💉 Checking the Pulse 07/08/26

Balance of power: Given that early-stage efforts are underway to bring another public hospital district to Whatcom County, a closer examination of the behind-the-scenes reporting of two recent stories involving a public hospital district-operated hospital in Skagit County is apt.

First, in April, I reported that physicians at Skagit Regional Health were questioning the timing of a hospitalist contract cancellation after the group unionized. Since the two-hospital health system’s Mount Vernon hospital is within Skagit County Public Hospital District No. 1, I wondered what involvement, if any, the district’s seven publicly elected board members had in the decision to contract with a new group. So, I called one of the commissioners, asked, and was told that he was surprised by the decision.

Straightforward enough, I mistakenly thought.

Shortly before publication, while on the phone with me, a member of the hospital’s executive leadership team responsible for communications reacted with surprise when learning that I’d spoken with a public hospital district commissioner. I was told that it must’ve been a new commissioner who’d spoken with me, not knowing the apparent prohibition on speaking with a journalist.

When I said that he wasn’t a new member, and in fact was not only a longtime board member but a sitting county commissioner and former county health director, I was told — again, by a member of the hospital’s executive leadership team — that members of the public hospital district board elected by Skagit County voters aren’t supposed to be speaking with me.

Then, while reporting our July 1 follow-up story that revealed multiple physicians left the hospital over the contract transition, I called a different board member of the hospital district. When reached by phone, the commissioner declined to comment and said they’d been asked not to discuss the contract change. The commissioner then recommended I speak to the health system’s chief executive officer, whom the seven-member board appoints.

According to the Association of Washington Public Hospital Districts, one of the roles of a public hospital district commissioner is to provide oversight of the CEO, which it specifies as “the board’s one and only employee.”

So, where does this leave us? As someone who’s told in some form or another weekly that I can’t talk to someone, know this fact, or see that document, I don’t share this account lightly. I share this because when considering approving a public hospital district or voting for a commissioner, the balance of power is a question that arises, especially in the founding appeals of transparency and accountability for the existence and expansion of such special districts.

Washington State Attorney General Nick Brown was recently in Bellingham, a few days after CDN’s unrelated story on WA lawmakers' attempts to pass corporate practice of medicine legislation. If you haven’t read that story, read it here before continuing to hear Brown’s reaction.

As the story lays out, the potential legislation raises the question of enforcement: Who will enforce the law if it’s passed? One discussed option is the state Attorney General, so my colleague, Alana Marcum, asked Brown about this, to which he said:

"So it will depend on what the law says. We kinda draw the distinction between our role and the role of the [Department of Health] or [Health Care Authority]. We are not a regulatory agency, so we don't license or regulate the practice of medicine or any other profession. We are the enforcement arm. There have been prior iterations of that bill that would put some of the responsibility on DOH and some on us (AG office), and so it depends on where the legislation lands. We want to make sure we are limiting the amount of regulatory role that we have because it's just not our expertise. But we'd do a pretty good job at enforcing the law, so it'll depend."

For more on the matter, I joined FOX 13 Seattle to discuss and, in the process, reminded myself why some journalists are best behind the screen and not on it.

It seems the private nonprofit has, of late, embarked on an effort to repair its public image. The hospital recently approached the local healthcare arm of the League of Women Voters, asking the group to co-host a community forum with PeaceHealth. The health-focused committee declined PeaceHealth’s offer.

Last month, someone based in Oregon from PeaceHealth’s communications team pitched CDN a story about the career milestones of two PeaceHealth directors. We passed on the story, but if you’re curious, fortunately for you, The Bellingham Herald ran it.

The federally qualified health center is recruiting a new chief executive officer and is offering around $300,000 a year for someone to lead the nonprofit's roughly 300 employees and multiple Whatcom County clinics.

Pay close enough attention to the healthcare world and you'll notice an often resurfacing frustration: wait times. Long wait times for services such as primary care providers is a nationwide issue, and locally, it's something I hear about often. It's partially why, in February, I reported on nurse practitioners trying to fill care gaps.

KFF Health News: The tax-exempt status of nonprofit hospitals in Republican-led Indiana is on the line for those who don’t abide by a new law capping prices hospitals charge people with employer-paid insurance.

The New York Times Magazine: In a refreshingly rare non-clickbait story about artificial intelligence in medicine, Helen Ouyang, an emergency medicine physician at Columbia University Irving Medical Center, details real accounts of how AI may impact doctors' thinking.

The UpShot: The federal No Surprises Act is supposed to prevent surprise medical billing. However, reporting from the Times reveals that surgical assistants are wildly profiting in drastic proportions from doctors through a legislative loophole.