Changes embraced as PMC pushed into new era of medicine
As Providence Medical Center pushes forward in its impressive construction and renovation project, we will publish a series of five articles centered around various aspects of PMC. This week focuses on developing the healthcare system and next week's will highlight shortcomings and necessary improvements.
After the construction of Providence Medical Center, a client base had to be established and the most effective way to get clientele is to bring in the physicians.
And that's what Providence set about to do and successfully did so, incorporating a family practice clinic at its location in 1994.
Dr. Willis Wiseman purchased a family practice clinic located at 214 Pearl Street from the Madsen family in 1975 when he moved from Wyoming to Wayne.
Nearly immediately, Wiseman began searching for physicians to join the practice because of the extreme need for health care in the area that he and the other clinic in town, the Benthack clinic, weren't able to keep up with.
"In 1979, I recruited Dr. Jim Lindau to come to town," Wiseman said. “Later that same year, we opened the Wisner clinic as a satellite clinic, which happened to be the first family practice satellite in the state."
In 1982, Wiseman and Lindau recruited Dr. Todd French to come to town and join the clinic's practice because there was still a serious need for family health care in the area and there was about to be a second satellite clinic opened, this time in Laurel.
Yet another physician was brought in, a doctor named Dave Wachs, who cost quite a bit to recruit, but by the end of his first year, the farm crisis of 1980s had its grip on the area.
"It hit us economically really hard and even though he was really popular, we had to let him go," Wiseman said. "It was very disappointing to a lot of people."
A mere six months later, French decided he was going to pull out of the family clinic to pursue anesthesiology.
This left Wiseman and Lindau to hold down three locations between two doctors, when, had they known, they would have made things work for six months with Wachs until French left.
During that time, the Benthack clinic had recruited Dr. Benjamin Martin and Gary West, P.A.-C. to work along side Dr. Walter Benthack and Dr. Robert Benthack. They also opened a satellite location in Wakefield.
Wiseman recruited Dr. David Felber, but he had a year of residency left to complete before he could join the practice in 1987.
It wasn't until 1988 that the two clinics merged, changing from Wayne Family Practice Clinic and the Benthack Clinic into one Northeast Nebraska Family Practice, Inc.
But changes that large don't come together seamlessly or overnight, so there were hurdles to clear.
"For a while we were operating the two downtown clinics at the same time, as one entity," Wiseman said. "Which was awkward."
That was when discussions began with the Missionary Benedictine Sisters of Norfolk.
"Finally, after a lot of negotiations they built the addition onto the hospital, which still is the clinic presently."
The clinic broke ground in August of 1994 and was dedicated in September of the following year. Wiseman, along with Felber, Lindau, West, and Martin operated under Northeast Nebraska Family Practice in thenew location for several years.
An additional physician, Dr. Mark McCorkindale, was added in August of 1995, just in time to see the new clinic open its doors.
During that time, the hospital benefited from the wide patient base the well-known physicians brought with them thanks to the established satellite clinics in Wisner, Wakefield and Laurel.
Mercy Medical Center out of Sioux City bought the clinic in 2001 and that worked for two or three years, Wiseman said. After a few years, the clinic's physicians made a change, accepting an offer from Faith Regional Physician Services of Norfolk, who currently operates the clinic.
Additional physicians and staff members have been recruited during and since the changes in clinic management, including Anne Liska P.A.-C., Dr. Samuel Recob, Dr. Melissa Dobbins and Ross Hansen P.A.-C.
After numerous years of service at the clinic, Wiseman retired in 2010, but it wasn't long before he found his way back to the clinic.
"I retired in about 2010 and Felber retired the next year, which put the clinic in a bind with two people retiring in a short time, so I went back and worked one additional year until these other physicians being recruited could get here."
Once things settled down for the clinic, Wiseman hung up his coat for the last time, retiring permanently from medicine.
During his time in medicine, Wiseman commented that there were huge leaps in technology and in information in the medical field.
Wiseman described being in family practice early on as a demanding occupation.
"It meant being on call. Every day, 24 hours a day, 7 days a week. That's an undesirable way to live," he said. "You never get to see your family, etc, so that was the real reason to recruit and get more physicians. It wasn't because we were lonesome, we wanted to cut the on-call responsibility."
Wiseman said that things in the early days of family practice and being on call meant being tied to a landline, having no cellular phone technology available for utilizing.
After a few years, Wiseman said they were given radio telephones that could do two things: receive a call from the hospital or make a call to the hospital, which meant you didn't have to sit at home near your landline.
Adding physicians and improved communications made work more enjoyable for all.
Other major changes included how speciality cases were handled thanks to technology.
Technology helped to speed up diagnosing and recommending care.
For instance, at one point, a radiologist had to come from out of town as far away as Omaha, once or twice a week to read x-rays. With the invention of the fax machine, images could be scanned and faxed to a radiologist for reading in a more timely manner.
Currently, Providence Medical Center has a contract with Advanced Medical Imaging out of Lincoln, who are available daily to read scans and x-rays via the computer, giving even faster diagnostic capabilities to physicians. A radiologist visits multiple times each month for specific procedures, but with the invention of computers and the software available, it's never been easier to read these types of images.
"It was a big improvement technology-wise. Laboratory work, EKGs — all the same thing with the advent of technology, things could go over the phone line and we'd get a report back from a specialist right away, so that improved care."
The operating room also saw dramatic changes, with pre, during and post surgical care.
Taking pulse and blood pressure manually changed to pulse monitors, blood-pressure monitors, oxygen-saturation monitors.
At one time, physicians at the clinic were on call for the emergency room at the hospital as part of their duties. Now, Providence has extra hands for the emergency room only and physicians working on call for the emergency room are compensated additionally for those hours.
These changes meant changes in the lifestyle of the physicians and their ability to make a living and enjoy their time outside of work.
The changes in insurance have been a driving force behind procedures implemented, and with good reason.
Prior to medicare and medicaid, there was private insurance or no insurance. Payment came in the form of bartering in some instances, with goods and livestock if a patient was unable to pay cash for a necessary medical treatment.
"People with no money wanted to do something," Wiseman said. "Chickens, eggs, different things like that, we accepted that in lieu of payments without any regard to how it worked out dollar-wise."
With the introduction of government-run insurance, rules and regulations were placed to ensure quality care and curb abuse of medical treatment by those involved.
Good or bad, the regulations brought about changes, such as computerized billing and eventually charting.
"What we currently have as a level of care — with physicians, the physical plant, with management — a lot of towns our size aren't that fortunate," Wiseman said.