Program with university will bring residents to Wenatchee
WENATCHEE — A proposal to establish a physician residency program in Wenatchee — a way to entice new doctors to stay in this area — is on hold as local physicians experiment with another program.
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WENATCHEE — People wanting to get medical help in 2014 could end up waiting longer for treatment than they did this year.
On Jan. 1, the first wave of patients who will enroll in the federal program known as ObamaCare enter the system. How big the wave will be is up in the air, medical officials say, but they are preparing for a large influx.
“We expect to have a bit of a tsunami in the first year,” said Dr. Malcolm Butler, medical director at Columbia Valley Community Health.
At that clinic, officials are preparing for a 10.5 percent increase in patient load. In 2012, the clinic had 102,073 patient visits. Its administrator, Patrick Bucknum, said that could increase by 10,700 in 2014.
At the Wenatchee Valley Medical Center, officials are preparing to treat 6,000 more people at its numerous walk-in clinics than the 63,000 seen at those clinics in 2012. That would be a 9.5 percent increase.
They are also predicting that they will treat 3,000 more patients at the Central Washington Hospital emergency room than the 30,000 patients they expect to treat there this year. That would be a 10 percent increase.
Will the local facilities be able to handle the load?
“We’ll be as ready as we can be,” said Dr. Pete Rutherford, chief executive officer for Confluence Health, the new affiliation that operates two hospitals and numerous clinics in NCW.
In 2012, Confluence Health hired 5 new medical staffers, which included doctors, physicians assistants and nurse practitioners. They will see patients in primary-care practices. In 2013, they hired the same number, and continue to recruit.
At Columbia Valley, Butler said, new hires since 2010 have accounted for one physician, two psychologists, and two midlevel providers, such as physicians assistants and nurse practitioners. The clinic has openings for two physicians and one mid-level provider.
“It is unlikely that we will find two physicians by Jan. 1, and we’ll be lucky to find them by Jan. 1, 2015, Butler said.
That is because all clinics and hospitals throughout the nation are trying to hire more medical staff, and there are not enough new medical staffers coming out of universities to fill all those slots, Butler said.
Butler advises people who are already Columbia Valley patients to make appointments now for things like annual physicals in 2014. Otherwise, they may find themselves waiting for an appointment behind hundreds of new patients.
At Confluence Health clinics, Rutherford said, “if people call and have an urgent problem, we will have slots to provide those in a timely manner. If they have a less urgent situation, like follow-up of high blood pressure, they may have to wait two to three weeks to get that appointment, depending on who your physician is.”
Fueling the influx are two key factors:
- Medicaid expansion: New rules increase eligibility limits for adults to 138 percent of the federal poverty level, or about $27,000 for a family of three. Officials estimate that up to 250,000 more people, ages 19 to 65, could become Medicaid eligible in Washington state.
- New rules governing people who earn more than 138 percent of the national poverty rate. Officials say they think 475,000 more people in Washington state could enter the health-care system this way.
But those numbers only tell part of the story, Butler said. He sees pent-up demand adding to the situation. Not only will there be more people with insurance and on Medicaid, but those people will be coming into the health-care system with issues they’ve been putting off.
That, he said, could mean patients coming into the clinic multiple times.
“In a sense, there is a dam about to burst of people who have not had mammograms or who have not had a wart taken off their hand because they haven’t been able to afford those things,” Butler said.
But will large numbers of new patients actually materialize in early 2014?
“I don’t think, at the beginning, there will be lines at the door because the enrollment process will take some time,” said Sheila Chilson, chief executive officer for the Moses Lake Community Health Center. That center operates a clinic in Quincy.
She said she has heard that enrolling one person into new health-care systems takes 40 to 60 minutes.
“We’ve got a lot to learn in the next few months,” she said.
Michael Marchand, communications director with the Health Benefit Exchange, said officials don’t know whether enrollment will be immediate or gradual. What officials hope, however, is that 280,00 non-Medicaid eligible people sign up for insurance through the Exchange in the first year. The numbers are critical if the system is to be self-sustaining, beginning in 2015, when federal grant money runs out, he said.
Also important will be signing up young people. “You need the risk pool of young people who are healthy in order to balance things out,” he said.