Local hospital adopts new model

Healdsburg Primary Care expands role for nurse practitioners at HPC
Amid rumors circulating about changes ahead for Healdsburg Primary Care (HPC), hospital officials have confirmed that HPC’s services will shift to a more collaborative model that expands nurse practitioners’ role in providing patient care.
The new model adheres to what local hospital officials describe as a national shift in the provision of healthcare. In addition to the cost savings associated with the model, it allows healthcare workers to provide coordinated services in light of a physician shortage in family practice and internal medicine that is being felt both locally and nationally.
In response to questions from The Healdsburg Tribune, Healdsburg District Hospital CEO Nancy Schmid outlined the respective roles of nurse practitioners and physicians under the new collaborative model: “The nurse practitioner diagnoses and treats minor illness and care of a well-defined single problem with standardized treatments,” she said. “The physician cares for the more complex and complicated patients with disease not limited to a specific disease condition or medical intervention.”
Schmid explained that nurse practitioners would follow patients through the course of treatment for illnesses within their purview, referring patients with more complicated health concerns to physicians.
Schmid also commented on local patients’ difficulties securing appointments with internal medicine and family practice physicians. “You cannot get an appointment because there is a shortage of primary care doctors, and it’s getting worse,” she said. “This is not a new issue – this is a long-term issue that has been going on. Many health systems have already addressed this.”
NSCHD Board Chair William Esselstein also pointed to national trends as motivation for the shift in HPC’s model, which has in his opinion already been adopted with positive results by such institutions as Kaiser.
“My sense is that the practice model that’s being considered and moved towards is very common in many other settings and my sense is that Kaiser, among others, does that just as a matter of course,” Esselstein said. “…They are regarded with a great deal of respect in how they manage healthcare and do a good job on the whole.”
Esselstein also pointed to cost savings as a factor that influenced the decision. “There’s a cost savings there which is of benefit to everybody,” he said.
In addition, Esselstein said the expanded role of nurse practitioners gives HPC a wider pool to draw from when recruiting caregivers and commented on the long waits that patients must endure in order to meet with their physicians.
“I think it’s a serious issue,” he said. “In our community people have always, since I’ve been in the area, had concerns about getting prompt access to care when they felt they needed it.”
Schmid also confirmed that HPC will continue to recruit additional family practice and internal medicine physicians and nurse practitioners, and that an additional family practice physician will be brought on in February of 2015. Schmid could not comment on the respective number of nurse practitioners and physicians that HPC intends to hire.
“Change is a difficult adjustment for everyone,” Schmid said, “but we believe the model we are striving toward will only benefit our patients, and we will do our best to make changes at HPC seamless to our patients.”
The above changes were disclosed amid rumors about the potential closure of Healdsburg Primary Care and questions about personnel changes.
While Schmid said she could not comment on the reasons for any staffing changes at HPC, she did confirm that one physician, Dr. Locke Wilson, will be leaving. Dr. Wilson could not be reached for comments about his reasons for leaving HPC or his next professional endeavor prior to publication.
Schmid said the upcoming changes will not affect HPC’s status as a hospital-based clinic.