To be able to have a clearer understanding of what the implications are.”

Flanked by two other members of the travel team, Kayla Cline, PhD, a Texas A&M business professor, and Bree Watzak, PharmD, CORH’s director of technical assistance, Dickey spent two hours Tuesday providing an overview to the community, that she had shared earlier in the day with county commissioners, and answering questions.

Weems is one of five hospitals around the county to receive year-long intensive technical assistance from CORH, thanks to funding from the federal government’s Health Resources and Services Administration.

This week was the travel team’s initial on-site visit, which included visiting Weems and its two clinics, as well as introducing themselves to the community. Following that, CORH will be in touch through telephone calls with Weems every three or four weeks, bouncing ideas off subject matter experts, consulting with its advisory board and then traveling back again in November, possibly sooner, to wrap up that phase of their inquiry.

The concept is to bring as much knowledge to bear on the problems facing Weems, by drawing on what has, and hasn’t, worked in other, similar rural areas, many of which have lost their hospitals.

Dickey said upwards of 100 rural hospitals throughout the United States have closed in the last decade, increasing travel times to receive care, and according to at least one study, have led to as much as a 6 percent increase in mortality as a result of lengthy distances to receive emergency care.

“It’s the entire United States, hospitals have closed in virtually every state in the country,” she said. “The challenges are not limited to you, they require a wide focus.”

In her presentation, Dickey, a family practitioner from outside Houston who went on to become the first female president of the AMA, said hospital closures impact more than just the health of patients, and their access to care, with chronic disease management often suffering when a hospital closes.

“If you don’t have reasonable good local access, then the chronic diseases don’t get well cared for and emergency issues increase in volume,” Dickey said.

She said closure can lead to a loss of well-paying jobs, have a negative impact on a city or county’s ability to attract new business and add impetus to population shifts, where “young people leave town and don’t come back.”

In response to questioning from St. George Island’s Gail Riegelmayer, a backer of Ascension Sacred Heart’s proposal to strike a deal with the county, and who has been active in building a consensus of recommendations from within the community on how health care here can be improved, Dickey was careful not to prejudge the conclusions CORH may eventually reach.

“I’m not here to give you an answer to that, we are willing to look at the proposals on the table, to identify the best solution for you going forward,” she said, promising to consider the whole of health care delivery in the county.

“We’re clearly hospital oriented but we recognize that the pieces of care are almost always interrelated in some fashion. I don t think anybody has defined a boundary for us,” Dickey said. “Not every small town will be able to maintain a hospital. We are willing to look at the whole continuum of care.

“Whether or not a community can maintain a hospital, most communities need access to some part of care,” she said. “None of these are magic solutions, all just an opportunity to put best heads together

Weems CEO David Walker did not comment throughout most of the evening’s forum, although just prior to the closing, he did speak out about what he called “false negatives” being voiced throughout the community.

He said claims being made by some in the community regarding Weems’ profit-and-loss numbers were incorrect, although he did not cite specific evidence to rebut any assertions.

In the end, Dickey said, the upcoming decisions are in the hands of Franklin County citizens.

“There is no perfect answer and health care is not done changing,” she said. “You have to decide what your community wants and what they’re willing to help support.”