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Clinic leaves town for now

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The Wright State physicians who operate the Yellow Springs Family Health Center at the corner of Xenia Avenue and Herman Street are temporarily relocating to Greene Memorial Hospital in Xenia at the end of next month. According to health center Medical Director Cynthia Olsen, she hopes to unyoke the practice from a rapidly deteriorating facility and raise funds for a smaller, more efficient building in the same location as the original.

The Yellow Springs Family Health Center has not been profitable for several years, Olsen said in an interview this week, and the practice operates in a building that is 50 years old and has many maintenance problems and space inefficiencies. But Olsen and her staff are committed to continuing the kind of community-based family healthcare they currently provide for 4,000 unique patients from the Yellow Springs, Xenia and Fairborn areas, she said. It is her hope that with enough support from individuals and businesses in the immediate area, as well as state and other public grants, the community will be able to build a new structure that serves its healthcare needs.

“I’m an optimistic person, and I’m optimistic that we can do this based on a number of supportive people I’ve spoken to — and people who have given verbal commitment to the project,” Olsen said. “We’re committed to wanting to stay here and be in the community.”

A new 11,500 square foot clinic could cost an estimated $2.7 million, according to a preliminary plan drawn by a Beavercreek architectural firm. The new clinic would provide the same services as the current one, including adult and geriatric care, children’s services and small procedures with laboratory and x-ray facilities in the building. And it is Olsen’s hope that within two years, construction on the new clinic could be underway.

Wright State is the public university that owns the health center and employs the physicians as part of its Family Medicine department, but the university cannot afford to finance the construction of a new facility in Yellow Springs, according to Howard Part, dean of the Wright State University Boonshoft School of Medicine. Especially with the recent economic downturn, the university “can’t take a loan out and go into debt for this project — we’re not in a position to do that,” he said. The school’s 13 practices currently operating in hospitals and clinics throughout the Miami Valley region are all expected to provide quality care in a cost-effective manner. But the Yellow Springs health center cannot do that in a building that is close to “falling apart,” he said.

The health center operates in a 20,000 square foot facility that was built 50 years ago and housed the Fels Longitudinal Study for many decades along with Wright State’s Lifespan Health and Research Center after the university acquired the building in 1979. But after Fels moved to Miami Valley Research Park in Beavercreek in 2000, the building was not utilized to its fullest potential.

The building is very expensive to heat and cool, and its long hallways and oversized spaces make it an ineffective use of space, Olsen said. The concrete is failing, the boilers cannot be fixed and the building suffered a water main break this past spring that forced the clinic to close for three days. The university’s engineers have evaluated the structure and have concluded that building new would be more cost effective than renovating, Part said, adding that he wondered if the current structure would withstand one more winter.

The clinic has also suffered a loss of patients. In 1997, the center received an average of 13,000 patient visits per year, according to the medical school’s archives. Last year, according to Olsen, the Yellow Springs clinic received 11,000 patient visits, which was before part of the practice involving Dr. Little and Dr. Bell moved to the Ollie Davis Medical Center in Dayton six months ago.

The practice’s profitability issues are also related to the fact that the Yellow Springs Family Health Center sees an average of 66 percent Medicaid and Medicare patients, a statistic that is higher than most other clinics in the area, including those operated in partnership with Wright State, both Olsen and Part said. The Yellow Springs clinic sees referral patients from social agencies and self-referral patients who have delayed medical care for financial reasons and are very sick but can’t find a physician who will take them. The local clinic also sees every new child in the Greene County Children Services system within 48 hours of referral, and “it’s part of our mission to make sure those children are cared for in a sensitive, gentle way,” before they are jettisoned into foster care, Olsen said.

With job loss on the rise and the economy still stalled, the number of uninsured or marginally insured patients is only increasing.

“We’re an important support for the more frail and ill patients within the community, and we’re real proud of that,” she said. “And the staff too — I commend them for accepting that responsibility.”

Few clinics can afford to accept so many patients with public insurance plans that reimburse providers (physicians) at a lower rate than private insurance companies, Olsen said. All of the Wright State clinics participate in a “safety net” as part of their mission, Part said, but because the Yellow Springs practice also sees a lot of self-pay, or no-pay patients, he is surprised that the practice has not lost money.

Being a provider for indigent people with nowhere else to go is a critical part of her clinic’s mission, Olsen said. It is one that she has been asked to change, but she refuses, pointing to the clinic’s mission statement to “…model the cherished principles of family medicine (continuity of care, prevention, integrated care, cultural sensitivity)…and maintain a work environment of mutual respect, collaboration, intellectual curiosity and support of diversity.” The university’s own mission statement for its clinics is even more clear that it will “…promote universal access and care coordination to the uninsured and marginally insured in the Greater Dayton Region… .”

“I am not changing the mission of this facility — I’ve thrown my body on the tracks for that,” Olsen said. “If we went away, there would be a lot of people with no healthcare options.”

The Yellow Springs center currently has five physicians, two physicians’ assistants and eight other staff members, all of whom will move to Xenia and hopefully return with the practice to Yellow Springs in a few years, Olsen said. Physicians hope to continue to serve the community as before, making rounds at Friends Care Center and seeing patients at home if needed (Olsen always travels with two home-visit medical bags in her car.)

The move is expected to be complete by July 31, according to a letter sent to patients last week, and the center’s temporary office will be located behind Greene Memorial Hospital near the main entrance and the radiology department on the ground floor. The new address will be 1141 N. Monroe Drive, Suite #1, Xenia, OH 45385.

The university will lease the hospital space for the clinic, and also plans to support the move and store large equipment, Olsen said. Though no official decisions have been made about the current medical building on Xenia Avenue, Part said that tearing it down looks like the logical thing to do.

Part believes that fundraising for the new building will be successful, due in part to the long commitment Olsen has made to the community she and her team cares for.

“This practice functions as a community health center and a teaching site that has helped to groom the next generation of family physicians at a time when there has been a steep decline in interest in choosing family practice nationally,” Part said. “Dr. Olsen graduated from Wright State medical school, trained here and has been part of the medical community here for two decades. We’re optimistic that we’ll be successful.”

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