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HOME > ABOUT > PRESS > WEST MARIN HEALTH CLINIC'S FUTURE IN QUESTION
Article published - December 8, 2007
Credit: MARIN INDEPENDENT JOURNAL
West Marin health clinic's future in question
By Rob Rogers
Although two doctors have agreed to replace Point Reyes Station mainstay Dr. Molly Bourne, the future of the West Marin Medical Center - the practice she will leave behind next month - remains in question.
Dr. Bourne, who has served about 4,000 patients at her private family practice for the past eight years, announced Nov. 27 she would leave her position. The doctor said the increased demands of the insurance industry, and the tendency of insurance companies to delay payment or question medical decisions, made it too difficult for her to continue.
"It's not just about me leaving as an individual," Dr. Bourne said. "It's a whole problem with our system."
Dr. Bourne's decision sparked concern among her patients, including many seniors and residents of rural West Marin. About 75 people attended a discussion of the clinic's future Thursday night at the Dance Palace Community Center.
"I think most of us thought we were in pretty good shape," said Amy Schliftman, owner of West Marin Physical Therapy in Point Reyes Station and one of Bourne's patients. "We had a young, brilliant, caring doctor who would be out here for most of our lives. But in fact she's had to pull the plug, and that has upset many people.
"We're left with either going with the Coastal Health Alliance, which is already very packed, or having to travel quite a distance to practices which are already overpacked to begin with," Schliftman said.
Patient Joannie Kwit said she'll miss Dr. Bourne, but understands her decision.
"She's choosing to leave because she just can't struggle any more," said Kwit, owner of the Pine Cone Diner in Point Reyes Station. "If Molly wants to go, she has every right to make her life better. But I'll never find another doctor like her."
While many of Dr. Bourne's patients tried to persuade her to stay, the doctor said she could not find a way to cope with the financial pressures the clinic faced.
"Some people suggested charging everybody (in the practice) $1,000 a year as a membership fee, to make sure that everything was covered," Dr. Bourne said. "I didn't think that was viable, because it cuts out the people who don't have any money, who are often the ones who need health care the most. And it's not helping the whole (health care) problem. I didn't want to work in a system where I was making money but nobody else is."
Dr. Michael Whitt - the longtime family doctor who sold Dr. Bourne his practice in 1999 and has continued to work there on a part-time basis - has said he will return to the practice to see her patients.
"He is buying back both the building and the practice," said John Severson, executive director of the Coastal Health Alliance, a county-funded organization which includes the Point Reyes Medical Clinic, Bolinas Family Practice and Stinson Beach Medical Center. "Molly has made this possible by asking almost nothing for it. She's really walking away with not a lot, to her credit."
Severson praised Whitt for returning to his former practice.
"He's doing what it takes to keep the practice open for the sake of the community," Severson said. "It's heroic on Dr. Whitt's part to take this on. It's the best shot the community has for attracting a physician who would keep the clinic open as a private practice in the future."
To make up for an expected deficit during the first three months of practice, Whitt has asked members of the community to provide the clinic with an unsecured loan pool of $50,000.
"As of (Thursday), he had already raised loans of $37,000," Severson said.
In addition, Dr. Eileen Gleiber, formerly of the Petaluma Health Center, has agreed to practice at the center on a temporary basis.
"Dr. Gleiber is very well-respected," Severson said. "She has said she will be able to be here six to nine months while Dr. Whitt looks for a more long-time purchaser or partner for the practice."
Dr. Bourne had approached the Coastal Health Alliance about purchasing her practice but it lacked the resources to take over.
"We were offered the chance to buy it at fairly reasonable terms," Severson said. "But having just completed a large construction project in Bolinas, our own reserves are drained at this point. Two years from now, with rebuilt reserves, it might be a possibility."
About one quarter of Dr. Bourne's patients have already left the practice, she said.
"Kaiser Permanente members may be seen by Dr. Michael Whitt at the West Marin Medical Center, physicians at the Coastal Health/Point Reyes Clinic, or by our physicians at any of the Kaiser Permanente medical offices," said Dr. William Elliott, assistant physician-in-chief for the company's Novato medical office.
In addition, Coastal Health Alliance clinics will continue to see patients regardless of their insurance plans.
Dr. Bourne will become one of the medical directors at the Larkspur-based Hospice By the Bay, which has offices in both San Francisco and the Valley of the Moon.
She's planning on writing about her experiences in West Marin.
"I'm hoping to write a book about what happened out here, and to let people know how to navigate the system," Dr. Bourne said. "I've also gotten so many responses from people that I'm making a little documentary about what happened that I can send around to political organizations."
She said she plans to continue working to reform the nation's health care system.
"There's not a quick fix," she said. "It's going to take a long time to turn the tides of this issue. But I don't want to go into primary care medicine again until we're able to fix this."
Severson said he understands her concerns.
"There's not a huge amount of negotiating that ever takes place on insurance rates," Severson said. "The insurance companies tell you what they'll pay, and you either accept it or you don't. Low reimbursement rates are endemic to the industry. They make the job hard to do, particularly in a rural area, and in the North Bay, where it's so expensive to live. Those problems won't go away, and are still barriers to someone else coming in and buying the practice."
FAREWELL
The West Marin Medical Center will host a farewell open house for Dr. Molly Bourne and nurse practitioner Cheryl Higgins from 4 to 6 p.m. Dec. 19 at 11150 Highway 1 in Point Reyes Station. For more information, visit www.doctormolly.org.
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