Healthcare District ‘Needs’ Survey Gets Strong Response

A 12 percent response rate to a survey might not sound like much, but to hear officials with the Southern Humboldt Community Healthcare District tell it, that’s an impressive amount.
“I was expecting 3 to 4 percent,” District Chief Executive Officer Matt Rees said last week, referring to a “community needs assessment” that was mailed out two months ago to over 6,000 people in Southern Humboldt. As of late last week, a total of 770 people had sent responses back.
“An 8 percent response rate would have been great. To get 12 percent is phenomenal. It tells me that lots in the community care about the hospital and have opinions about the hospital.”
“If you get a 5 percent response rate [to this type of survey], you’re doing really well. Getting 12 percent is unbelievable,” chimed in hospital board member Gary Wellborn.
“It tells us that people are interested in their health care and want to have a say” in whatever changes are made, he added.
The survey was conducted by Rural Health Solutions, a Minnesota outfit. The survey’s printing and mailing costs came to approximately $3,600.
While Barbara Truitt, the board chairperson, made the observation that, “Our community is more engaged than many communities,” she also said she was “surprised by the numbers we got.”
“I was expecting half that, or less,” she remarked.
Kristen Rees, Matt Rees’ daughter and the quality data coordinator for the district, said that though responses are still coming in, the rush is clearly over.
“I was getting hundreds a day. Now I’m getting five to 10 a day,” she said.
As for the responses themselves, Truitt said they were less surprising. “The responses we received were reflective of the conversations I’ve had with people for as long as I’ve been on the board.”
She acknowledged that that was true with one exception: People identified a pediatrician as the medical specialist they would most like to have available locally, followed by specialists in pain management, psychiatric counseling and ear, nose and throat (ENT).
The odd thing about the preference for a pediatrician, as Matt Rees pointed out, is that a majority of the people who participated in the survey — 52 percent — were seniors.
“Evidently, seniors in the community think about broader community needs,” was Truitt’s explanation.
Whatever the reason, Wellborn said the take-home message was clear: “Lots of families with kids would like to have [pediatric] services closer than up in Eureka or Fortuna.”
“Going up to Fortuna [or] Eureka blows at least half the day,” he pointed out.
“If you have young kids, there’s a huge benefit to [eliminating] an hour commute time to the doctor,” added Truitt. 
While a cardiologist does come to the area on a regular basis, a pediatrician doesn’t — nor, for that matter, do specialists in some other medical fields, such as urology, neurology and orthopedics.
Rees, noting that Redwoods Rural Health Center in Redway doesn’t have a pediatrician either, said that the closest one is in Fortuna.
The reason for the dearth of specialists locally is simply that patient volumes aren’t large enough.
In terms of pediatrics, Rees said: “There are not a lot of kids [in the area] under 2.” He also pointed to the size of the graduating class at South Fork High School, which he said numbered just 50 students.
“There’s not enough volume to keep a pediatrician busy,” he commented.
Rees said the high priority assigned to pediatrics by survey respondents has led him to contact his counterpart at St. Joseph’s Hospital in Eureka regarding “different specialists he could send.”
“I’m trying to see if we could have a pediatrician sent down one to two days a week,” Rees shared.
Another option he’s exploring is for a pediatrician to be available locally via telemedicine.
He also suggested turning to a family’s general practitioner.
“They know the family history, so lots of times family practice doctors are a good way to go [with pediatric issues] unless there’s a specialized problem.”
“I’m not sure people are aware of that,” he added.
Getting back to telemedicine, Rees indicated that the technology could be used to bring other specialists, such as a mental health counselor, to the area in a virtual sense.
One way to make that happen, he said, is to turn to the University of California Davis Medical Center, which has a telemedicine program that is frequently used by rural hospitals.
Going that route would require joining forces with other facilities, Rees added.
“You have to buy a block of time from UC Davis [for doctor-patient consultations]. If you don’t fill up that time, then you’re paying for nothing. So it’s a good idea to partner with other hospitals,” he explained.
As for getting specialists aside from pediatricians to physically come to the area, Rees said a general surgeon is a possibility.
But in terms of other specialists, such as urologists or ENT doctors, the problem is that there is a shortage of those types of physicians. “So I don’t know how doable that would be.”
It would depend, he added, on the type of specialists based in places such as Eureka and Ukiah and whether their schedules would allow them to make periodic visits to Southern Humboldt.
In terms of existing services, 627 survey respondents said that the emergency room is “very important.” A large number — 526 — said the community clinic was also “very important.” In comparison, just 276 assigned “very important” status to the district’s inpatient hospital beds. And only 209 called the district’s nursing home “very important.” 
Kristen Rees pointed out the relatively low importance given to inpatient beds and the nursing home during last month’s regularly scheduled meeting of the district’s governing board.
That drew a response from Truitt, who, referring in particular to the district’s skilled nursing facility, said: “Just because the community doesn’t express a desire for it in large numbers, it is still something we know is valuable.”
Besides, she added, a total of approximately 500 respondents said that inpatient hospital beds and the nursing were “important.”
As for how people feel about other matters, 497 respondents said it was “very important” to have laboratory services available locally. A similar number — 490 — said the same thing about X-rays.
A total of 344 said it would be “very important” to have a CT scanner. While the district currently does not have the important diagnostic tool, it is in the process of acquiring one. Matt Rees said earlier this month that a CT scanner would be up and running at the hospital in three to four months.
Almost as many respondents — 340 — said it would be “very important” to have an ultrasound machine. Rees said that while the district has one, it is only used in the emergency room, primarily to identify foreign objects in the body.
For scheduled ultrasounds, he said the district would need to acquire a different machine and hire a qualified technician to operate it.
A total of 232 people said it would be “very important” to have colonoscopies performed locally. While Rees said colonoscopies are currently not done locally, they could be if the district ends up building, as it hopes to, a new hospital facility.
“In a new hospital, we could maybe have a surgery suite where we could do colonoscopies and have a general surgeon come down and do hernias, gallbladders and appendix [operations],” Rees speculated.
Rees said the fact that a majority of the survey respondents were seniors wasn’t surprising since older folks “utilize health care more than others.”
While 40 percent said they were on Medicare and 15 percent said they get their insurance through Covered California, 35 percent indicated that their health insurance is provided by an employer or via a private pay individual policy.
Rees said he was “pleased and surprised” about that.
“Commercial insurance pays well so it’s good to see that that population cares about our facility,” he said.