In my capacity as chief medical officer at the Pagosa Springs Medical Center, I have an oversight role in the quality of care delivered at the institution. Throughout my 26-year career as a board-certified physician, I acknowledge that I have made some mistakes. I believe I have kept those to a minimum, and never out of neglect. So, when reviewing the care delivered by our physicians, it is with that frame of mind that I receive a complaint of dissatisfaction from patients we have served.
However, quality can mean different things to different people. Recently a Letter to the Editor complained about the care rendered at the clinic, by a provider whom I consider to be very competent. We are sorry that the patient had a negative experience. Although we would all like to believe that we could come to Pagosa Springs Medical Center and have a “one stop shopping” experience, unfortunately that is not always possible.
Patients sometimes arrive at the ER or clinic that would be better served at another location, either because of diagnostic or treatment limitations, or due to time constraints. The complaint in question centered on this issue. The patient was referred to the ER, not due to physician ability to diagnose, but because of efficiency of care. The patient observed other patients coming in and being seen before him and correctly assumed that this was because they had scheduled appointments.
The physician he did see examined the patient, and as a result of history taking and examination, correctly decided that this patient would be better seen in the emergency room. That decision was multifaceted, including the fact that there were scheduled patients for her to see besides this patient. In addition, the costs of the extended clinic visit would surely have increased as time and studies would have added to the basic office visit charge.
We have had the unfortunate experience of having patients wait too long to see their provider, and we strive to keep that from happening. In this case, the patient would have experienced a quicker time in ER than in the clinic. Therefore, it appears that the writer’s complaint centered on a financial expectation of the ER and not a quality issue. In the end, he ended up at another emergency room with imaging studies being taken at no small cost.
We strive to keep our charges in line with other institutions, and in many cases we are below neighboring institutions. The board of directors, administration, and staff are all quite aware of the financial sacrifices the community has and continues to offer for this institution.
We are committed to developing an integrated healthcare system for our community that is first rate in quality and cost efficient. We have made some mistakes, hopefully keeping those to an absolute minimum. We strive to learn from each and not repeat them, and I am proud to be associated with all who work at this institution.
“Leakage” is a measure of the supply versus demand in local retail sales for Archuleta County. “Supply” an estimate of the retail sales of local businesses for a period of time. “Demand” is an estimate of the amount spent by consumers at retail establishments. Demand that exceeds supply indicates that retail goods and services are being purchased outside the county. This is the “leakage,” or opportunity to increase local retail sales.
I obtained a report from the Fort Lewis Small Business Development Center (SBDC) that shows the estimates of leakage for 2010, by type of purchase. What does the data show? It shows that very little leakage occurred, except in a few categories. The two biggest sources of leakage are $16M in auto sales, $1M in electronics and appliances.
For all other categories, supply equals or exceeds demand — local retailers are selling as much or more than locals and tourists are purchasing. These include food and beverages, health and personal care items, gasoline, clothing, jewelry, sporting goods, books, music, office supplies, stationery, etc. — exactly the types of merchandise that most “big box” retailers sell!
What are the economic development implications? As a community, we will give away incentives of some type to entice a big box to come here. Many local businesses that don’t benefit from these incentives will go into direct competition with the big box. Many will go out of business within a short time. The community will then become very dependent on the big box. So the big box will demand continuing incentives to stay. In the process, the unique character of our town and county may change, and this may in turn impact tourists’ interest in coming here. So are the benefits of a big box worth the risk?
In my view, it would be a much better strategy to help both existing and new local businesses stay in business, be more successful and capture more of the leakage. We could selectively focus our business attraction strategy on those categories where there is significant leakage. I believe our community would be better off.
Your tax dollars at work, specifically $18,000,000,000,000, and counting. After Harry Reid and his Nevada constituents skimmed the cream off the top of the Yucca Mountain Radioactive Waste Repository, specifically skilled construction jobs, supplying the materials and the huge local economic multiplier (typically said to be 7X), this taxpayer funded/deficit expenditure “investment” has been killed off by the infestation of unicorn aspiring environmental green policy makers infiltrating our Federal regulatory fabric, Congressional caucuses and more recently (has it only been a little over two years — gosh it seems like a lifetime) the Executive Branch. These do-gooder groups willy-nilly oppose, demagogue and dismantle technical solutions and commercial realities, and instead focus on advancing social engineering endeavors — and spend, spend, spend dollars. Bottom line is the federal taxpayers, 50 percent of the able bodied population that actually pay Federal income taxes and the future generations that choose to attend school to prepare themselves to contribute to the economic growth of our country, stand on their own two feet and visibly contribute to the national economy vs. those that suck the government tit and bitch, must pay the tab for this now defunct uber profile “investment.” Killing off this repository for nuclear waste, is the social engineering proxy to underpinning higher energy costs and a less secure energy supply for this country.
