The Blackfoot Valley's News Source Since 1980

PureView holds board meeting in Lincoln, addresses questions about Parker Medical

The Lewis and Clark County Commission approved an agreement Thursday, Sept. 5 that would end the county's relationship with PureView Health Center.

The PureView Board of Directors voted June 5 to end the 25-year partnership with the county and to begin operating as an independent nonprofit effective March 1, 2020, but news of their decision raised concerns from the Lincoln Hospital District about PureView's future at Parker Medical Center.

PureView held their September board meeting in Lincoln Sept. 4, the day before the County's vote. Although they discussed regular business related to the operation of both clinics, they devoted considerable time to questions regarding Parker Medical. A written list of questions submitted to PureView by the LHD Board, and PureView's answers kicked off the discussion. The questions revolved primarily around the number of patient visits at Parker and on the relationship between PureView, the community and the LHD. (see full questions and answers below)

During the meeting, LHD Secretary Judy Spath, who said the LHD is really hoping to build a strong, good, trusting relationship with PureView, asked about educational differences between Physicians, Nurse Practitioner and Physician's Assistants. The question was at the crux of a 2016 dispute between the LHD and PureView following the resignation of Dr. Leonard Blinder.

PureView Executive Director Jill Steeley explained that with eight years of college plus a residency, physicians have the most education, while Nurse Practitioners start out as registered nurses who go on to get a Masters, and sometimes a Doctorate, in nursing. Physician Assistants don't necessarily start in nursing, but they get a master's degree for their licensing.

Though their schooling is a little bit different, Steeley said the clinical training of NPs and PAs is probably equivalent, although NP's may start out with more experience. "If you think about a nurse whose been in the field for a while, then goes back to get their master's degree, they're probably going to have a little bit more knowledge and experience," she said.

Regardless, Steeley said PureView's mid-level practitioners handle the same things the doctors do. Re-iterating a point made during the 2016 discussions, she explained that prior to hiring Broussard, PureView looked at the codes for the services provided at Parker by Blinder.

"There wasn't one thing on there a mid-level could not do. Within a hospital, physicians probably have different credentialing and can do different things, but within our organization they do the same things (as mid-levels)," she said, adding that physicians cost about twice as much as mid-levels.

PureView is currently contracting with a traveling Nurse Practitioner to provide medical services here. Steeley said earlier in the meeting that they have been interviewing applicants for the full-time position here. Although the job ultimately drew a lot of interest, she said most potential applicants weren't interested in a position at a small, rural clinic. She said they have interviewed four applicants, and have narrowed it down to two promising candidates, a Nurse Practitioner and a Physician's Assistant.

Parker is also likely to see the return of a familiar face, from time to time. Steeley said PureView has hired Dr. Justin Smith to work at their Helena location. Smith and his wife Courtnay Crowell were the medical providers at Parker for seven years before moving to Canada. They recently moved back to Helena and Steeley said Smith will be coming to Lincoln on occasion to help out.

"He loves it up here. He's the one who said 'I want to go up there,'" she told the BVD.

During the meeting, Spath also raised questions about the clinic's x-ray machine, which hasn't been utilized in several years. Steeley said the machine does need to be serviced, but is still capable of producing quality images. The only issue they had in the past was an inability to e-mail x-rays over their secured system, but she said the faster internet installed to handle tele-health visits should solve that problem, once they can bring the service back. Steeley admitted it may be some time before that happens.

Jessica Menard the nurse at PMC, has been trained as an x-ray technician, but hasn't been able to complete the full array of required clinical internships. Steeley said she has to have clinical training in x-raying different body parts, which requires her train elsewhere.

Jerry Cain, former president of the LHD, said the availability of x-rays are impactful for PMC and asked if there was any prediction on when x-ray services may be brought back.

Steeley said current ongoing staffing shortages have pushed it down on the priority list.

"It costs us 30 percent more to have a traveling nurse practitioner here, so to fund a traveling nurse to be here while Jessica goes to training really isn't an option," she said.

"They will offer it eventually, once they can get to it," said PureView Vice Chairman Mike Murray.

Turning to patient load at Parker, LHD treasurer Karen Frank-Plumlee said advertising the services available at PMC is important for the community and noted the large advertisements they run don't really tell people what services they offer.

Steeley said they are working with a marketing firm and are following a process related to the rebranding to PureView a couple years ago.

"The first phase is to really saturate the market with your new name. The second phase is to start to tell people what you can do. That's the phase we're in with both Helena and Lincoln," she said, adding they are working on ads that include bulleted lists of what they do at Parker that will differ from ads in Helena. Additionally, she said they have created rack cards detailing services at Parker that will be distributed throughout Lincoln.

Lisa Smith said it's also important for people to know they can come to Parker if they have a non-life-threatening emergency.

There are emergency appointments available as well as scheduled appointments, and Steeley said depending on the severity of the injury or issue, they may not have to go to the next level of care. But she also doesn't want to give the wrong impression. "It's not an emergency room. There are very limited on what they can do. They can triage a person and call an ambulance, which is usually what happens," she said. "We see cuts and head injuries and all kinds things all the time. We see cardiac patients all the time, not realizing that's what's happening."

Steely also put to rest a lingering question about dental service at Parker. In response to a question by Spath, she said it will not return.

"It had stopped before I started," she said. "We went back and looked at the data. Thirty percent of the dental visits were not completed. People didn't show up or they cancelled without warning."

She said that meant the dentist was coming up from Helena and not doing anything, which was not only expensive, but also increased wait times at the clinic in Helena, since it was left short a dentist.

Steeley said the review led the PureView board to decide against beginning dental service here again. "We don't want to have it fail and stop the services again."

Following the meeting, Steeley told the BVD that once the separation from the county is completed, they may actually be in a better position to expand services here.

"I think that it probably won't happen right away, but it sets us up to be able to apply for grants that are specific to nonprofits that we aren't eligible for right now being part of government," she said. "I just think there is a lot of potential there to grow and expand services by going on our own, just by nature of not being part of the local government structure, and being able to operate like private health care."

Relationship building questions

submitted by the Lincoln Hospital

District to PureView

 

Reader Comments(0)