A remote Aleutian island would seem an unlikely place to find a model delivery system. But that's just what healthcare executives from "the lower 48" states found on a recent visit to Dutch Harbor, Unalaska.
People in metropolitan areas across the country are trying to create the kind of efficient local delivery system exemplified by a clinic in the fishing port of Dutch Harbor, Ronald A. Spaeth, president of Highland Park (Ill.) Hospital, told a meeting of state hospital administrators.
At the independent, not-for-profit Iliuliuk Family and Health Services Clinic, care is provided around the clock by three mid-level practitioners, three registered nurses and one laboratory/X-ray technician in a cost- and resource-effective manner. Iliuliuk's medical director visits the clinic from Anchorage one week during each quarter.
Formerly two small huts dating to World War II, the $6.1 million clinic was built in 1992. It's headed by Administrator Stephanie Combs and was created through the efforts and funding of its clients: employers at canneries, city government, local organizations and local citizens. It operates with an all-volunteer board.
The clinic, which has about 8,000 patient visits a year, serves three main populations. The first includes the residents of Unalaska Island, 800 miles southwest of Anchorage, as well as non-natives and on-shore fish processors.
The second group includes employees of foreign and domestic fishing vessels. They often arrive in the large reception area in groups of 60 to 80 at a time, accompanied by a self-styled translator, Ms. Combs said.
The clinic also treats patients from other Aleutian islands and occasionally provides emergency care for household pets.