Saturday, July 28, 2007

A Model to be Looked At?

Mark Woodring has referred me to an article in the July 9, 2007 issue of the Los Angeles Times, which includes a report of an interview with Dr. Donald Klitgaard of the Harlan [IA] Clinic.

The 9-physician Harlan Clinic is part of the Myrtue Medical Center (MMC) of which Woodring is CEO and Klitgaard is Chief of Staff. MMC also includes the 40-bed Myrtue Memorial Hospital (MMH). It provides high quality, low cost care to the 13,000 residents of Shelby County, some 5,000 of whom live in Harlan, its county seat.

Harlan is my home town (we still maintain a small home there) and Klitgaard’s father Don and I attended Harlan High School together.

The LA Times article was about picking a doctor. Klitgaard was interviewed because the Harlan Clinic is one of 36 family practices participating in a performance study being sponsored by the American Academy of Family Practice. The study is scheduled to run through 2008.

I have watched MMC develop over the years under the uncommonly capable leadership of Woodring and his predecessor Steve Goeser. It is a single corporation that employs the physicians of Harlan Clinic as well as the staff of MMH. It is of manageable size with low overhead and impressive operational flexibility. It refers patients in need of specialty care to larger facilities in Omaha, Nebraska, some 50 miles away, from which a number of specialists travel to MMC to hold clinics on a regular and scheduled basis.

It seems to me that MMC offers a model that ought to be looked at as part of the health system of the future. Now that protocols and quality reporting are relatively well established, clinical performance could be readily monitored. I see no reason why the model could not function in urban as well as rural areas. It could be a sort of McDonald’s of health care, offering basic health services safely, at a high level of quality, and at reasonable cost.

In the past, all the glamour in health care has gone to the big urban teaching hospitals and little attention has been paid to institutions like MMC.

Maybe that ought to change.

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