Dr. Boyle Contract on Hold
Health Care Board wants her to pay to equip the clinic; she wants a turn key set up
by Rob Shaul

The Sublette County Rural Health Care District Board had planned to sign a contract with Dr. Judy Boyle of Daniel to take over management of the Pinedale Medical Clinic at its meeting Monday night, but three things prevented this from happening.

First, to the chagrin of several of the Board members, Dr. Boyle wasn't at the meeting. Second, although Dr. Boyle notified the Board she wanted the job at the Pinedale Clinic in early December, as of Monday she hadn't met with interim Medical Director Dr. Tom Johnston to discuss the transition.

Finally, there is an emerging dispute between Dr. Boyle and the Board over what office equipment and medical supplies at the clinic each party will provide when and if Dr. Boyle takes over as Medical Director.

Slow Transition

Because, Dr. Boyle has yet to meet with Dr. Johnston, according to several of the Board members, she isn't prepared to sign the contract with the Board until she and Dr. Johnston have worked out the transition details.

Dr. Boyle didn't attend the meeting to explain her position and it was left to the Board members to describe the current situation.

Both Garry Eiden Sr. of Marbleton and Jim Greenwood of Halfway said they'd spoken with Dr. Boyle, but each had a different interpretation of where things stood. There seemed to be some confusion of when exactly Dr. Boyle would begin working at the Pinedale Clinic, and when she'd take over the Directorship. Her current contract with Dr. Burnett at the Big Piney/Marbleton Clinic expires on January 15.

Mr. Eiden said he understood from Dr. Boyle that Dr. Johnston didn't want to give up the contract at the Clinic until the first of February.

However, Board Chairman Dave Racich of Pinedale answered that he'd spoken with Dr. Johnston and that the doctor was willing to give up the contract as soon as possible.

Mr. Greenwood said that he understood Dr. Boyle to say that she intended to start working at the Pinedale Clinic on January 16, the day after her contract with Dr. Burnett expires. But she wanted Dr. Johnston to remain as Medical Director until the first part of February. This would allow her to get her feet on the ground before signing the contract with the Board.

Several Board members expressed frustration with Dr. Boyle because she hadn't met with Dr. Johnston to discuss the transition even though it had been a month since the Board started contract negotiations with her.

Without Dr. Boyle being present, the Board was unable to act, so it set a special meeting for next Monday, January 15, 7:30 p.m. in Pinedale at the courthouse. The sole agenda item for the special meeting is to sign a contract with Dr. Boyle.

Dr. Glas' Supplies

The Board terminated Dr. Glas' contract at the Pinedale Clinic in November. When it terminated Dr. Glas, the Board asked him to provide an inventory and total cost of his office equipment and medical supplies at the clinic. He did so, but at its December meeting, the Board flinched at his total asking price - approximately $34,000. The Board asked Dr. Glas to attend Monday's meeting to discuss the issue.

"We're questioning the amount you came up with," Chairman Racich told Dr. Glas. Mr. Greenwood said he felt the Board had decided to set a cap of $10,000 on the amount of supplies it would provide for the doctors at the clinics.

"Well guys, do you want me to take it out tomorrow?" fired back Dr. Glas.

"That would be my suggestion," responded Garry Eiden just as quickly.

"It closes the clinic!" exclaimed Dr. Glas. "Every pencil, every piece of computer equipment, every syringe - it's all my property," he said.

Dr. Burnett noted that the physicians, not the Board, have always stocked the clinics.

"You can't ask me to give that money away," continued Dr. Glas. That would be unreasonable." Dr. Glas said the computer equipment in the clinic was 6 months old and he would consider discounting it 20% for depreciation. He suggested the Board purchase his equipment and supplies, and sell them back to Dr. Boyle when she takes over the Medical Directorship. Dr. Glas said that the Board has to serve as a "bridge" between one doctor and another during the transition.

