Ms. Keary, if you find your investigation into the U.S. health care system difficult to make sense of, as you note in your recent editorial, you are clearly doing something right. Anybody who claims to grasp it, whether lawmaker or doctor, pretends to understand the unknowable.
Your editorial asks for reader input regarding Proposition One, the pending levy to support Valley General Hospital. You describe it as convenience versus continuity. I define it largely as a matter of choice. I have been a doctor in the Skykomish Valley, first in Monroe, later (and still) in Sultan, for two decades. My colleagues and I see over 10,000 patient visits per year. As family doctors we understand our patients’ needs in a unique way. In most cases we are able to diagnose and treat patients here. Now as an independent clinic, we are free to use our judgment to provide best overall care for the patient, considering additional required diagnostics and treatment, cost, convenience for the patient and family, insurance coverage and intangibles varying on personal circumstances.
When patients require services beyond what primary care physicians can offer, we make referrals based on relevant factors such as convenience for the patient and their families, and of course quality of the specialists and reputations, including feedback from other patients. We have referred patients to specialists from Valley General, Evergreen, Western Washington Medical Group, Virginia Mason, University of Washington, Everett Clinic, Northwest, Overlake, Swedish and, yes, Providence. No single medical group is best at everything. All doctors and hospitals are not created equal. Every patient has specific requirements. A primary care provider who best knows the patient and is concerned most about what is the best option in a given circumstance for that patient and family is one of the parts of the system that works as well now as it did in the era of Marcus Welby MD. The ideal style and model of care continuity is provided by a person and not a system. Systems facilitate information exchange but are no substitute for relationships. And by law all health care providers have access to their patient’s health care information.
Finally, I don’t consider eliminating inpatient care (hospital beds) or emergency rooms contributing to the so-called continuity of service, and these go far beyond convenience. It’s a choice of keeping a treasured community resource that saves lives.
That is why I support Proposition One to save Valley General Hospital.
Dr. Mark S. Raney
Sky Valley Family Medicine