The Puget Sound region is home to some of the most dedicated and knowledgeable health care practitioners in the world. But all of these resources can only make a difference in the life of an individual when he or she has access to them. This year as part of Top Doctors, we’re singling out for praise just a few of the many local health care practitioners and researchers—and their associated clinics and hospital outreach programs—who are making a difference in underserved, disenfranchised communities.
Kathryn is in her early 50s and lives on the shore of Lake Washington with her husband, Bill, in an elegant contemporary home filled with sunlight and exquisite art. Bill, a successful entrepreneur, retired in his mid-50s. Bill and Kathryn* are too young for Medicare, but felt well protected since they had purchased one of the best health insurance plans on the market. She thought the Affordable Care Act a good thing—for other people who need help. As politicians argued about the merits and costs of “Obama Care,” Kathryn was aware of the debate raging in Congress, but thought neither she nor Bill would ever need it. She was wrong.
Bill developed a rare and aggressive form of cancer. With surgery, multiple rounds of chemotherapy and radiation treatments, and numerous hospital visits, Bill’s medical expenses totaled more than $1 million in under 12 months. The costs surpassed his policy’s annual cap for expenditures, as well as the lifetime cap. His health insurance was canceled. It was impossible to obtain new insurance. Not eligible for Medicare or Medicaid, Bill and Kathryn were on the brink of bankruptcy.In a very up-close and personal way, Kathryn gets it now: Without the Affordable Care Act, preexisting conditions mean no access to health insurance—for some of the people who need it most. Health care reform affects everyone (or will at some point in live) from prominent executives with company-paid medical plans loaded with benefits to employees who lose their insurance along with their jobs. Ditto for seniors, children, adults with preexisting conditions, those with serious illnesses, working moms and young adults. Some of its most important provisions, such as expanded coverage for children and young adults, are already in place, while the most significant changes are coming, beginning with open enrollment in a state-run health insurance exchange this fall and implementation in January of the “individual mandate” requiring everyone who can afford it to have health care insurance. While other states hesitate to embrace reforms, Washington state is a leader in national reform efforts and has been experimenting with new approaches to health care for years—even before the passage of the Affordable Care Act—making Washington better prepared than most states to meet the challenges of implementing health care reform. More than 10 years ago, Virginia Mason Medical Center became the first in the nation to adapt the lean principles of the Toyota Production System for health care. Called the Virginia Mason Production System, it enables the medical center to identify and eliminate waste, improve quality of care and patient safety, and lower the cost of care. In 2008, the Virginia Mason Institute was established to teach other hospitals and health organizations how to implement the lean principles. Virginia Mason chair and CEO Gary S. Kaplan, M.D., has testified before Congress and was ranked number six on the 2013 list of the “50 Most Influential Physician Executives in Healthcare” by Modern Physician and Modern Healthcare magazines.Other local health care executives, such as Group Health Cooperative president and CEO Scott Armstrong and Everett Clinic CEO Rick Cooper also feature prominently in the national discourse on health care reform with their efforts to address challenges in primary care. And under the leadership of its executive director/CEO, Lloyd David, The Polyclinic, Seattle’s largest multispecialty, physician-owned practice, became the state’s first Medicare-approved accountable care organization in July 2012. Accountable care ties provider reimbursements to quality metrics and reductions in the total cost of care. The Polyclinic has experimented with accountable care models with health insurance companies such as Premera Blue Cross for several years. Washington even “developed its own state-based health insurance marketplace to better meet the unique needs of the uninsured in our state,” says Richard Onizuka, chief executive officer of Washington Healthplanfinder.
At a Glance: Washington HealthplanfinderWashington was one of the first states to receive conditional approval of its health plan exchange by the U.S. Department of Health and Human Services. “The exchange will be a one-stop shop, allowing consumers to make apples-to-apples comparisons between plans, determine eligibility for tax credits or less expensive copays and deductibles, and receive personal assistance in finding, selecting and enrolling in the right health plan,” says Richard Onizuka, chief executive officer of Washington Healthplanfinder (wahbexchange.org).Key dates to remember:September 1, 2013: Washington Healthplanfinder call center opens, providing detailed information about state exchanges to individuals, families and small businesses. October 1, 2013: Open enrollment begins for coverage that starts January 1, 2014. The plans offered specifically for the exchange will only be available through open enrollment in the fall. March 31, 2014: Enrollment period for 2014 closes. The next open enrollment period kicks off October 15, 2014. —S.M.
Specialty: Urogynecology Hospital affiliation: Virginia Mason Medical CenterWhy did you choose to specialize in urogynecology? I’ve always had a big interest in women’s health issues and learned in medical school that I loved surgery—urogynecology is the perfect blend of those two interests. I’ve read that 30 percent of women ages 65 and older suffer from pelvic floor disorders (most commonly urinary incontinence and pelvic organ prolapse), yet many won’t talk about it or seek treatment.
Specialty: Medical oncology, head, neck and lung cancerHospital affiliation: Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, UW MedicineAs a native of Brazil, what drew you to pursue your career here in Seattle?
Specialty: CardiologyPractice: EvergreenHealth CardiologyHospital affiliation: EvergreenHealthWhat attracted you to your specialty?My interest in cardiology started during my residency. I had originally wanted to be an internist, but when I saw how people were so sick and got better so quickly, I changed my focus. It is very gratifying when you thought someone was going to die and then they walk out of the hospital a week later.
Specialty: Orthopedic surgeonHospital affiliation: Group Health CooperativeHow has your early dance experience, including a stint in New York with the Martha Graham Dance Company, influenced your approach to your job?
Can I first just say how much I love voting via mail? Oh, the hours-long voting lines I've stood in at libraries, VFW halls and cafeterias in my great native land of Oh-Hi-O. So, kudos Washington, on that genius move.
Ryan Caldeiro, M.D., Group Health, Northgate Clinic, 9800 Fourth Ave. NE, Seattle, 888.287.2680; Group Health Cooperative; Case Western Reserve University, 2004; addiction psychiatry, consultation psychiatry
Armed with good timing and the grace of an easy traffic day, bliss awaits you in the form of San Juan Islands tranquility. Getting there is half the fun (right?)—the other half, once you’re there, is all about taking it easy. Good thing there’s something about the islands that forces you to slow down and make that happen.
If you gaze out over Elliott Bay this weekend you might catch a glimpse of the Hugo Boss yacht, a carbon fiber, 60 mono-hull racing boat with around 600 square meters of sail (that’s the size of a soccer field) helmed by British skipper Alex Thomson, who races her all over the globe.
Spend an evening with Valerie Steele, fashion historian, author and curator from the Museum at the Fashion Institute of Technology (MFIT) this Friday night, July 19m at 7 p.m. Steele will be in town to give a talk on the Japanese fashion influence and “revolution” in the 1980s as part of the SAM Talks series.
Within months of establishing their settlement in November 1851, Seattle’s founding families realized they had made a mistake. Their location on the western, forested shore of Elliott Bay could not support a good harbor, which would be central to the new community’s success. Trade vessels from the Pacific Ocean could travel down Puget Sound to its toe at Elliott Bay but without a deep-water dock the journey was a waste. So in the middle of winter, three men boarded a canoe with a heavy line and horseshoes in order to sound the depths of the rest of the bay.