Low cost energy is necessary to sustain employment opportunities in this country to produce goods that are competitive beyond our shores. Why doesn’t the federal government support/promote natural gas powered vehicles, a home grown. Natural gas is a strategically secure commodity that generates high paying jobs at home, American vs. Chinese demand for materials/technology and local economic multipliers, at rock bottom unit costs. If one subscribes to a belief that Global Warming is caused by the actions of mankind, natural gas powered transportation produces far less emissions than liquid or coal powered energy sources. Seems like a palatable plan for all.
What happened to common sense and saluting the laws of physics? In the upcoming national election, forward thinking, reflective patriots must be sent to the top of the food chain, not fiddle playing, no game plan demagogues that lack focus on the economic futures of our children and their children, and the USA. Our generation has drunk from the trough long enough, tolerating massive deficit spending and collectively running up far too much national and public debt. It’s high time to focus on a sustainable growth plan for the USA. Where’s the constructive dialog? Where is Nobama’s National Energy Policy? Where’s a measured balance to developing energy sources? Where’s the leadership from the top? What is it going to cost you to fill your tank next year, and thereafter? The USA is blessed with bountiful resources and world class ability to Git-R-Done. The shackles must be broken to allow the American worker and private enterprise do what they best know how to do. Reflectively cast your vote in the upcoming national election.
After reading Ms. Morrow’s comment on the economy, I have to wonder why people so concerned about federal spending cannot take the time to understand where our tax dollars actually go.
There are three things that are causing the deficit and they are not presidential trips and welfare.
We have a deficit because of massive uncontrolled defense spending, loss of revenue, and rising medical costs, yet neither Party seems willing to address the issues. The Republicans are proposing a budget that will add trillions to the deficit over the next ten years, while the Democrats are proposing a budget that would also add trillions to the deficit over the next ten years. Both plans promise to balance the budget around the middle of the century based on ginned up figures from some political crystal ball. The only real difference is whether we want our future financial disaster with or without social spending.
People need to understand that there are alternatives to the status quo proposals that do nothing to address our actual problems. There is for instance a proposal that was put forward in the House known as the “People’s budget” that does in fact address these issues; of course it has been totally ignored by the media as well as the leadership of both parties.
We need to have a serious discussion about our economic troubles, and blaming the president’s bodyguards is hardly a step in the right direction. People need to understand the issues and for them to do that, our media, including local media, need to re-establish its responsibility to educate and inform.
Printing this sort of nonsense, even as “opinion,” with no opposing view, does nothing to improve the dialog, and in fact does a disservice to our community in general.
F. John Lozen
Prior to moving full-time to Pagosa from Denver in December 2010, my husband Everett (Ed) and I did “research” of the available medical doctors and facilities available here in Pagosa. When we learned of the new hospital and clinic, we deemed there was adequate medical care available. We never dreamed we’d have to utilize those facilities so soon! In March my husband received emergency treatment and subsequent admittance to the hospital. Two weeks ago, his 92-year-old mother (who also moved to Pagosa at the same time) went to the clinic and then was admitted to the hospital. We chose our primary care physician Dr. Marshall in early January; not only does he provide excellent care but we’ve also utilized the services of Dr. Borja and PA Schreiber-Custer. All are highly educated and have unique prior work experiences. Additionally, the office staff is extremely courteous and helpful in answering questions about insurance, billing, etc.
We simply could not have asked for better care in the hospital. In both instances, both my husband and mother-in-law received immediate results to lab work and X-rays. If one were admitted to a large city hospital, those test results probably would not have been so quickly forthcoming! The emergency room staff was very professional and quick to diagnosis my husband’s illness. When both were admitted to the hospital, the nursing and support staff were extremely kind and nurturing. Again, the doctors and nurses in the hospital have some amazing career experiences and are very knowledgeable and well-qualified. Many thanks to Dr. Galloway for taking care of my family!
