The prospect that there is a move afoot to switch providers at the Point Roberts health clinic from the current SuperTrack Urgent Care to another, seemingly less capable, operator has continued to spur concern amongst clinic patients since the district’s regular monthly meeting in May.
According to superintendent Barbara Wayland, the hospital district has received 22 letters regarding the clinic, 18 of which were in support of SuperTrack. Of the four letters against, two of them involved hearsay or third-party criticism.
Around three dozen people had showed up in person or by Zoom at the Point Roberts hospital district’s regular meeting at the community center on May 8, apparently fearful that two of the three commissioners wanted to replace SuperTrack Urgent Care, the current operators of the local health clinic on Benson Road. The concern was sparked by a posting on May 5 of an article on the Small Point Bulletin (smallpointbulletin.com), an online blog owned by Vic and Shannon Riley. (The blog has no connection with the All Point Bulletin or the ePointBulletin.)
Following a presentation by Dr. John Anwar offering his services as a potential replacement for SuperTrack at the board’s April board meeting, Vic Riley made an extensive Open Public Records (OPR) request to the hospital district. In it, he asked for copies of communications between board chair Stephen Falk and district superintendent Barbara Wayland involving meeting agendas, Dr. Anwar, fellow commissioner Sara Oggel, Deb Shields and her family (Shields, a physician’s assistant, has previously sought to operate the clinic and is part of Anwar’s recent proposal), and Virginia Lester (a nurse practitioner who used to work at the clinic).
Riley made a similar request for all communications between those listed above and commissioner Sara Oggel as well as those with superintendent Barb Wayland. (Note: the All Point Bulletin subsequently made an OPR request for the materials supplied to the Rileys.)
The result of Riley’s OPR request was a startling revelation of undisclosed meetings, violations of the Open Public Meetings Act (OPMA) and communications involving commissioners Falk and latterly, Oggel, in ongoing attempts to help Shields obtain the contract to run the clinic beginning in 2020 and remains ongoing. In doing so, Falk sought to keep the district superintendent unaware of his efforts.
On May 2, Wayland discussed what had been learned from the OPR request with Matthew Ellsworth, executive director of the Association of Washington Public Hospital Districts. In response, Ellsworth told Wayland that he was “very concerned about the practice of commissioners conducting district business outside of public meetings. If one commissioner wants to educate themselves on a matter one-on-one with a party, that is allowed with the understanding the RCW is explicit that one commissioner has no authority to obligate, contract, or act on behalf of the district.
“My concern is that it appears that two commissioners are communicating with an outside party about doing business with the district. This is a clear violation of the OPMA. Even if the two commissioners’ discussions are not simultaneous/same conversation.”
Wayland sent Ellsworth’s assessment to all three commissioners, adding that Ellsworth had offered to do a presentation on the OPMA. By law, commissioners are required to undergo training on the act when they assume office and every four years thereafter.
A common theme running through the letters recently received by the hospital district is a comparison between the services currently offered by SuperTrack versus what Dr. Anwar’s group would be able to provide. Currently, SuperTrack has three MDs each working one day a week as well as a registered nurse. Dr. Anwar, a part-time resident of Point Roberts, is an internist meaning the clinic would not be able to provide medical services to patients under 18. Deb Shields is a physician’s assistant as is another possible staff member. Both would be working under Anwar’s supervision and are unable to offer services beyond his sphere of expertise.
Lucy Williams, whose husband Dick was chair of the hospital district, questioned the reasoning behind replacing SuperTrack with the Anwar group and asked, “If there is a reason for this idea, the people of this town need to hear it, otherwise please sideline this insanity before people lose local access to their doctors.” The All Point Bulletin reached out to all three commissioners to ask them that question. Only commissioners Falk and Newbolt replied; Oggel did not respond.
District chair Stephen Falk said, in part, “At this point, the hospital district has heard about what medical services Dr. Anwar is currently offering in Point Roberts. We have not really heard what services he would be proposing to offer if given the opportunity. In order to persuade the district board to make a change, he would have to show us what he would offer and how he would accomplish that, not just with respect to the main health care providers, but also with respect to “back office” issues relating to finances, insurance, support staff, etc.” He added, “Supertrack’s physicians come to Point Roberts one day a week. I am sure, as good physicians, they are dedicated to their particular patients. But I do not see a deeper commitment to the community as a whole. I have long felt that health care providers who live here may have or develop a greater commitment to the community.”
