By Kathleen Davis, MD
An important event will take place tomorrow evening at McMurray Middle School. It involves medical care on the island. I hope everyone will come to listen, learn and ask questions.
Highline Medical Center, which manages the Vashon Health Center, has affiliated with the Franciscan Health System. Highline is a secular institution, and the Franciscan Health System is affiliated with the Catholic Church.
Dianna Kielian, Franciscan’s senior vice president of mission, will be at the meeting to explain the advantages of the new affiliation and to respond to your questions, as will Highline Chief Executive Officer Mark Benedum. We are fortunate to have this opportunity to hear from them.
What do I want to learn?
The Vashon Health Center is by far the largest clinic on our island. And as a retired Vashon physician, I have a number of questions about what this new affiliation will mean for health care on Vashon.
Will this new arrangement mean increased accessibility for health care offered at our island clinic?
I see in this affiliation an opportunity to improve access to health care on Vashon. I expect that the Franciscans accept a wider range of insurance plans, making their facilities more open to islanders. The network also has a mission to care for people without insurance and of limited means, so more islanders may be able to receive health care on Vashon. I want to know if this is true.
What capital improvement projects can we expect as a result of this merger?
I have read that the Franciscans have already contracted to support an integrated electronic medical record system that is now required as a standard of medical care. The Vashon clinic also needs major building improvements, as well as other infrastructure upgrades. I hope the Franciscans are able to address these needs.
Will there be changes in the delivery of health care at the clinic and Highline Medical Center?
In providing care, the Franciscan Health System must adhere to a specific set of directives in its delivery of care — the “Ethical and Religious Directives for Health Care Services” written by the United States Conference of Catholic Bishops. It is no surprise that the directives forbid certain types of health care: contraception, abortion, some modern fertilization techniques and some options for terminally ill patients.
Will the Vashon providers be allowed to discuss and prescribe contraceptives and the morning-after pill? Will they be able to continue to offer vasectomies and refer patients for tubal ligations? In instances of rape or incest, what options will doctors be allowed to offer? How will the hospital respond to same-gender or infertile couples — married or not — who want to conceive children? If a patient has filed a health care directive stating that no “extraordinary” life support systems be employed, will hospital staff honor this?
If a patient suffers from a terminal disease and asks the doctor for help under Washington’s Death with Dignity Act, may the doctor help the patient through the procedure of getting a confirming opinion? (Two doctors must agree before the prescription may be written.) May the doctor help acquire the medications? Must a patient leave the grounds of a religiously affiliated care facility to take the medications?
If any of these services are not available through the Highline/Franciscan system, may a doctor tell a patient where to go to get the care? May a doctor in the system even mention the prohibited options? Will the hospital require all practitioners — both those who adhere to the religion as well those who may adhere to another faith — to follow the religious guidelines or directives?
These decisions are not easy under the best of circumstances. It may be that Highline and the Franciscan Health System have made arrangements to refer patients to another facility if necessary. Or maybe not. We need to ask.
Why do you need to come to tomorrow’s meeting even if you don’t use the Vashon Health Center?
The clinic provides the majority of on-island health care, so this new Franciscan affiliation will affect health care services across the island. Access to health care, including full prevention, reproductive and end-of-life services helps make a healthy community. We need to know if and how health care services will change with this new affiliation.
I hope you will join me tomorrow to learn the answers and ask your questions.
— Kathleen Davis is a retired primary care internist who works in public health on Vashon and globally
A public meeting on Highline’s affiliation with the Franciscan Health System will be held at 7 p.m. Thursday, April 25, at McMurray Middle School.
