More often than not, the word “industry” is considered in terms of business, like in the context of agriculture and manufacturing; things that grow and are made. But healthcare is also a type of industry, referring to the organizations that deliver medical care to people. It encompasses healthcare delivery models, support services, clinical research, healthcare technology, healthcare exchanges, and healthcare information flows (sciencedirect.com).
In Colville, with a population of 5,021 as of 2022, approximately 95% of citizens are defined as having medical insurance (datausa.io). The rate of uninsured people is growing as is the rate of persons with disabilities, according to the United States Census Bureau. It was determined that 15.5% of Colville’s population in 2022 is disabled, which is greater than the Washington State average of 13.5%.
Unfortunately, even with health insurance, it can be a burden financially to seek medical assistance. According to the State Health Access Data Assistance Center, the median amount spent out of pocket for medical expenses in Washington state in 2022 was $1,800. Over 9% of citizens said that they have forgone medical assistance due to cost and an additional 9% said that they were currently experiencing trouble paying medical expenses. In a rural location such as Colville, doctors are likely to be less accessible with its citizens feeling like they may need to choose between a physician’s assistant or no one at all. As a result, some may look to alternative healthcare methods that have popped up in the community.
One such alternative is Heartland Medicine, located on Main Street in Colville. Founded in 2019 by Dr. Barry Bacon, Heartland Medicine was born from a need for expanded access for people without insurance and a need for urgent care as an alternative to the emergency room (Bacon). Dr. Bacon, who has been a family doctor in Northeast Washington since 1990, practices what he refers to as “cradle to grave medicine,” from delivering babies, to performing surgeries, to geriatric care.
“Heartland Medicine is based on a very successful model called Direct Primary Care that has been around for a couple of decades now,” said Dr. Bacon. “The funding comes entirely from members of the clinic who pay a monthly fee. This fee gives members access to services that we provide on-site, such as x-rays. We also negotiate for the lowest possible costs for various services including lab fees, medications, and off-site imaging.”
Despite the fact that Heartland Medicine has been able to provide a financially viable alternative to those who could not otherwise afford health care, Dr. Bacon has faced challenges with the clinic. “We will treat all patients, including those with chronic pain and addiction,” explained Dr. Bacon. “Because of this, we get opposition from people who think that Heartland Medicine is a pain clinic or an addiction clinic. But we are not a pain clinic. Not an addiction clinic.”
In Colville, treating patients with addiction, especially opioid addiction, is becoming increasingly common. In a study completed by the Spokane Regional Health District on addiction in Stevens County from 2018 through 2022, two out of three overdose deaths involved opioids. Sixty-percent of those deaths were from fentanyl overdoses. As addiction and overdoses in Colville increase, the medical community has taken on more patients dealing with addiction.
Dr. Caleb Holtzer, a family physician as well as director of Providence’s rural residency track, also focuses on opioid use disorder and stimulant use disorder. “I provide full spectrum family medicine, ranging from family medicine to hospitals, clinics, and outpatient,” said Dr. Holtzer. “As the director of rural residency, I help to train two physicians every year in their residency.” He spends three days per week practicing clinical medicine for the Providence clinic in Chewelah, and one day per week attending to substance use disorders at the Providence clinic in Colville.
“There is such a high need for this in the area,” said Dr. Holtzer. “We provide medication based treatment such as Suboxone and Sublocade.” Suboxone and Sublocade are medications used to treat moderate to severe opioid disorders and block the rewarding effects of opioids. “We also provide non-medication based treatment such as therapy.”
Like many clinicians who treat addiction, Dr. Holtzer has had to work through opposition. “Six years ago, we did a lot of community engagement work to teach against the stigma that is connected with addiction. All people have seen the lethality and destruction of opioids. Fortunately, we have seen that the stigma of medicine in order to treat addiction has diminished.”
Funding is provided through a “pay for performance contract.” Dr. Holtzer explained that it’s not a grant, but money provided through the state.
“It’s important for people to know that all of our physicians see patients with opioid disorder. We all look after it and can treat it,” said Dr. Holtzer.
Another critical aspect of the healthcare industry is blood donation. Blood donations help people survive surgeries, cancer treatment, chronic illnesses, and traumatic injuries. According to the American Red Cross, the national supply of blood products has fallen more than 25% since July 1, 2024. Currently, only 3% of eligible people make the decision to donate blood. The need for blood donors has extended to Colville. In April 2024, the City of Colville’s official website appealed to potential donors, stating that, “We are in critical need of blood donations. Every blood donation has the potential to save three lives” (colville.wa.us).
Vitalant is one of the nation’s largest nonprofit blood organizations, providing hospitals and patients across the United States a safe blood supply (Vitalant.org). Susan Brudnicki is an account manager and recruiter for Vitalant in the region that includes Washington, Idaho, and Montana.“I work with schools, churches, businesses, and community organizations in places like Colville to sponsor blood drives,” Brudnicki said. Vitalant hosts regular blood drives, recruiting donors three to six times per year.
“We will either drive a bus to a location such as the Super 1 parking lot or set up in school auditoriums,” Brudnicki said. The bus is a blood drive on wheels. It contains all of the equipment, beds, and staff necessary to accept a blood donation.
“Vitalant is the provider of blood products to 44 hospitals in our region,” said Brudnicki. “We start planning a drive six months in advance. We start by asking the hospitals how many pints of blood are needed, and then we go and get it.”
Vitalant is a nonprofit organization that charges hospitals for the blood collected. They also have a foundation that raises money and is used for science, technology, engineering, and math (STEM) grants for schools. Vitalant partners with the Blood Center Foundation of the Inland Northwest to offer STEM Grants for schools. Any school can participate by hosting two drives per year. This year, Vitalant and the Blood Center Foundation of the Inland Northwest are hoping to give away $90,000 in STEM grants to area schools. The STEM Grant Program is a great way to teach students about blood, the need for blood, the importance of community service, and leadership skills. When schools host a blood drive, they become eligible for these grants. Two blood drives can raise 40 units of blood. “This process helps teach students about the importance of donating blood,” explained Brudnicki. “Students can donate blood once they turn 16. This also builds leadership skills.”
Right now, 250 units of blood per day are needed in order to serve every person who needs it. Sometimes, Vitalant is unable to meet that need. “We are at a critical status when that happens,” said Brudnicki. “We do a lot of advertising to make up for the deficit. We want everyone to know that just one donation can save the lives of three people.”
There is a constant need for donors. Before COVID, about 100,000 people donated blood annually. “Then the high schools shut down, and people didn’t show up,” said Brudnicki. “We lost a lot of ability to collect. Post-COVID, the annual donor list dropped to 20,000 people.
“Imagine a doctor telling a child who has cancer that he can’t get his treatment this week, because there is no blood,” said Brudnicki. “Vitalant is here, because no one else is doing it. If we fall short and can’t do it, then hospitals won’t have the blood.”
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