Asked what reasons the district had for opening up the contract to other providers, Newbolt answered, “There are no reasons at all. SuperTrack, in my opinion, has gone above and beyond their contract in bringing in three doctors and a registered nurse who can and does supply antibiotics and other meds, can and does take blood samples which eliminates some patient’s trips down to Bellingham and gives excellent treatment and care to the residents of Point Roberts.”
The district’s regular monthly meeting on June 12 is the last meeting before the June 30 deadline where either SuperTrack or the district would have to notify the other party if they did not want to renew the annual contract or solicit competing bids for service. Both Falk and Newbolt (and Oggel) were asked if or how they would vote if a motion to open up the contract was made at that meeting. Falk said, “I am not sure whether I would offer that motion, or whether I would vote in favor of such a motion. I am concerned about the issues I have described above, but I am also aware of the relationships that some members of our community have developed with their physician, particularly, it seems, the Thursday doctor. Ever since Dr. Anwar made himself known to the hospital district earlier this year, I have struggled with those competing issues – the desire to learn about other options and the concern about disrupting residents’ relationship with their current provider.”
Newbolt wrote, “If a motion is presented, I would definitely vote for the contract to roll over. No question! SuperTrack’s contract period is currently on a year-to-year basis. I would actually prefer a 5-year contract. The commissioner position is to serve the residents of Point Roberts with the best health care situation we can and to listen to the people of the community and pay attention to what they are asking for. I believe that has been accomplished with the SuperTrack contract and it would be a disservice to see them leave Point Roberts particularly for another entity that isn’t offering anywhere near the expertise and services that we now have. I believe the people of Point Roberts have spoken and do not want to see SuperTrack leave.”
As noted previously, Oggel did not respond to the request for comment. A copy of Falk’s and Newbolt’s complete responses to the All Point Bulletin’s questions may be found below. The original story may be found here: Hospital commissioners get message loud and clear – no changes needed | All Point Bulletin.
Noel Newbolt:
APB: Can you think of any reasons why the district should consider opening up the contract to other providers?
NN: There are no reasons at all…Super Track, in my opinion, has gone above and beyond their contract in bringing in three Doctors, an RN, can and does supply antibiotics and other meds, can and does take blood samples which eliminates some patient’s trips down to Bellingham and gives excellent treatment and care to the residents of Point Roberts.
APB: The June 12 commission meeting is the last one before the June 30 deadline to notify SuperTrack that the district does not want the contract to roll over and would like to solicit competing bids. Should such a motion be presented, how would you vote?
NN: If a motion is presented, I would definitely vote for the contract to roll over. No question! SuperTrack’s contract period is currently on a year-to-year basis. I voted prior to have the one-year term changed to two years. I haven’t changed my mind on that and I would actually prefer a 5-year contract.
The commissioner position is to serve the residents of Point Roberts with the best health care situation we can and to listen to the people of the community and pay attention to what they are asking for. I believe that has been accomplished with the SuperTrack contract and it would be a disservice to see them leave Point Roberts particularly for another entity that isn’t offering anywhere near the expertise and services that we now have. I believe the people of Point Roberts have spoken and do not want to see SuperTrack leave.
Stephen Falk
APB: We have received a number of letters to the editor regarding SuperTrack and Dr. Anwar’s expression of interest in taking over the Point Roberts Clinic. Some of the letter writers have raised the question, why would the hospital district bother to consider Dr. Anwar’s ‘proposal’ given the disparity between his organization’s capabilities and those of SuperTrack’s? (Chief among the advantages cited are the three doctors and RN on duty, their wide range of expertise and experience, their ability to offer urgent and regular care, telemedicine etc. All of these are then compared to Dr. Anwar’s team and raise the point that he would be part-time, is only qualified to treat patients over the age of 18 and so on and so forth.)
I think it’s a fair question worth asking – would you like to take a stab at answering it?
SF: At this point, the hospital district has heard about what medical services Dr. Anwar is currently offering in Point Roberts We have not really heard what services he would be proposing to offer if given the opportunity. In order to persuade the District board to make a change, he would have to show us what he would offer and how he would accomplish that, not just with respect to the main health care providers, but also with respect to “back office” issues relating to finances, insurance, support staff, etc.
Why would we even consider it? I think that involves a multi-factor response.
1) Before I came to Point Roberts, all of my medical care had been by physicians. That, together with coming from a family of physicians and would-be physicians (2 grandfathers, 1 brother, and a father who would have become a physician, but for the rise of Nazism in Germany and then some less fatal antisemitism at McGill University), must have given me a prejudice in favor of physicians. However, the success of the Point Roberts Clinic from the time of its founding rested on health care from non-MDs. Once here, I quickly dispensed with my earlier prejudice and recognized the quality care provided by APRNs and PAs.
