Q9 Acute Care for Who

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We asked who should receive Acute Care assistance AFTER clinic hours and provided an opportunity for comments.

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Comments regarding who receives Acute care AFTER clinic hours.

For WhoComments
xnone of the above
xthere is always the fire station ...
xThey should contact the Fire Dept./ if needed they can be flown off
xWe already pay the fire department to offer this service! Including a doctor to discuss options on the phone!!
xIs this not where the EMT can work with the clinics?
xMedical Emergencies=911, Acute issues generally can be handled same or next day. Uncontrolled acute issues like uncontrolled bleeding are already being handled after hours if not 911 appropriate. We live on an island and accepted the fact when we arrived that there are certain things that cannot be done on an island.
xI don't have an informed opinon about this.
xI really don't know on this one. Wonder how the partnership with EMS fits in and their take on it?
For patientsMaybe an extra fee if no-residents.
For patientsOrcas Family Health provides this already with PAs and MD, as part of their care. Tell me why UW cannot. It is a VERY small patient population!
For patientsWe do have an excellent EMT service
xDitto fhe above
For patientsUntil such time as there is a single clinic AND pricing for non-residents can cover their costs
For patientsI don't want to pay the costs involved to make acute care available after hours. My wife's mother broke her arm in a fall and had to wait until moring to catch a ferry. That solution worked fine. Living on Orcas Island and paying lower taxes has broad appeal. We don't need or want to turn Orcas into a suburb with every possible service available. The way it works now is fine and should not be expanded because people who have lived in area with more services want after hours acute care here. Buck-up campers! We don't need to staff an urgent care unit for after hours non-emergency treatment. Now, if some group wants to fund that themselves, fine, but I shouldn't have to pay for it.
For patientsEMTs should cover this.
For patientsI don't want acute care at the clinic at all !
For patientsEMS can provide the needed prompt attention to others.
For patientsBeing registered gives clinic a way to bill patients insurance or cash
Only residentsYes, since we the property owners via property taxes are paying the full price of this service.
For patientsacute care after hours is difficult to manage. Drs often forget to get the info needed for the billing and those type of visits end up not being paid for.
Only residentsSee comments above
Only residentsThis is the way it is the city. Tourists go to ER. I am concern that having on call MD that doesn't have the history of the patient is problematic.
Only residentsPref should be given to registered UW patients
Only residentsNon-residents might have to pay to offset higher costs to receive equal access to residents?
Only residentsIf they are paying the taxes, they should receive the care they are already paying for. If you add on a fee for the actual cost of the service, not the cost beyond taxes, but the two costs together, and collect that before service, then treat anyone, but preference for those supporting the clinic through taxes, and the others as timing permits. Also only the cases that would likely not be flown off anyway. There is no sense to a doctor here coming in to send a patient to a hospital elsewhere, when the Paramedics here have been performing that function adequately for many years.
Only residentsGuests and visitors too but not if capacity overwhemed and they must pay for services
For everyoneYou can?t discriminate without creating potentially dangerous situations.
For everyonewith fee for non-clients
For everyoneWith surcharge for non residents.
For everyoneYes!!!!!!!!!
For everyoneYes, it seems that troubles such as trouble with children breathing, severe cuts to the face, broken bones, and extended high fevers are just part of life and they arent confined to business hours.e
For everyoneThe acute care rate for non-residents should have a 'public health district' surcharge.
For everyoneTriaged
For everyoneVital
For everyoneWhat is Acute Care? Define your terms so we know what we're talking about here.
For everyonewith an access fee for non-residents
For everyonewith an additional "convenience fee" to help pay for the additional staff hours this would need
For everyoneSince there is no emergency room, acute care is necessary for this island. Some "acute care" can become life-threatening or damaging if put off. I.E. an elderly or pregnant patient with a bladder infection; lacerations (which must be sutured within 12 hours), etc. To not offer acute care services after hours here is both poor patient care and an increase in liability.
For everyoneSee above comment.
For everyoneSee answers to 6, 7 and 8 above.
For everyoneSee comment above on appropriate fee scale and availability to residents and non-residents.
For everyoneSee comments above
For everyoneSame as above.
For everyoneFor everyone, regardless of residency or being a client
For everyoneFor everyone, regardless of residency or being a client
For everyoneSame full ride - patient bears full costs
For everyoneSee above
For everyonesame as above
For everyoneSame as above.
For everyoneNon-residents and non-patients should pay full price at time of service.
For everyoneSame answer initially only to clinic patients then I felt it was best for the community that Cute care should be available to everyone
For everyoneIt's hard to envision denying services to someone in dire need regardless of his or her place of permanent residency.
For everyonelife saving
For everyoneNeed to consider what acute care is available from Fire Dept
For everyoneIf off-island will pay appropriately
For everyoneI'm assuming we are working with the OIFR. I mean we can't tell the child who cut off his hand that he is an out-of-towner, sorry!
For everyoneIn addition to the comment above, I feel that service to tourists and other visitors would qualify the clinics to request funds from the lodging tax to support facility improvements. Worth a try?
For everyoneInclusivity
For everyoneIs there a way lodging tax monies can contribute?
For everyoneIsn't this a hypocratic oath issue?
For everyoneIf not a resident or registered patient there should be an extra/premium charge
For everyoneI'd hate to travel somewhere and be told only locals are given that level of care.
For everyoneIf care should occur immediately and not wait for next ferry travel.
For everyoneIf it's acute, I'd call 911, so unnecessary
For everyoneI want Orcas to have a 24-hour, 365-day Emergency Medicine Facility.
For everyoneI think if service is for everyone on the island then property ownership taxes are unfair. It should include a sales tax part. Also a fee tacked on to the ferry and camp ground users if they get to use the services (tax the tourist )
For everyoneI really think there should be priority to residents and registered patients
For everyoneI telephoned for a neighbor with an acute care problem and was told that maybe someone could call me back later that day, We drove the individual off-island and took her to a medical facility near Seattle where she was sen in an ER, admitted to the hospital and had surgery the next day. This is a disgrace to all citizens of Orcas to be treated in this manner.
For everyoneI answered for everyone but this question really needs to have a price tag associated to it. What we pay for needs to be island appropriate. The commissioners projected a $0.55 to $0.60 levy rate and they need to live within that projection. I am grateful that that the UW is here and appreciate their services.
For everyoneFor the on-call MD at the clinic to triage and see patients as they deem necessary, otherwise EMS.
For everyoneHow much money to cover this?
For everyoneHIPPOCRATIC OATH
For everyoneBut this will require someone to evaluate whether Acute Care is really called for.
For everyoneCould be a patch-thru from EMTs. I thought benefit of joining with UW was access to tele-doctors at all times.
For everyonedepending on severity of injury - no one should be exempt from urgent care
For everyoneEMTs
For everyonefor non locals, their insurence should pay full cost.
For everyoneA possible example - a grandchild's sudden earache among other things - since we don't have ready access to a hospital emergency room, I would hope a clinic doc might see him/her.
For everyoneAt least by phone or online
For everyoneAnother hard choice. The final decision should include EMT input
For everyoneAcute Care needs are needs, period.
For everyoneAcute is acute
For everyoneAfter triage with nurse, specially if there is bleeding or broken bones
For everyoneAgain I think for everyone
For everyoneagain partner with ems and 911 to cover need,Comunity para medicine where the provoider does house calls
For everyoneAgain, it will be difficult to exclude non-residents and residents who are not patients.especially for incidents that occur after the last ferry.
For everyone Non-residents must pay extra to fund added staff.
For everyoneA majority of island visitors who might require acute care probably have insurance or the ability to pay.