The future of Town of Webb health care came into finer focus Tuesday, as the town board hosted Robert Scholefield, Chief Operating Officer for St. Elizabeth’s Medical Center, for an informational meeting that had Scholefield answering questions from the local public for about an hour.

And the audience indicated its approval of the presentation by its closing applause.

As reported last week, St. Elizabeth’s has been tapped by the board as the most promising provider of future health services for the Town of Webb, following the review of two viable proposals.

A contract has yet to be drawn and details are still being worked out, but Scholefield was able to give some precise detail as to what a clinic run by St. E’s would look like.“We would be willing to come to the Town of Webb and assume full responsibility and operation for the health care center,” he said.

“Meaning that we would provide the physician staff, we would employ the nursing and other staff, we would do the billing, we would do the housekeeping, we would maintain the premises within the space of the clinic.”

They would also incorporate all state requirements for hospital-sponsored clinics, as well as national Medicare/Medicaid standards.

Scholefield said St. E’s employs a large administrative staff to support its clinics, such as the one proposed for Webb.

They make sure clinics have what they need to take care of patients, he said.

The Town of Webb’s needs and expectations are particular in some respects and must be accommodated as best possible, according to town Supervisor Ted Riehle.

“One of the concerns of the board was that we retain the other services in the building—the dentist office and the physical therapy group,” he said. “Those were services we didn’t want to lose for the community.”

Robert Scholefield explained the difficulty.

“Our operating certificate does not include dental services,” he said, which would require adherence to significantly greater regulation.

It was more of a challenge than St. E’s was willing to bite off, he said.

Still, Scholefield said he was hopeful an arrangement could be made that a physical separation could be established in the building—a corridor to prevent intermingling—that would allow continuance of the dental practice.

“I would be open to whatever discussions, because I realize that is your only dentist and those are services that, as primary care, we want to make sure the patients have,” he said.

The same goes for existing physical therapy services.

“We were invited to help solve the primary care needs. We don’t want to create a different problem as a result of that,” Scholefield said.

“So, I would be open to whatever discussions,” he said.

Other peculiarities involve the kinds of injuries suffered locally.

“I was kind of surprised at all the fishhook injuries that show up at this clinic,” Scholefield said. “From what I understand it’s a regular occurrence, and one guy not too long ago came in twice in one day.”

More importantly, according to Dan Rivet, a local Emergency Responder, fish-hook injuries are symptomatic of a greater problem:

The fact that many injuries happen on weekends in the summertime, when the local population grows exponentially with people enjoying the outdoors.

Rivet said it is imperative that the clinic be open seven days a week to prevent an overburdening of local ambulances—at least from mid-June to mid-October, 12 hours a day in office.

“When [911] gets a call, any kind of emergency, they call us,” Rivet said. “And the ambulance has to respond.”

This is the case whether the person has suffered a bee sting, a bug bite, a fishhook puncture, or a sliced finger in the kitchen.

If the clinic were to be open, then many patients could be dealt with locally and ambulance trips lessened.

Scholefield said staffing the clinic seven days with full physicians would be a tall requirement.

Family practitioners typically keep regular office hours, he said.

“Being realistic, recruiting new young physicians to the community [and requiring] 12 hours a day, seven days a week… it is highly unlikely,” he said.

And Physician Assistants and Nurse Practitioners would be little comfort for many of the intensive injuries resulting from outdoor recreation, from a patient standpoint, Scholefield said.

Doctors in an earlier era sometimes would come in to see patients in off hours, Scholefield said.

“But that’s an unusual arrangement in this day and age. I know that Dr. Webster indicated that he had done that years ago and continued to do that on occasion, but that isn’t the usual,” he said.

Which doesn’t mean doctors are inflexible, Scholefield said.

Though not typical, doctors will sometimes come in at night to follow-up with a child they had seen earlier in the day, he said.

Beyond that, a doctor is always within reach, Scholefield said.

“There’s an exchange that [patients or their families can] call—an answering service—and their physician or his call coverage would make a return call back.”

And the physicians would be permanent, Scholefield said.

“At all of our practices, the providers who are there are there all the time. We don’t rotate doctors,” he said.

“Our goal would be to bring two doctors [to the Town of Webb] then, if the volume necessitated it, a third person.”

That person would likely be a Physicians Assistant or a Nurse Practitioner.

Patients would be able to choose between the two doctors, he added.

New patients would be accepted. And no one would be excluded from treatment at the facility.

“The mission of the Medical Center is we care for anyone regardless of their ability to pay,” Scholefield said.

“We accept every single insurance, we also accept self-paid patients.”

The biggest challenge will involve out-of-state patients with unfamiliar insurances. But this too will be worked out, Scholefield said.

Those without appointments are handled too, he added.

“Under New York State Health Code, all clinics are required to see a patient if they walk in, so we would accept walk-in patients as well,” he said.

Slots would be allowed to minimize disruptions to the appointment schedule, he said.

“Your board made it very clear to us that they had concerns for the summer months particularly,” Scholefield said, referring to patient volumes that rise tremendously in June, July and August.

So it is well understood that resources need bolstering in the summer to accommodate increased walk-ins, he said.