Local clinic says expansion of services not a matter of 'if' but 'when'
by: Marcus Hathcock, Jan Funk, a medical technician at Firwood Medical Center in Sandy, examines some X-rays taken of a fractured wrist. If the clinc expands its hours and days and becomes an urgent care facility, locals could have X-rays taken after business hours.

If a skier breaks her leg during the weekend, a skateboarder bumps his head or a jogger gets a nasty dog bite after dark, where do they go?

Almost always, the answer is Gresham, where patients will get bandaged at either Gresham Urgent Care near the corner of Highway 26 and Powell Boulevard, or they will make their way to Legacy Mount Hood Medical Center on Stark Street.

As the greater Sandy area continues to grow, local leaders and medical professionals wonder: Should local residents have to drive so far to get treatment?

'You can look at it two ways,' said Sandy City Manager Scott Lazenby. 'You'll find that a lot of cities our size in Oregon have to go a lot farther to get to a hospital. In that respect, we're lucky to have the choices we do, as far as non-emergency situations.'

On the other hand, he said, for basic, minor emergency care, there's a void in the Sandy area.

Phil Moyer - operations director for American Medical Response ambulance services in Clackamas County and a Sandy City councilor - says that with Mount Hood Medical Center in Gresham and a potential new hospital in Damascus coming in the next decade, the Sandy area is sitting pretty in terms of hospital care.

Instead, he said, a clinic that could treat 'less life-threatening types of conditions that wouldn't require hospitalization' would be a more appropriate option for the community.

'There's a lot of activity up and down the mountain, a lot of traffic through here from (all over),' he said. 'It's certainly a good idea to have something that can handle minor emergencies like simple fractures - something that had maybe some X-ray capabilities, orthopedic capabilities, lab work, maybe some type of diagnostic assessments that can't be done during the evening hours now.'

'I think we're a big enough city now that we need something a little closer than a 15-mile drive,' added Mayor Linda Malone. 'It would be nice to have a place in town where you could set a cast without having to drive over to Gresham or Sunnyside Hospital.'

Firwood stepping up

In the past, Lazenby and Malone have lobbied local clinics to get expanded medical services to the Sandy area. 'It probably wouldn't be a hospital, but an urgent-care type of thing,' Lazenby said. 'It would allow people if they had a health problem to come in on the weekend.'

They talked with representatives from Sandy Adventist Health Clinic and Firwood Medical Center to see if they'd be interested in expanding their hours to provide a level of urgent care for the community.

'We didn't want to go out and find a new office if (our local clinics) were interested in expanding their hours,' Lazenby said. Firwood Medical Center - the 25-employee doctors' office on Industrial Way - showed interest in the idea of providing urgent-care services to the community.

Although Malone and Lazenby first discussed the idea with Firwood Administrator Paul Nicholson about a year ago, the issue is still very much in the forefront of Nicholson's consciousness. He said as recently as last week he has been working out the details to see when - not if - Firwood could begin operating as an urgent-care facility.

'This is at a very high level on our agenda, and I'm very optimistic that it will happen,' Nicholson said. 'We think the community is growing rapidly, recognize deeply the absolute need for (urgent care) to happen here. We're 100 percent confident that it is going to happen, but there are still some details that have to be addressed.'

Details still being formed

While Nicholson said it's too early to predict exactly what urgent-care hours would look like, he said Firwood would be open later in the evening Monday through Friday and limited hours on weekends. Firwood Medical Center now is open 8 a.m. to 5 p.m. weekdays.

'If somebody breaks their leg up at (Mount Hood) Meadows, they could stop in Sandy instead of Gresham - a considerably shorter length of time,' Nicholson said. 'If people are working on the weekends and they cut a finger, sprain a leg, break a bone or whatever, we'll most likely be able to take care of them here in their home environment, and they won't have to wait hours in the E.R.'

Moyer said 24-hour urgent care would be ideal for the Sandy area, but at the very least, a facility should be open until midnight on weekdays with some limited weekend hours. That probably would reduce the number of calls his company receives, since locals would go to urgent care by private car rather than calling 9-1-1.

Challenges ahead

Adding hours and services would pose a few challenges for Firwood, the most daunting being staffing the clinic. Nicholson would need doctors willing to work nights and/or weekends as well as reception staff and medical assistants.

'It's a very difficult thing to accomplish because you're winding up hiring many more employees to be able to cover more hours,' Nicholson said. His concern is that instead of having new patients who would take advantage of the new hours, existing patients would spread out, which he said would spell financial disaster for the clinic. Instead, the goal is for new patients and urgent-care recipients to use those hours without compromising the existing client base.

As a privately owned and operated medical facility, Firwood needs a partnership with a hospital or larger medical group and/or some sort of government grant to bring expanded services to Sandy, Nicholson said. He added the clinic is in 'very serious talks' with a few Portland-area healthcare providers, although he declined to say which ones.

'It's a huge expense; it's something we're probably willing to embark on, but we need the security of some financial partner,' Nicholson said. 'We recognize the fact that if we spend more money than we bring in, we'll no longer be available here for all the other public we serve. We'll be bankrupt and gone.'

Nicholson said he doesn't know how long it will take for urgent care to materialize locally.

'I would say that it's something we're avidly working on and that it will happen when the time comes that we're able to provide this service in a quality manner that won't fail,' Nicholson said.

'Any time you rush into something, you know the consequences for it. We want this to happen seamlessly so it's something that will be successful long-term for the community.'

Malone said she's excited to see that Firwood still is seriously considering offering urgent care in Sandy.

'It will be a positive aspect of the community in regard to the medical services that are available,' Malone said. 'I think we're big enough to support it, and Firwood is already a trusted member of the community.'

'It's encouraging,' added Moyer. '(Firwood) has enough physicians there to take it on. They'll be able to do a good job for the community in broader terms than they are now.'

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