Journal of the San Juan Islands


Crisis in health care on San Juan? Indeed; here's why | Letters

June 11, 2014 · Updated 1:08 PM

As an interested and hopefully unbiased observer of the state of medical care on this island, I attended the May 2014 meeting of the County Council’s Board of Health.

At that gathering, I stated with some passion that we have a crisis in primary care on San Juan Island that is as least as important as the other “usual” issues discussed (argued about? evaded?).

This extends to but is not limited to women’s health care in general and mental health services for children and youth. The present cadre of primary care providers is dangerously shorthanded and are themselves approaching the end of their careers.

In the absence of strategic planning, within a few years there will be no primary care for our people.

The bigger issue is that the stakeholders—care providers of all persuasions, clients, government services, hospital districts, philanthropists, etc., each have their own agenda and do not talk to each other.

Grants or other catalysts are not prerequisites to begin real conversations. I firmly believe that if this had occurred several years ago there would be  a single group practice serving San Juan Island, a real system of care, and no hospital.

What has happened is the full manifestation of Edmund Burke’s iron law of unintended consequences: a toxic and inevitably fatal mix of private, public, and ecclesiastical institutions that do not address our collective needs and has left most of us out of the process.

There must be a stepping back, a significant correction, a change of the locus of control, and a community wide approach addressing our real needs. In this rapidly changing national medical environment coupled with our unique geography, costs, and demographics, the absence of a plan for remediation and a strategic vision for the future has placed us all at real risk.

The council and the town need to own this, not subgroups or vested interests, and lead the way.

My wife and I have just celebrated 10 years on San Juan Island. We love this place and are absolutely committed to the well-being of its people, as we are sure do all its residents young and old, rich and poor.

If not now, when? If not  all of us, then who?

Dr. Mark Fishaut/San Juan Island


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