Kathleen Kaufman: Lawmakers don’t know how hard it is to find a doctor

(Rick Egan | The Salt Lake Tribune) Dr. David Sundwall checks out a patient at the Health Clinics of Utah clinic on 1950 West, on Thursday, July 30, 2020.

On Aug. 3, The Salt Lake Tribune reported that budget cuts made in a special appropriation session in June will close the doors of three medical and two dental clinics that are state-funded. Apparently just enough funds were left to close the Ogden and Provo clinics on the 15th of this month and the Salt Lake Clinic on the 31st of October.

These clinics, The Health Clinics of Utah (HCU) provide primary care to 13,000 patients. These patients are those who are on Medicaid, some on Medicare, and some simply uninsured. The clinics are also the places where new refugees go to get their state-required physical exams and their required immunizations. Some HCU patients have lost their jobs and their insurance due to the COVID pandemic.

Primary care is the basic foundation of good health for many people. In primary care, the patient is seen and cared for by the same doctor or provider on a regular basis. This is important in prevention and education of patients, and primary care is essential in proper management of chronic health problems that afflict many.

Apparently, legislators believe that the care given at Utah Health Clinics is “a duplication of services” according to Rep. Paul Ray. These 13,000 should just go get care at a (partially) federally funded community health center. Their medical care at the homes at the (state funded) Health Clinics of Utah is not important nor relevant enough for the state to support this care in this time of belt-tightening for a better budget. I wonder if any discussion of an alternate source of funds for these clinics was considered. Was any discussion of another place to find the funds entertained?

I wonder how many people on that appropriation committee have recently tried to find a primary care provider who will accept new patients? I doubt that any have done this. I am a retired nurse and offered to find a new primary care provider for two family members who have insurance, my daughter and her husband. I spent over six hours on the phone, checking which clinics accepted their insurance and were located within reasonable distance to their West Valley home. Then I called all nine of the clinics and was told at every one except one that no one in eight clinics was accepting new adult patients. I finally found one clinic where a physician’s assistant had a few spaces available. Simply put, many providers are not accepting new patients, even those with insurance.

Will the 13,000 patients have the tenacity, ability, energy and, yes, courage, to try to get a new primary care provider? This question bothered me so I did some research on how they might find a new provider. (Mind you, a new provider will give them care, and check their history, but will not develop a strong provider-patient relationship for a long time.) The care at HCU is not “duplicative.” It is essential and will be hard to replace.

Health Clinics of Utah personnel started out to find new caregivers by giving lists of Community Health Centers located near their patients to each patient. Patients will find front-desk personnel very adept at saying there are no openings. Now the HCU are trying to give actual referrals to specific community health centers to get past some front-desk resistance. Perhaps this will work better.

There is absolutely no guarantee that community health centers can absorb the 13,000 left adrift by the legislative budget cut decision. Some of these centers are already truly full with no room for new patients. Community Health Centers do a fine job with primary care, but several have waiting lists of unknown length, while some are full.

I appeal to the health care providers in this state. Do you support the legislators who made this draconian decision? If you have any room in your private clinic, would you please welcome some of these patients into your practice? If you are willing to consider this, please call Michelle Grossman at 801-715-3500, at Health Clinics of Utah; she will see that patients get a referral to your clinic as soon as possible.

If this referral process does not work, perhaps the state of Utah or the Health Clinics of Utah need to hold a GoFundMe campaign to keep the clinics open, or at least buy them time to get their patients resettled. If the latter, then the 41 employees of the HCU can sign up for unemployment in this COVID time once the clinics close.

These patients have established ongoing primary care at the HCU clinics. Patients with complex chronic conditions need continuity in their care. Without a primary care provider, many will turn to urgent care centers. If they have any trouble breathing, they will be rejected and sent to the local emergency room.

Now all the dollars saved by having primary care through HCU (whose annual cost for care is $192/patient/year) will be lost to high emergency room costs. Of course, this is only distantly felt by the state legislators, as the care will affect the hospital’s bottom line. Legislators may never know.

Utah, do the right thing. Keep these clinics open or replace them responsibly.

Kathleen Kaufman

Kathleen Kaufman, R.N., is a retired nurse educator and advocate for nursing and the health of the citizens of Utah.

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