Another health care growth spurt on its way

The health care community in Southwest Washington is experiencing movement, causing both a clinic closure and further plans for growth.

One company announced it will introduce a clinic into the market, while another – faced with hefty physician losses – is consolidating its efforts. And both area hospitals are moving forward on plans for expansion.

The added capacity will expand services to patients, but it has some worried about the potential workforce implications.

Shrinking provider pool

August 29 will mark the closure of Vancouver-based Family Physicians Group’s Salmon Creek clinic. All of its operations will be consolidated into the physicians group’s Fisher’s Landing clinic, where 24 providers will practice after the consolidation is complete.

The announcement comes after the loss of eight providers in the last year at the Salmon Creek site due to competitive pressures, said Administrator Kurt Litvin.

“There is such a huge demand coast to coast for primary care practitioners that it’s difficult to replace them quickly,” he said. “We simply found ourselves too short of providers to allow us to keep the doors open there.”

The providers who left the clinic represented more than half of the practitioners there.

“The pool is so small that it was going to take us, and has taken us, more time that we would like to have replaced those providers,” Litvin said.

However, he said, the physicians group in conjunction with Southwest Medical Group has ambitious recruiting goals and is pursuing plans to open a primary care presence in Battle Ground in the next three to six months. Additional full-time recruiting resources have been hired to allow the physicians group to “come back into the marketplace in a big way,” Litvin said, and space already has been secured for the Battle Ground location.

Family Physicians Group, which is a subsidiary of Southwest Health System – also the parent company of Southwest Washington Medical Center – has plans to expand further into Clark County after the Battle Ground location opens.

One of the medical group’s goals is to grow primary care in greater Clark County, said Director of Marketing Chad Dillard.

Entering the market

At the same time, Providence Medical Group will expand its presence into Southwest Washington with the opening of a family medicine clinic in late 2008.

The clinic will take shape in the two-story, 15,000-square-foot building at 315 S.E. Stonemill Drive the medical group has owned since 1991.

The practice will start on the first floor with three or four primary care physicians and have the ability to grow to eight or nine physicians in the next few years, said Dr. Craig Wright, chief executive of Providence Physician Division.

It will offer physical therapy, lab and digital X-ray services and provide room for specialists to rotate throughout the clinic. The cost of coming into a community and starting a clinic is significant, Wright said, but specific figures were not available.

Wright said he expects to open the clinic with about 12 employees, adding that competition from existing regional practices is not an issue.

“We think there is a real need in the Clark County community for primary care services,” he said. “We already have patients traveling from Clark County to our clinics in North Portland, Gateway and Gresham. We do not believe there will be a detrimental impact on the long-term success of other practices.”

Hospital expansion

Both regional hospitals, SWMC and Legacy Salmon Creek Hospital, have build-out projects in the works.

Legacy Salmon Creek will start construction to complete its 47,000-square-foot sixth floor in September with plans to open by mid-summer 2009 – two years ahead of schedule, said Lisa Wood, communications specialist for Legacy Health System.

The project includes moving the hospital’s Progressive Care Unit to the sixth floor and adding a second PCU. The former PCU on the third floor will be transitioned into a neurosciences unit to allow room for additional Intensive Care Unit beds over time.

It also includes an orthopedic unit – part of the hospital’s new Total Joint Center – and moving a general surgical care unit from the fifth floor to the sixth. This will free space on the fifth floor for overflow patients from the Family Birth Center.

The expansion will add 64 beds, bringing the hospital’s total licensed bed count to 220, which is the maximum allowed with its current state certificate of need.

Any time a health care facility wants to open in an area, it must apply for a certificate of need from the state to ensure it is not encroaching on existing services, Wood said.

Along with the build out, Legacy Health System opened a family medicine clinic in Fisher’s Landing July 8 at 16703 S. E. McGillivray Blvd. The clinic currently has three physicians and features on-site X-ray and lab services.

It is the first clinic Legacy has opened in the community that isn’t attached to the hospital, Wood said.

At SWMC, construction is scheduled to start in the next six weeks on the $45 million build out of its Firstenburg Patient Tower. The fourth, fifth and sixth floors will be constructed into intensive care, coronary care and telemetry units, respectively.

The added capacity is key because the greatest demand tends to be for critical care services.

As it stands, ambulances commonly have to bypass (or be diverted from) the hospital because it doesn’t have the capacity to handle the patients.

“Even though there is the additional regional hospital, the number of hours on divert are up prior to Legacy’s opening,” Dillard said.

The flip side to expanding capacity is the cost and the additional workforce required.

“But by not creating the capacity in critical care, are we just short-changing ourselves and making it less convenient for patients?” Dillard said. “If we have demand for that portion of health care in our community, (patients) have to go somewhere. If the ambulances end up in Portland, it’s not like they’re not busy, too. It is part of a bigger issue in terms of the problem of using ERs for everything.”


With the benefit of expanded area patient services comes the need for more trained health care workers.

“Any health care operation in Vancouver is going to be competition,” said Valerie Meister, a recruiter at The Vancouver Clinic. “Nurses, in particular, are hard to find. As is any position that requires any sort of licensure. They are that much more difficult to find because there are fewer of them.”

The Vancouver Clinic is in the midst of building its new facilities on Northeast 87th Avenue in Vancouver, which is slated to be complete in October. All staff at the current 87th Avenue location and Physicians’ Pavilion will move into the new building.

Competitive forces are behind the upcoming closure of Family Physicians Group’s Salmon Creek clinic. But it’s not just competition from expanding local health care operations.

“The competition is universal now,” said Kurt Litvin, administrator for Family Physicians Group. “You can just as easily lose one of your practitioners to someone across the country as across the river. The competition is there on a local, regional and national level.”

At Southwest Washington Medical Center, critical care services will be expanded with the build out of its Firstenburg Patient Tower – which will require more specialized nurses. And they aren’t easy to come by, said Marketing Director Chad Dillard.

To recruit from within, SWMC recently launched a critical care nursing internship program and three interns are taking part. Ultimately, the program will graduate 12 or more interns per year, said Registered Nurse Julie Jones, director of project management and staffing services.

The hospital also has internships for hard-to-recruit operating and emergency room nurses.

“We developed the internship programs to ensure a supply of nurses,” Jones said. “Everyone is concerned about the forecasted nursing shortage.”


Megan Patrick-Vaughn can be reached at