I feel extremely fortunate to be living in such a beautiful place as Pagosa and knowing that our routine and emergency medical care needs are being taken care of in much more than an “adequate” way.
The Tea Party movement (like any other large group of people) has a few odd characters … that’s life. But at least they don’t have Obama’s view of transparency, which is like the light in a coal mine at midnight. And you’d have to be brain dead to even suggest, “they advocate some destructive destination.”
Personally, I’m delighted that there is a growing mass of citizens who think it’s important to restrain government and not impose burdens of future generations. We are lucky to have it. That’s because the tea partiers, who may not all agree on gay marriage or birthright citizenship, are definitely united behind a couple of sound goals: curtailing the cost of government and absolutely refusing to live at the expense of future generations. Those are goals that, for years, had many rhetorical supporters in Washington, but few authentic champions.
Recently, some of the budget hawks were left wondering what happened to republican tightwads, who thought every dollar spent by the government was a dollar that had to be justified as a vital necessity. The tea-partiers were dismayed to see these penny-pinchers replaced by poll-driven insiders with an appetite for earmarks. That’s one big reason hard-right candidates have scored so many upsets in recent GOP Senate primaries — like Rand Paul in Kentucky, Sharon Angle in Nevada, Joe Miller in Alaska, and Christine O’Donnell in Delaware. They didn’t get nominated because they look and sound like the popular image of a savvy, experienced, well-informed, practical-minded U.S. Senator. They got nominated because they don’t.
A passing thought: Maybe Ms. Brenda McCooey is right. Bashing Obama is a little depraved; kinda like pickin on a retarded kid. So … I guess we should jist stick ta pointing out that he is an imposter and an anti-American communist. And not bring his complete lack of character or inability to form complete sentences without a teleprompter into the situation. But he jist might be able ta walk a wing on Mr. Bob Dungan’s Sopwith Camel? You and I know that the “Troglodyte” of Arboles would never allow a bug scratch on Obummer.
So, until we get a POTUS who can lead. I’ll have to concede, that for now, the Tea Party will have to do. Why? Because the Tea Party is about returning to the first principles of the U.S. Constitution: limited government, local empowerment, and personal freedom.
That the Tea Party has been subject to such heated abuse — from both progressive liberals and moderate conservatives — makes me wonder about the vitality of Americans’ constitutional consciousness. Maybe it’s time for all of us to condemn the illegal and dangerous course that Obama has set this country on, both at home and abroad.
And keep some powder dry.
This is in response to the letter in The Pagosa SUN dated June 9, 2011 about the latest water fiasco by PAWSD. The content of this article in The SUN is written only to cover up the ineptness of this organization.
The article stated that this happened on Thursday, June 2. It was also stated that PAWSD contacted the Archuleta County Department of Emergency but it doesn’t say when the County DEM was contacted. My family was not contacted until after 9 p.m. on Friday night; more than 24 hours after the problem began. The article further states that Gene Tautges worked with DEM to draw a circle on a map of the area that might be affected. A pencil and a string to figure out areas that might be affected? Is this the dark ages? And then the reverse 911 calls? This article stated many, many people were removed from the list to save money? Isn’t most everyone in this county dependant on PAWSD? So why not contact everyone from the PAWSD list, not reverse 911?
Further in the article it was said that “field experience” was used on how to decide the affected areas. What? Mr. Peterson made the statement that this program is “only” a map, not a database. Again with the string on a map. Peterson went on to say that anyone without land lines should register their names, numbers and preferred method of contact. Doesn’t PAWSD already have this? And as I see it, it is not the problem of the customer to know if they need to be contacted in case of a water problem. It is the responsibility of PAWSD. Period. It was also said at the end of the article that a Facebook page is also under development. So what? Dozens and dozens in this community do not use Facebook. So how does that help?
PAWSD has gone up and up on their fees and yet we get less and less service for this increase. This community is growing way beyond the capacity of what PAWSD is capable of taking care of. And this latest fiasco is just another example.
Is PAWSD going to reimburse all of the people inconvienced by this? Meaning, are they going to reduce out next monthly bill? I have my doubts. And are they going to reimburse everyone who was forced to buy water? Not likely. This ineptness is not acceptable. To me this is just another way of government doing whatever they want and then blaming everyone else.