This idea didn't sit well with former Board member John Linn of Big Piney. "It's time the doctors take responsibility for their soft supplies, computers, etcetera," said Mr. Linn, noting that this is the way it has worked at the Marbleton/Big Piney Clinic. "I don't see any reason a doctor who makes $120,000 to $150,000 per year can't invest $30,000 in their long term business," continued Mr. Linn. He noted that any contractor starting a business in Sublette County would probably have to invest at least $30,000 just to purchase a new pickup.

Board member Gregg Anderson of Daniel said that even if the Board agreed to provide $20,000 worth of supplies at the clinics, no two doctors would come up with the same $20,000 worth of inventory. Mr. Anderson said he'd be in favor of providing the new doctors with a "turn key operation," but that defining "turn key" would be a problem.

Dr. Burnett said he agreed with Mr. Linn that the doctors should be willing to make a business investment, however, he also agreed with Dr. Glas that the Board had to serve as a "bridge" for any new doctor coming into the clinic. He suggested that the Board purchase the equipment and supplies for the new doctors and then establish some kind of incentive where they will pay less for the items the longer they stay at the clinic.

Mr. Racich said he was in favor of buying the supplies from Dr. Glas and then selling them back to Dr. Boyle over time. He said he was concerned that if a new doctor had to provide these up front, it would lead to recruitment problems for the Board.

Mr. Anderson said the Board had already set this precedent by financingDr. Healey to purchase supplies for the Marbleton/Big Piney Clinic when he took over for Dr. Burnett. But he felt the Board should not purchase any office equipment.

Mr. Linn reiterated his objection to the Board purchasing any supplies or equipment for the doctors. "I don't think the Board should get into the supply business," he said.

Mr. Greenwood said he liked Dr. Burnett's idea to develop some kind of incentive program involving the supplies.

Mr. Eiden said he was open to the Board financing Dr. Boyle for the supplies, but only if she wanted them.

As for Dr. Glas, he said he'd be willing to wait until next Monday to see if either the Board or Dr. Boyle would purchase his equipment and supplies.

"A Turn Key Operation"

In an interview Tuesday night, Dr. Boyle said the issue of office equipment and medical supplies caught her by surprise. "I sort of thought it was a turn key operation."

Dr. Boyle definitely feels the Board should supply the office equipment. "My feeling is that that equipment should belong to the clinic and the County ... If I chose to leave, if ever, that equipment would stay just like the x-ray machine."

Dr. Boyle said she'd also like the Board to supply the initial inventory of soft medical supplies. She says she's also looked at jobs in Douglas, Rawlins and Rock Springs and this hasn't been an issue. These have all been turn key operations.

While she understood John Linn's argument that a new doctor should be willing to make a "reasonable" business investment of $30,000 when going into the clinic, Dr. Boyle said Mr. Linn isn't accounting for the many other business expenses doctors face that other business people don't have to confront. These include school loan debt and malpractice insurance. "There's a lot of other things that we pay for that I don't think John Linn and the public realizes," said Dr. Boyle.

Further, Dr. Boyle said she would make a lower salary in Pinedale than her peers across the nation. Dr. Boyle is a board-certified internist and pediatrician. She said that the median nationwide salary for an internist alone is $140,000, and she is making $120,000 working at the Marbleton/Big Piney Clinic under Dr. Burnett. Dr. Boyle said she earned $150,000 at her previous job, but was willing to take the pay cut to live in a rural area.

However, without that higher salary, it would be financially very difficult for her to purchase office equipment and the initial medical supplies at the clinic. "We want to stay here, but what I think the Board and the people here in Sublette County need to realize is that there are not the incentives to make it attractive."

Dr. Boyle said she would meet with Dr. Glas and go over his inventory of medical supplies. She is possibly open to purchasing these supplies, but only if it's economically feasible for her to do so. But she was adamant that the office equipment should go "part and parcel" with the clinic.

"I think it's workable, it's doable. I want to stay here," said the doctor. "My plan at this point is to be in the Pinedale Clinic as of January 16. I'm hoping to get it [contract with the Board] signed and everything worked out."

Meanwhile, Mr. Anderson said the Board had interviewed three doctors interested in working at one of the clinics in Sublette County just last week.