2) In its second contract in 2020, SuperTrack “upped the ante” by committing to provide physicians for the clinic. That was appealing, but their choice to provide 3 days of service per week with 3 different physicians has always struck me as bringing SuperTrack’s “urgent care” model to our primary care practice. If you have chronic conditions and can schedule your care in advance, you can pick your day of the week and see the same physician each time. But if you are an occasional user of health care or have an unexpected medical issue, there is a good chance you will not see your regular provider. That has troubled me since the new contract was implemented in 2021.
3) SuperTrack’s physicians come to Point Roberts one day a week. I am sure, as good physicians, they are dedicated to their particular patients. But I do not see a deeper commitment to the community as a whole. I have long felt that health care providers who live here may have or develop a greater commitment to the community.
For those reasons, as well as issues we periodically hear about instances of poor service, I am willing to hear about alternatives to our current provider.
APB: While you’re in the swing of things, here’s another one. It’s clear from seeing the response to our OPR requests that you have been helpful to both the Shields and Dr. Anwar in several ways in their effort to gain the clinic. I am not characterizing that assistance one way or another but it is clear that your assistance, at the very least, was not widely known by the public and this lack of transparency could be perceived as evidence that you are biased towards those parties and therefore you should recuse yourself from any discussion or vote on not renewing the SuperTrack contract effective June 30, 2024. How would you respond to a request that you recuse yourself from such discussion and/or vote?
SF: I would think that to be biased in favor of an alternative provider for the clinic, I would have to have some interest in the outcome, other than the greater good for Point Roberts. I have no such interest. I have no personal, financial, professional, or social connection to Deb Shields or to Dr. Anwar. I would consider the discussions I have had with them to be the same as I would have with any member of the community inquiring about the clinic or the hospital district. I have described how the district operates. They can then make their own decision on whether to approach the district with a proposal, and when.
I do not see any basis to recuse myself from any actions or decisions by the hospital district board. As noted, I have no interest or conflict of interest regarding the outcome. And, hard as it probably is for some members of this community to believe, I am not sure how I would vote on a motion not to renew the current contract. And if that step were taken, I could certainly not predict today whether I would select SuperTrack or Dr. Anwar (assuming they were the alternatives) to be the provider for 2025 and beyond – we haven’t heard the proposals that that decision would be based on. I am, in fact, completely open-minded on that issue.
APB: In my review of the OPR response, I have seen very few examples of client complaints against SuperTrack and its employees – you were copied on the few that I saw. Other than that, do you have concerns about how the clinic is being operated by SuperTrack and if so, can you explain what they are?
SF: I have always been concerned about complaints about SuperTrack that have reached the hospital district. Some have involved the quality of care, others have concerned support staff issues or billing related issues. However, I am equally concerned about the complaints we are not receiving. It has been clear from the start that clinic patients who have had what they perceive to be poor quality care (either in the care received or how it was delivered) are very reluctant to come forward. Most want to remain anonymous because they are voicing dissatisfaction with the same practice (and doctor, if they happen to hit the same day of the week) they are going to have to see again the next time they need care. This creates a bit of a “Catch 22” because our superintendent chooses to discount all anonymous complaints as inherently unreliable simply because they are anonymous. While it could be possible to game the system under the shadow of anonymity, I certainly do not believe that that has happened to date with any of the complaints we have received, and I do not believe our community members would engage in that “mischief.” (In addition, if we had a flood of anonymous complaints, I think we would take steps to try to ascertain whether the flood was genuine or contrived.)
APB: The June 12 commission meeting is the last one before the June 30 deadline to notify SuperTrack that the district does not want the contract to roll over and would like to solicit competing bids. Do you intend to offer such a motion at that meeting?
SF: As noted above, I am not sure whether I would offer that motion, or whether I would vote in favor of such a motion. I am concerned about the issues I have described above, but I am also aware of the relationships that some members of our community have developed with their physician, particularly, it seems, the Thursday doctor. Ever since Dr. Anwar made himself known to the hospital district earlier this year, I have struggled with those competing issues – the desire to learn about other options and the concern about disrupting residents’ relationship with their current provider.
The misinformation and disinformation that has been disseminated to the community has only complicated my decision-making process. I am trying to make my decision based on the factors that matter to me. And specifically, not to make my decision out of spite or as a result of intimidation. Ultimately, I may never be able to truly know how I came to my final decision, but I will do my best to make it for the benefit of the community, and not in reaction to the manufactured controversy.
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