Story Photos
 Dr. Janice McClean talks about the future of the Wahkiakum Family Practice Clinic Tuesday in Cathlamet. Roger Werth / The Daily News
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New Cathlamet clinic doctor enjoying change of scenery
Wednesday, August 20, 2008 11:44 PM PDT
By Barbara LaBoe
Printable version
E-mail this articleCATHLAMET — Not many people would leap at the chance to take over a rural medical clinic on the brink of closure. But Dr. Janice McClean said she relishes the challenge and the chance to return to the type of medicine she enjoys.
McClean, 53, arrived in Cathlamet in May, essentially keeping the doors of the Wahkiakum Family Practice Clinic open with her arrival. Both of the two long-time doctors, Richard Avalon and Keith Wright, either had left or were about to, leaving a nurse practitioner and physicians assistant. And one of them was soon to leave as well.
As if that wasn’t bad enough, after losing money for years the clinic had been put on notice by the county that taxpayers can’t keep subsidizing its operation.
The clinic is the only doctor’s office in the Cathlamet area and serves roughly three-quarters of the county’s population. Losing it would be a major blow to the small Columbia River community.
McClean last worked in the Seattle and Everett area in thriving family practice clinics. She was named one of the Top Doctors for Women by Seattle Magazine in 2003.
Her work in Cathlamet is far different from the big city — and that’s exactly what drew her, McClean said Tuesday from her new office.
She’d been looking for a rural clinic or setting and learned from the state Department of Health that Cathlamet’s situation was the most dire because of the doctors’ departures. One visit to town and McClean knew she’d found her next job.
“In the city, medical care is very volume-driven,” she said. “It’s too easy to lose touch with what we really should be doing: taking care of people. ... This is a lot more like what I always thought medicine should be.”
McClean isn’t just treating patients. She’s also heading up the resuscitation plans for the clinic itself.
Initially, the clinic had to “stabilize the system” and ensure that patients were seen and that the clinic remained accessible. An after-hours nurse line helps with minor health questions. Clinic staff also is on call for more serious cases, and hours also will be extended.
Next, staff had to be boosted — physicians assistant Mike Meno was recruited from Seaside Urgent Care and more medical assistants will be hired. Clinic operations also had to be streamlined.
Changes included no longer doing rounds or visiting patients admitted to St. John Medical Center. The travel and time was just too much, so patients are now cared for by St. John staff and then released back to local doctors, McClean said.
A clinic doctor also used to serve as medical director of the local emergency ambulance service. That proved too time consuming, though. That responsibility has been taken over by a local doctor who works in the St. John Emergency Department. McClean and the clinic, though, still back up the ambulance crews for local calls.
“(The changes) really allowed us to bring our focus into the clinic,” she said.
In the next few years, McClean would like to expand the clinic and offer more specialized services locally.
Overriding all those concerns, though, is money.
The county has pledged to subsidize the clinic through December, but after that it has to be financially independent. McClean said a number of the changes should allow that to happen in the long run. In the here and now, though, the clinic still needed money.
So, after examining all their options, officials decided the easiest thing might be to ask community members to support the clinic they so desperately wanted to retain.
The “Keep the Clinic Open” campaign started in June, and donations already are rolling in, she said. So far they’ve received about 10 percent of the roughly $250,000 needed to make ends meet through 2009, but McClean is encouraged by the support.
“I’m really impressed with this town that is so determined that the clinic should survive,” she said. “It makes it worth working really hard for.”
There’s still a long road ahead, but McClean said she and others are focusing on the positives.
“With this kind enthusiasm it’s hard to even fathom failure, so we just won’t,” she said.
Wahkiakum County Commissioner George Trott said he’s also optimistic about the clinic.
“It looks like they’re doing pretty well,” he said. “I think things are looking better.”
Attracting a doctor to Cathlamet would have been difficult even without the financial crisis. Nationwide it’s difficult to fill rural posts and in Washington it’s even harder, McClean said. St. John Medical Center also struggles with recruitment.
And, even after doctors are lured to small towns, about half leave rural posts within three to five years, McClean said.
Some leave for more money or a more urban lifestyle. But even those seeking a bucolic setting sometimes learn that while their friends and neighbors lead a laid-back life, the only doctor in a region rarely does.
McClean, though, said she’s good a multi-tasking. And she likes the challenge of keeping updated on several different specialities because a cardiologist or dermatologist isn’t just down the hall anymore.
And, she knows how important keeping the clinic is to her patients, many of whom can’t afford to drive to Longview or Astoria for regular care.
“This opportunity changed my life,” she said. “In the city you can become a machine and it’s hard to keep your faith and it can be very stressful. ... Here I get to do good medicine.”
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Wahkiakum Family Practice Clinic hires new doctor (Feb. 19)
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