The hospital at the end of the road: SPH celebrates 60 years of patient care
Over the last 60 years, Homer’s South Peninsula Hospital has transformed from a little hospital at the end of the road that had trouble attracting doctors, to a modern facility with a staff of 400 employees.
This year, as it celebrates these past six decades with an anniversary party on Saturday, July 9, the hospital continues to look toward the future and what it means to be a health-care facility on par with hospitals in major cities.
As the health-care landscape changes, SPH is changing as well, said SPH CEO Robert Letson. One of the things it is doing is preparing for the future, which will have an emphasis on keeping patients well and managing chronic diseases by involving primary care doctors, behavioral health services, and using a case manager to help keep a patient’s care on track.
Instead of the onus being completely on a patient to remember to schedule their next appointment or complete a lab test, a care coordinator will be aware of a patient’s needs and call with reminders, said SPH Director of Public Relations and Marketing Derotha Ferraro. This model of care coincides with the Patient Center Medical Home certification SPH applied for.
The certification is one of the steps SPH is taking to integrate and work with Homer Medical Center. The medical practice, which SPH acquired in 2012, and the hospital plan to use this model to improve patient access to care and help them maintain their health and prevent major medical events, such as surgeries.
“In addition to it being a care model, it’s a model that’s being compensated for by some insurance companies and the Affordable Care Act. It’s a model of care that a lot of medical insurers are moving towards,” Ferraro said.
It most likely will take a few years for all insurance companies to take on this model of care, but it is what Medicare and to some extent Medicaid is doing now, Letson said. As Medicare starts a new model of care, Medicaid does so too, and then the private insurers follows suit as well.
The idea is to spend less on procedures and more on care management by catching problems that, if left untreated, would otherwise require surgery, Letson said. Instead of surgery being seen as the primary fix, it is now the safety net.
“One example is the diabetic — someone who discovers the illness early can manage it. If it goes without being treated, they end up having vascular problems that end up with amputation or blindness. If you wait to long, it can turn into other issues,” Letson.
This is why it is important for people to get an annual check-up with the doctor, who can identify small abnormalities in a person’s health and investigate further, instead of waiting until something is terribly wrong to seek medical attention, Letson said.
“Case management makes sure they get in for an appointment,” Letson said. “Right now it’s episodic care.”
The model of care for the Lower Peninsula community that SPH is moving toward coincides with the theme of their 60th anniversary celebration: care in the community, by the community, for the community. Despite the hospital’s growth over the years, the focus is still on the community that has supported them and encouraged such expansion. In some ways, the community helped drive it as expectations for the level of care changed, said Dr. Bill Bell, Homer Medical Center’s chief of staff.
“The town has changed a lot since Dr. (Paul) Eneboe and I were the only doctors in town,” Bell said. “Expectations were we live at the end of the road and what we got was what we got and now the expectation is now they get the same level of care as at the Mayo Clinic or anywhere.”
As Homer and other parts of the peninsula changed from homesteaders who got by with what was available and went to Anchorage or other major cities for more advanced care when needed, to people who moved in from places with more advanced care, patient expectations changed, Bell said.
SPH and Homer Medical Center worked to meet those expectations, resulting in medical faculties that impress out-of-town visitors who aren’t sure what they might get when they need care in this rural Alaska town, Ferraro said. In addition to having advanced technology, modern equipment and a large staff of doctors that includes surgeons and specialists, SPH’s care of individuals stands out.
For those who live in or near Homer, it’s the community aspect where doctors not only see you in the office, but also in the grocery store, Bell said.
“I have this analogy of the community being like a tapestry and the more threads you have linking people together, the richer your tapestry is,” Bell said. “It has fulfilled everything I wanted to do as a family practice physician — to be involved in all aspects of people care from ER to OB from birth to death and in between.”
Bell’s perspective on patient care is similar to the atmosphere of the hospital when Homer’s first resident doctor, Dr. John B. Fenger, worked here in 1956-1965. Fenger started in Homer with his wife, Grace Fenger, who was a nurse, by opening up a practice in the old hospital. There he worked with the hospital’s staff — three nurses — Helen Alm, Wilma Cowgill and Kay Cowles.
Later, in 1962, Dr. Fenger opened a separate medical office building with the area’s first X-ray machine, said Eric Fenger, Dr. Fenger’s son who resides in Homer.
Dr. Fenger was an integral part of the Homer community, where he worked 24/7 for 10 years. Six decades later, his son Eric still feels that sense of community as many people still living in Homer received care from his father.
“I have a lot of people that have said to me, ‘Your dad delivered me, or he set my arm when I broke it,’” Eric said. “One of the reasons I moved back (to Homer) was that feeling of belonging.”
Dr. Fenger tried to entice other doctors from the Lower 48 to come up and either share or take over his practice from him, but no one was interested in working as a doctor in Homer, Eric said. For one, it wasn’t a very financially viable practice as a result of the town’s tiny population, which was still in the hundreds in the 1950s and was just exceeding 1,000 in the 1960s.
“He spent a lot of effort, flew up prospective doctors at his own expense. More than one or two got to the airport and went back on the next flight,” Eric said.
In 1965, Dr. Fenger gave up on attempting to find a resident doctor to replace him and moved his family back to the Lower 48, Eric said. Homer wouldn’t have another resident doctor until Dr. Eneboe came in 1967 with his wife, Bette Eneboe, who was one of Homer’s first midwives, Ferraro said.
Homer’s medical landscape changed quickly, however, as population grew more rapidly over the next few decades. In 1990, Homer boasted a population of 2,209, according to city of Homer’s website. When Dr. Fenger last paid a visit to Homer in 1995, he was surprised by the change that had occurred in the 30 years since he left.
“He was amazed at how many doctors were here at the hospital and Homer Medical Clinic,” Eric said. “He shook his head at the progress. At the time (he was working in Homer) it was a small town, not quite of the grid.”