It's no accident that San Juan County is one of the nation's healthiest.. here's why | Guest Column

San Juan County has one of the oldest populations in the state, which should make it one of the sicker populations, yet that is demonstrably not the case.  It is not a statistical aberration as it has been consistent for over 20 years, and it came about due to extremely hard and dedicated work by many individuals who set high personal standards and held themselves accountable to meet them.

It is absolutely not true that our county is ranked number one in the state year after year because sicker people move away.  While some people as they get sicker move away to be closer to family, it is equally true that Islanders move their relatives here for the same reason.  It is also true that the Convalescent Center often takes very sick patients that mainland Centers decline.  The numbers speak for themselves and are very impressive.

While we have one of the oldest populations in the country, we are among the healthiest.

Population %Over 65yo % Over 85yo

USA 12.6% 1.7%

Wash 11.8% 1.6%

SJC 21.5% 2.3%

It is not a great mystery about why our county is ranked number one in the State year after year.  30 years ago we started with a relatively low ranking which due to hard work and dedication quickly climbed to one of the best in the state, where it has remained for over 20 years.  The vision created by those physicians, providers and community members, that continue to give their time, is what makes this high ranking a reality for our county year after year. A brief summary of accomplishments illustrates the point.30 years ago the physicians of the county set up an Emergency Medical System with rapid response vehicles, paramedics and on call physicians, working with the Sherriff’s office for dispatch.

They set up an air medevac system and a ferry medical priority load system.  Our EMS protocols were years ahead of the American Heart Association Guidelines.  We were one of the first places in the country and the first in the state to administer the clot busting medications for heart attacks in an out of hospital setting, saving many lives.  At that time the majority of hospitals were still not using these treatments.  As a result we have a great emergency system and our out of hospital cardiac arrest survival record is the best ever published, as noted in the Wall Street Journal. Island Physicians have been involved in every aspect of the healthcare system, supporting the development of the mental health system, hospice, drug and alcohol counseling etc.

They have sat on the boards and supported the initial development of all of these systems. They have supported the development of the Adult Family Homes and helped assure that care in this setting has remained top quality. They have worked with the Public Health Office, the Prosecutor’s Office, Child Protective Services, DSHS and multiple other public agencies to help assure the health of islanders.With local physician leadership, our nursing home has been on the forefront of care, being the first in the State to use advance directives, which are now required throughout the country.

The Convalescent Center was one of the first in the State to have an Alzheimer’s wing.  It was the absolute first in the State that did not mandate feeding tubes for all residents, and for several years we had patients moving here from all over. Years ago when mental health funds were cut and residents were discharged from mental health institutions, our Convalescent Center took many of these frail and compromised patients when other institutions declined to care for them. Our physicians have been on the forefront of preventative medicine, offering consistent advice on smoking, diet, exercise, blood pressure, cholesterol and tight control of diabetes years before these became popular.  The continuity of care combined with an emphasis on good health and preventative medicine has shown huge benefits for the residents of San Juan County as evidenced by the percentage of the population over 85years of age.The physicians are not alone.  

Our county is blessed with extraordinary ancillary and alternative practitioners.  We have some of the best Physical Therapists, Chiropractors, Mental Health professionals, volunteer Hospice groups, Acupuncturists, Naturopaths, and Massage Therapist in the country.

I could go on and on and don’t intentionally mean to leave out any of the absolutely top notch people helping make up the network that supports good health. Lastly and perhaps most importantly we have one of the most supportive communities in the country. When one of our friends, family or a member of the community is in need, I have never failed to be amazed at how the community responds.  This is exemplified by the incredible number of groups that offer a helping hand. Just to name a few: Hospice, Dollars for Scholars and all the other local scholarships available to our students, The Thanksgiving Dinner and  Christmas events, The San Juan Eagles, the Red Cross, the Senior Center, Family Resource Center,  Homes for Islanders, American Legion, Lions, Kiwanis, Soroptomist and our Churches are all made up of wonderful individuals.

The list is long, the sheer number speaks volumes about our community.As a final feather in our cap, our Medicare cost per patient is among the lowest in the country.  Having the oldest population, best mortality and morbidity and low cost is not accidental.  It is an extraordinary accomplishment of which we should all be proud.It is worth reviewing these accomplishments:

EMS: 24-hour coverage coordinated with the Sherriff’s office, paramedics with rapid response vehicles.First in the USA to use early defibrillation in the field.First in the State to certify non-paramedic personnel to do defibrillation. One of the first level V trauma centers in the State.First in the State to do “clot busting” treatment in an out of hospital setting.First in the world in out of hospital cardiac arrest survival rates.Participation at the State level promoting expanded EMT roles and involvement in the writing of the training program for EMT use of these treatments.

Life Care Center of the San Juan Islands: First in the State to use advanced directives.First in the State to NOT mandate feeding tubes on terminally ill patients.One of the first Alzheimer’s units in the State.Caring for ill patients turned down elsewhere. With one of the oldest average patient ages in the Life Care system.

Medical Offices: Aggressive  preventative medicine including Mammography, Colonoscopy, PSA, Blood pressure control, Cholesterol control, diabetes treatment.  Cholesterol and Diabetes treatment results rate better than the Cleveland Clinic, praised by President Obama in July 2009 as a role model of cost effective, patient centered health care.Long term collaborative relationship with mainland specialists and attention to coordination of care.   Early adopters of Electronic Medical Records and Electronic Prescribing.Lower re-hospitalization rates than National average.

Ancillary Services: Superb Physical Therapy, Occupational Therapy, Speech Therapy, Chiropractic, Counselors, Drug and Alcohol treatment, Naturopathic, Acupuncture, Jin Shin, Massage Therapy, and other alternative treatments.Superb volunteer hospice.Superb visiting nurses.Superb adult family homes.

An Extraordinary Community:Too many great people and organizations to list

— Dr. Burk Gossom of San Juan Healthcare, San Juan Island



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