Two points in your recent article on the work of the Vashon-Maury Health Collective deserve clarification (“Attempts to support island health care unsuccessful so far,” July 8).

First, we found widespread support among the island community for improvement in the delivery of health services on the island. Interest in improved communication and coordination of services was lacking in the community of independent health care providers, not in the general community at large. We observed a divergence between what our group perceived to be the best means of advancing the interests of the island community and the conduct of current independent island providers. We found the majority of current independent providers not inclined to take modest steps to work together.

Second, the “rural” designation allows for certain increases in medical fee reimbursement and other benefits. Vashon qualified for the designation under a population-provider ratio test. We lost that necessary ratio when one of the independent island practices added a very limited part-time provider. We suggest this speaks to the importance of developing communication and cooperation among the island’s health providers.

We consulted state and federal experts, founders and managers of rural clinics, state legislators and private medical organizations developing new care models. Our group concluded that strengthening the current network of on-island independent providers is the best way to lay the groundwork for adding additional resources and services that are not beholden to off-island management and directives (whether economically or philosophically based).

We do not claim to have all the answers to a thorny problem, nor that our approach is necessarily the best one. But as one watches the slow parade of providers leaving the island or restricting their practices, each citing the same reasons for doing so, it seems reasonable to suggest that these common challenges may have a common solution. That common solution requires cooperation and, we think, a sense of urgency.

— Tag Gornall and John F. Jenkel