By Dave Ranney
KHI News Service
Lea Shivley, a nurse practitioner at the Mother Mary Ann Clinic in Wichita, consults with Elmer Dempsey, a patient, about his medications. The clinic, located next door to Via Christi-St. Joseph Medical Center’s emergency room, has seen more than 400 patients since opening July 2. (Melissa Lacey Nagy/Via Christi)
WICHITA, Aug. 9
More than 400 people used Mother Mary Ann Clinic last month.
“We”re off to a good start,” said Jim McFadden, a long-time Via Christi Wichita Health Network executive who came out of retirement to launch the clinic.
The clinic, which opened July 2, was designed to give poor and uninsured patients an after-hours alternative to the Via Christi-St. Joseph emergency room, which is next door.
Via Christi officials hope the clinic will lower the emergency room”s uncompensated-care costs.
Last year, Via Christi Wichita Health Network”s two emergency rooms
one on its St. Joseph campus, the other on its St. Francis campus
racked up more than $9 million in uncompensated care.
Forty-five percent of the patients who used the Via Christi-St. Joseph emergency room last year were either uninsured or on Medicaid; 80 percent of their visits were not considered emergencies.
“In our first 26 days of actual services, we”ve seen 436 patients,” McFadden said of the new clinic. “Now, some of those folks
about one or two a day
we take a quick a look at them and send them on to the emergency department, and some we”ve treated and said “Come back in three days,”” McFadden said. “But most folks, we”ve seen them once and that”s it.”
The clinic is open from 4 p.m. to midnight, Monday through Friday. It usually has one physician on duty.
The clinic is the only one in Kansas that”s next door to an emergency room. The two facilities are about 30 yards apart.
Eventually, the clinic will be open seven days a week. “I doubt we”ll be able to get there in September, maybe in October,” McFadden said. “We”re having a little trouble recruiting evening-shift physicians who are in a position to moonlight.”
In the clinic”s first month of operation, McFadden said he and his staff have noticed three trends:
* Infections:
“We don”t know why, but we”re seeing a lot of infections from spider bites, cuts…things like that,” he said. “I”m talking about infections that require incision and drainage or high-level antibioticsboils and abscesses.”
* Uninsured:
“We”d projected that 55 percent of our patients would be Medicaid and that 45 percent would be uninsured,” McFadden said. “But, so far, it”s been 70 percent uninsured, 20-plus percent Medicaid or HealthWave, and a smattering of Medicare or commercial insurance.”
* Asthma
: “We”ve seen a lot of people for asthma, more than you”d expect.”
Asthma attacks and being uninsured go hand-in-hand, said Lynn Crabtree with the American Lung Association of the Central States-Kansas office in Topeka.
“If you”re working poor, uninsured, or having trouble getting your kids on HealthWave, (the state”s health insurance program for children in low-income families) you”re probably having a hard time getting your prescriptions filled,” Crabtree said. “But it”s very important that you take your maintenance medication to reduce the inflation in your lungs, and that you understand what triggers an attack.”
Heat and pollen often trigger asthma attacks, but cigarette smoke, she said, “is the No. 1 stressor.”
ER traffic
“We”re off to a good start,” said Jim McFadden, executive director at the Mother Mary Ann Clinic, commenting on the clinic’s first month in operation. The clinic is named for Mother Mary Anne McNamara, a Sisters of St. Joseph nun who served as the hospital”s executive director at for 22 years. McNamara, whose portrait hangs in the clinic’s entryway, died in 1991. (Melissa Lacey Nagy/Via Christi)
It”s too early, McFadden said, to measure the clinic”s success in keeping non-emergency patients out of the emergency room.
“We”re just getting started,” he said, “and, really, at this point, we”re trying to keep things calm until we get some bugs worked out
things like getting in the right equipment and getting the software to work. And we”re not open on the weekends.”
Eventually, hospital officials will use clinic and emergency room data to see whether the clinic”s benefits outweigh its costs.
“Essentially, it will all come down to whether we can show there”s been a significant improvement in after-hours care for the uninsured in the community we serve, how the program in perceived in the community, and financial performance,” McFadden said.
So far, the clinic has been seeing 17 to 30 patients a day and there”s been a slight decrease in the traffic at the emergency room.
“We”ve seen a slight dip in census, approximately five or six patients a day,” said Sharon Grunden, emergency services director at Via Christi. “So I can only wonder how the other 15 to 20 patients they’re seeing would have gotten their healthcare needs met had the clinic not been open. I’m afraid many of them would have gone without until their minor problems became major ones.”
The Via Christi-St. Francis emergency room sees about 150 patients a day.
Some patients, too, have said they came to the clinic to avoid hours-long waits at other emergency rooms in the city.
McFadden said he expects the clinic”s census to grow as word spreads among the region”s uninsured.
“We”ve communicated with the other emergency rooms and with charitable organizations like Catholic Charities, Urban Ministries and the health departments,” he said. “And we did a direct mailing to 1,500 frequent users
those who used the St. Joe emergency room three or more times for non-emergency care in the previous year.
“I suspect if we did another mailing, we”d kick things up a notch.”
McFadden said he”ll put off doing another mailing until after to the clinic is open seven days a week and until after school starts.
“We”re pretty much convinced that once school starts and kids are back in big groups sharing stuff, we”ll be seeing a lot more communicable disease-type stuff,” he said.
McFadden said he and his staff have been struck by how many patients try to pay their bills, which are based on a sliding scale.
“I”d say four out of 10 try to give us something, which is more than we”d expected,” he said. “They seem appreciative of the fact that we”re here and what it is we”re trying to do. I think we”re here to stay.”
Others, too, are appreciative.
“I think they”re a fantastic addition to what we”ve got going on in Wichita,” said Dave Sanford, executive director at GraceMed Health Clinic, which serves the poor and uninsured.
“The fact that they”re open evenings and, hopefully, will be on weekends, is going to give people access to care that the rest of us would love to provide but can”t,” he said.
-Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.