Admitting it was a hit right out of left field, Judith Wiley insists the resignation earlier this month of physician Janice Owen and two nurse practitioners is but a temporary setback for the CEO of Central Community Health Centre.
As documented in this corner two weeks ago, Owen jumped ship amidst claims of ineffective management and the sense she was churning through clients with less than half the funded complement of clinical staff.
Sitting down with City Scope on Wednesday at the Talbot Street centre, Wiley said it is imperative she and her staff not take Owen’s comments as a personal attack.
“You can’t take this personally,” Wiley advised. “You cannot take your eye off the big picture. And, I think that’s one of the strengths I bring to the agency. I know what we’re going to be when we’re up and running successfully.
“And, I know how important this is to the community. This community is unique in how people care and how agencies come together. We’ll come out stronger in the end.”
Wiley stressed the CCHC is different than a medical model, “and that’s what distinguished us. It’s a multi-disciplinary model where a whole team of people are responsible for your care.”
To date, the centre has registered 471 clients, with 242 of those actively managed by staff.
So, was Wiley unresponsive to Owen’s concerns about a rapidly climbing client intake in the two months the centre has been open?
“We’ve had a hiring strategy in place looking for additional people, but what we did was freeze it (client intake) at 242 quite some time ago because the numbers were much larger than we anticipated.”
What is particularly galling to Wiley is she was attempting to deal with Owen’s message that there were “serious safety concerns for patients of the Central Community Health Centre,” as outlined in her letter of resignation to the board.
“Two days before they resigned we had a staff retreat at which point Dr. Owen was complaining about the caseload. And we developed a multi-disciplinary team, three people, to look at it. We all agreed we would do this, it had priority.”
So, was Owen the right fit for their team-oriented philosophy?
“She was recommended by one of the nurse practitioners, they had worked together. And, certainly we were hopeful. And, very disappointed when she left.”
However, as Wiley added, Owen’s days at the centre were likely numbered in any event.
“She was on sabbatical this year and could only give up two days a week and it was always understood it was temporary. So we never looked at her as the foundation (on which to build the rest of the clinical team).”
Let’s cut to the chase, was Owen a difficult person for staff to deal with?
“I don’t know how to answer that. I don’t think so. I think people are pretty generous with their time and understanding. We hold each other accountable, so that in itself is an interesting dynamic.
“The toughest thing is to break down the sense of a medical model and understand that . . . we’re part of a whole team. The model only works when all the players are working corroboratively and respectfully.”
Do you get the implication Owen might have been the square peg in a round hole?
Concerns raised by the London physician that numerous staff were “unaware of how to process patient reports in a timely manner,” and furthermore, were “inexperienced in community health centres or primary care offices,” are a mystery to Wiley.
“I just absolutely don’t know where’s she’s coming on that. Both of the medical secretaries have more than 20 years experience each in very busy offices. I know they have been very responsive to any suggestions. They are very well received by the clientele. I simply don’t know where she’s coming from on that.”
In any event, Wiley assures, the clinic is open for business and the hunt is underway for replacement staff.
“It’s a challenge, we have three (family physicians) at the moment who are considering coming on board with us. And we have two residents who finish in July who are adamant they want to come on board. So, we may have a stroke of luck. ”
Wiley is confident the introduction of a mobile clinic will prove an attractive drawing card for the CCHC. The clinic, similar in concept to a bookmobile, will traverse the county with a fixed schedule of stops in communities.
“We will have a mobile clinic in place before March 31 and ultimately somewhere between 1400 and 1800 clients.”
To meet the need, Wiley anticipates a roster of 19 staff, three full-time equivalent physicians, two nurse practitioners and two RNs.
“The ultimate goal is to take pressure off walk-in clinics and the emergency room. Ultimately the goal is there will be no people out there who don’t have access to healthcare.”
QUOTE OF THE WEEK
“I think we’ve got a lot of room for change and we certainly feel when you’re at the bottom, you’ve got no place left to go except up.”
Bill Fehr who is seeking the Progressive Conservative nomination in Elgin-Middlesex-London for the October provincial vote.
City Scope appears every Saturday in the Times-Journal. Questions and comments may be e-mailed to: firstname.lastname@example.org.
I would like to address some of the inaccurate statements quoted by Judith Wiley, the executive director of the Central Community Health Center in the article entitled “Community health center takes a hit from left field”.
Ms. Wiley stated that my “days at the center were likely numbered”. I started my position as a part-time physician at the Central CHC in October, with every intention of increasing my time at the Center after I completed some other work committments. I had originally intended to start working at the Center in January, 2011, but the CHC had hired three excellent Nurse Practitioners who were ready to start seeing clients and needed a physician on board before they could begin. To that end, I agreed to start on a part-time basis so the CHC could start enrolling people who needed the services offered by the CHC. Ms Wiley was aware of this and so I am quite surprised by the comment that my time at the CHC was always understood to be only temporary.
I would also like to state that I opted to join the team at the CHC because I was excited to work in a multidisciplnary service delivery model of care. I had suggested to the staff at the retreat that we needed to shed the concept of the tradional “medical model” of care delivery and have all allied health care personnel and the health promotion team involved in the client intake process. I had worked in a multidisciplinary care setting previously and saw the benefits first hand.
Unfortunately, my confidence in managment’s ability to develop a safe place for people to receive care was shaken on many occasions with the final straw being the lack of an urgently needed decision to stop seeing new clients until we were able to deliver safe effective care to the ones we had already started a clinical relationship with. The committee approach she suggested for making this decision would have worked if it were not for the subsequent illness of two of the three members leading to further delay of the decision. At a time like this, management needs to step up to the plate, do what’s best for the patients already enrolled, and stop taking on new patients until the current patients are effectively cared for. Despite that fact that Ms Wiley said that a freeze was placed on client intake, I can assure you that even after I requested a halt to taking on any new clients and after myself and the nurse practitioners all handed in our resignations because our concerns regarding safe effective care were not being addressed, previously unseen clients were still coming in and giving their medical histories to the registered nurse with no assurance that anyone would be able to attend to their health concerns in a timely manner.
Janice Owen, BA, MSc, MD, CCFP, FCFP