For the first time in 23 years, a new physician will begin practice on the Key Peninsula. After 15 years of active recruiting, Dr. William Roes is pleased that Paul Schmidt, D.O., has joined his practice.
“I had a lot of dates,” he said, referring to his long series of unsuccessful interviews, “but never made it to the prom.”
The “date” is a handsome young physician who will finish his family practice residency at Tacoma Family Medicine in June. Dr. Schmidt is one of eight third-year residents in the Tacoma Family Medicine program. His primary facility has been Good Samaritan Hospital in Puyallup; but due to funding issues, that program will close this year. To gain experience in rural medicine, Schmidt has been coming to the Key Peninsula one Saturday a month and one month a year during his three-year residency. He spent the month of April in clinical rotation at Dr. Roes’ office.
“It’s really nice to be working with the community and the folks I’m familiar with,” said Schmidt. “It already feels like I’m part of the clinic; knowing the staff and knowing some of the patients will make it a smooth transition.”
Schmidt and his wife, Elesa, his “high school sweetheart,” are from Gig Harbor, where they have lived for the three years since he returned from medical school in Kansas City and the University of Health Sciences – College of Osteopathic Medicine. The Schmidts are the parents of three boys, ages 5, 3, and one born this past March.
Health care on the Key Pen has always been in short supply. In 1974, the Longbranch Community Church began offering volunteer clinics and safe adult respite day care with Jean Broadsack, nurse practitioner, and nurses Nat Knox and Judy Wilson. Their work was supported by donations, volunteer labor, and the Angel Guild. Sometime later, a nonprofit community corporation now known as the KP Community Health Center, was formed.
Roes first came to the Key Peninsula as a medical student, studying at Washington University in St. Louis in 1977. In 1978, the KP Community Health Center received a grant that enabled it to expand. The center brought in Dean Shriner, nurse practitioner, and moved from the Longbranch parsonage to Key Center, into the building now occupied by A Lot of Love grooming salon. At that point, they began contracting with insurance companies and third-party payors, and started charging fee-for-service.
The director of Tacoma Family Medicine, Dr. Roy Verac, served as medical director of KP Health Center. He and Dr. Shirts, as part of the residency program, would send the chief resident to the Peninsula to see patients for half a day each week, and supervise Shriner. The residency program’s electives included exposure to rural medicine and urban underserved areas.
In 1979, Roes began his rotation on the Key Pen and when he completed his residency, he began a full-time practice here in 1981. The National Health Service Corps had designated the KP as a “healthcare manpower shortage area,” and offered medical training loan repayment to physicians who made a three-year commitment to work in such areas.
In 1981, the Health Center received a grant from the federal Housing and Urban Development agency to build a new facility. The first phase was the completion of the building housing the local branch of the Pierce County Library. In 1982, the Health Center moved into its present location in that building.
From 1981 to 1984 the staff worked as employees of the National Health and Human Services Department of the U.S. government. In 1984, Dr. Roes became an independent contractor and medical director of the KP Health Center. The board of directors sold the business—equipment, accounts receivable, and access to patients—to Roes in an arrangement to provide medical services in lieu of rent until 1993, when he built his present office at 15610 89th Street, just up the hill from the library.
Dr. Roes’ staff grew, as he added nurse practitioner Karen Schneider in 1987, for part-time work after her retirement from the Navy. Though his former receptionist, Frankie Johnson, has been retired for seven years, she says her times at the clinic are her best memories.
“It’s the most positive place I ever worked in my life,” she said. “I don’t think people realize that the practice barely covered expenses. In fact, Dr. Roes may still be driving the Mustang his parents gave him when he went to college.”
The practice has not been able to accept new patients for quite some time. With Schmidt’s arrival, “which effectively doubles the number of doctors on the KP,” Roes said they will accept new patients, and expand their weekly schedule to be open Saturday mornings and Wednesday evenings, regularly.
“We’re very fortunate to get Dr. Schmidt. Many physicians are moving out of the state—even though there’s a crying need to keep them. We’ve lost orthopedists and neurosurgeons, and OB is tight,” he said. “I gave up obstetrics in 1993 because the insurance was so expensive.” The single biggest challenge to the practice is the cost of professional liability insurance. “In one year, 2003-04, my premium increased 44 percent,” he said. “Even though the rate increased only 3 percent this year, I hope a solution is found soon. I have a low-risk practice, perform no significant surgeries, do no OB, and I’ve had no claims.”
Dr. Roes has made an application to the Washington Health Foundation to expand the clinic’s services. The clinic offers well child clinics, flu shots (in the clinic, at KP Senior Services and on Herron Island), and sports physical examinations twice a year for Key Peninsula Middle School students.
Dr. Schmidt already seems at home in the 4,000-square-foot clinic, moving among its eight examination rooms and seeing patients on a recent Saturday morning. One room is designated for casting, splinting and small procedures. There is an X-ray machine, and minor laboratory services are offered on-site. A new service called colposcopy enables the evaluation of abnormal pap smears.
Because the office is so conveniently located, many patients are very sick when they arrive. “We’ve had two patients who (cardiac) arrested because they came in, instead of calling 911. Sometimes I think we’re a level 3 or 4 trauma center,” Roes said. Just in case, there is an emergency defibrillator on the “crash cart” in the closet.
Schmidt’s osteopathic practice focuses on musculo-skeletal manipulation for acute and chronic pain, the frequency of which he leaves to the discretion of the patient. “The patient can tell when they need a manipulation,” he said.
He wants to make a clear distinction between his practice and chiropractic: “They are not the same.” Osteopaths practice a “whole person” approach to medicine. Instead of just treating specific symptoms or illnesses, they regard the body as an integrated whole, according to the American Osteopathic Association Website.
Schmidt’s special interest in sports medicine, health maintenance and family medicine includes children. “As a young physician, I want to be able to follow them throughout their lives,” he said.
Fifteen years is a long time to anticipate a date to the prom, but Schmidt’s presence in the clinic should prove to be worth the wait. Roes hopes to have more free time when Schmidt’s practice is going strong, so he can spend more time with his band…but that’s another story.
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