Question about medical clinics

[seren_ccd]

Oh, all-knowing friends-list, I have a question. Actually, I have two questions.

1. If you have a small town of roughly 2,000 people, would it be possible for them to only have a smallish medical practice of say, four nurses, one permanent MD, and one part-time MD? Said town is located fairly close to a larger town with a hospital, so it wouldn't take too long to reach it in an emergency. Does that amount of staff sound reasonable? Perhaps they have some visiting consultants?

2. In said clinic, would it be reasonable for them to have x-ray equipment and the supplies to handle broken bones? Nothing complicated or anything that required surgery, but just the basics to tide someone over until they could get to a large hospital the following day?

Thank you!!!

Comments

[jal80.livejournal.com]

I lived in a pretty small town, and that was fairly close to the set up we had, so I think it's believable! And our little "doc in a box" as we called it had x-ray stuff.

There was actually some controversy over the fact that we didn't have a hospital, though (it was like a 15 minute ambulance ride to the nearest one). So if you want to throw in the occasional grumpy senior citizen bitching to McCoy about the lack of hospital, that would be very realistic, haha!

[seren-ccd.livejournal.com]

Oh, good! They could handle the occasional broken arm or serious sprain?

And that actually sounds like a great idea. I'm toying with how to have the locals react to McCoy and a grumpy senior citizen sounds perfect. Because who can out-grump McCoy? :D

[jal80.livejournal.com]

Yup! I actually broke my finger in middle school (THIS IS WHY I SHOULD NEVER PLAY SPORTS EVER), and they x-rayed and set it. So I'm sure a place like that could handle most any broken bone.

And hee! I love the idea of a grumpy old lady complaining to McCoy! And Christine could overhear, and just be ENDLESSLY amused...oh, this story will be so much fun! :)

[ostarella.livejournal.com]

My hometown (pop 3200) is 26 miles from a major medical center. We had, for many, many years, a clinic and separate hospital, 2-3 on-staff doctors, x-ray machines, etc. It was only 8-10 years ago that it became financially impossible to keep the hospital going. We still have the clinic ;-)

[seren-ccd.livejournal.com]

Oh, thank you! That sounds close to what I'm looking for. :D

[ostarella.livejournal.com]

Here's a snapshot of the hospital info (before it closed, of course ;))

http://www.hospital-data.com/hospitals/COMMUNITY-MEMORIAL-HOSPITAL-SPRING-V152.html

[aj.livejournal.com]

OH MY GOD. I was born near Decorah! And my nephews and niece finished school in Mabel after North Winn closed! OMG!

[ostarella.livejournal.com]

I went to Luther for a year! LOL

[aj.livejournal.com]

HA! The internet is a small place! WIPPY DIP FOREVER.

[aj.livejournal.com]

The town I lived in that had a pop of 3,000 had a clinic with 2-3 doctors and a host of nurses, but that didn't count as it was bordered by a town of 14,000 and 6,000 respectively. Ah, urban sprawl.

Anyway, your assessment sounds right!

[seren-ccd.livejournal.com]

Oh, awesome. My hometown had two hospitals and a ton of clinics, as does the town I live in now. So, I'm never quite sure what scale things are. Thank you!!

Btw, did I miss your birthday? I think I did: HAPPY BIRTHDAY!!! ♥

How was Priest? ;D

[aj.livejournal.com]

See, the town I was born into had 24 people in it, and there was a hospital a half hour in either direction. No doctor, just 4-wheel drive and the knowledge that if you were really sick and the weather was awful, the plow would come by and pick you up.

Did I mention I've lived an eclectic life?

[jeymien.livejournal.com]

I say it would depend where this town is located.

I grew up in a small town of 1100 people. Our hospital was rather large with 4 full time MDs, atleast 10 nurses (I can't remember how many nurses, just there were alot of them), a fully equipped x-ray facility with a fulltime x-ray technician (happened to be my Mom!) who also doubled as a lab technician with 3 other lab techs. It didn't do major surgeries or anything, but it did also serve as the local hospital for 3 surrounding villages of about 200ish too.

I was always x-rayed in the town hospital (once for something almost frivolous, my mom saw my middle finger bent weird.. and dragged me in for an x-ray and got one of the doctors to look at it.. never fractured he said, just grew that way.)

[seren-ccd.livejournal.com]

Ah, yes, that makes sense. Since this particular town is going to be fairly close to a major city, it can get away with not having as much equipment and staff. Thanks for confirming they'd at least have an x-ray machine. :D

[jeymien.livejournal.com]

Yep, no problem :) Also, the town itself is only an hour outside of Winnipeg, a city of about 685,000 people, so we're pretty close in.

[wendelah1]

I'm a nurse here in California. I can see this community supporting one doctor and another part-timer in private practice. I think they'd send patients to the consultants, who would have their own offices somewhere else, presumably that larger city.

I can see nothing to keep four nurses busy, however. It's not a hospital. You don't need two shifts of people. For a small practice like this, you need a front office person, someone to meet and greet and take billing information. If the practice isn't that busy, that person can bill people's insurance, too. You need a back office person to put people in exam rooms, take blood pressures, draw blood and so on, who would usually not be an RN. They would be a medical assistant, someone with a few months of training, or perhaps an LVN--a licensed vocational nurse, who would have a year or so of schooling. An NP, a Nurse Practitioner, who is an RN with a Master's degree in Nursing and hours of clinical training, who could see patients with minor complaints and write prescriptions, might be useful to a busy practice and would be cheaper than a part-time MD, too. But four nurses? What would they do?

[seren-ccd.livejournal.com]

But four nurses? What would they do?

That's a very good point. I may keep the staff down. A couple of part-time folks, with a minimum of full-time. It also means less characters for me to keep up with. ;D Thank you!

[sivonni.livejournal.com]

There's a town of about 3000 nearby (45 miles away) in the mountains. They have two Urgent Care facilities and an "Immediate Care" facility with about the same features (x-ray machines, etc) and number of staff as you mentioned in each, a few extra personnel in one, and a Veteran's Hospital.

[seren-ccd.livejournal.com]

Oh, that's interesting. Thank you! :D

[hiddencait.livejournal.com]

Yeah I agree with what just about everyone else is saying; the one thing I would add is that you would probably have a volunteer EMS, etc through the fire department since the town probably wouldn't be able to afford any kind of hospital ambulance or whatever on it's own. But with a volunteer staff you're good to go.

[maggietimelord.livejournal.com]

Depends on where and when. There is a rural health initiative that gives 25 bed (and smaller) hospitals better reimbursement through Medicare and other government programs.
Amount of staff always depends on how many hours the project is open.
A clinic isn't necessarily a doc-in-a-box anymore. It is also a term for a group of smaller practices. Carilion Clinic in the Roanoke Virginia area has 3 small hospitals and several group practices encompassing over 100 doctors. The whole organization also supports several 50-100 bed facilities.
Also, with most hospital-type settings, there has to be pharmacist review. Fortunately, this can be handled remotely. I know ... I know ... everyone is all about Doctors and Nurses ... but darn it ... I'm a pharmacist!!!!
*laughs hard*

[seren-ccd.livejournal.com]

There is a rural health initiative that gives 25 bed (and smaller) hospitals better reimbursement through Medicare and other government programs.

Oh, that's very interesting. I didn't know about that. Thank you!

I'm a pharmacist!!!!

Hee! Don't worry, I'm planning on there being a proper drugstore, with an old-fashioned facade and possibly a soda fountain at one end. :D