With the island facing health care changes and challenges, a group of islanders is working to develop creative ways to strengthen the delivery of medical care on Vashon.

The Vashon-Maury Health Collaborative formed more than two years ago and is now looking to assist the island’s independent health care providers — medical doctors, naturopathic physicians, nurse practitioners and others  — and support the delivery of local medical services. Recently, it distributed surveys to several local medical professionals to better understand and address their needs. Representatives are also working to determine if Vashon could be designated as a rural area, which would provide improved student loan forgiveness for providers and increase Medicare and Medicaid reimbursement rates.

“We are trying to provide economic and sustainable island-directed health care,” said Tag Gornall, a retired veterinarian and the group’s president.

When the coalition started in 2012, it focused, in part, on Vashon’s lack of an urgent care facility. Now, having determined that Vashon does not have a large enough population to support such a facility, the group has turned its attention to supporting the current health care picture here and is considering creatinga nonprofit organization that would offer support services to island providers. Such a step is important to assist and retain the providers who are here, they say, as well as draw new ones to the island.

In recent years, several of the island’s longtime health professionals left their jobs, with many attributing their departures to an unsustainable lifestyle in part because of the after-hours call burden. Chad Magnuson, the most recent doctor to leave, attributed his decision to an increasing load of non-medical tasks: billing, working with insurance providers, participating in audits and keeping records to comply with state and federal regulations.

Several of Vashon’s current providers express the same frustrations as those who left, according to Gornall and John Jenkel, an attorney and the group’s secretary and treasurer. After considerable research, the men say that members of their coalition believe creating a nonprofit that develops in stages according to need and possibly grows into a clinic or other medical facility is likely the best option to achieve the collaborative’s goal: to create an island-owned or directed system that is not beholden to any larger entity.

“Our vision is not entirely clear, but is evolving,” Jenkel said.

Such an organization would serve several providers, taking advantage of the benefits that come with economies of scale, and could include diverse offerings: insurance billing services, assistance with on-call service and coordination, recruitment help and the ordering of medical and clinic supplies.

By taking up these aspects of medical care, the organization would lessen some of the issues that “eat away” at providers, Gornall said, allowing them to focus on patient care.

“If we do not take care of our providers … they cannot provide,” he added.

Katie Konrad, a popular nurse practitioner who began working at the Vashon Women’s Health Center this month and previously worked at Fulton Family Medicine, recently joined the collaborative because she believes it has the potential to improve medical care on the island. From her own experience, she is familiar with the island’s demands of providing clinical care,  which caused her to take a several-month sabbatical earlier this year and then return to work just one day a week after wondering if she could return to work on the island at all.

“I think we need innovative solutions,” she said.

Konrad, like some others on Vashon, noted that there is a shortage of primary care practitioners on Vashon, and in particular, a shortage of those who will accept Medicare. Gornall added this is particularly troubling given the island’s demographics: 17 percent of the island’s population is over 65, compared to 12 percent in the rest of King County.

The Franciscan clinic sees patients with Medicare, but Fulton Family Medicine is closed to new Medicare patients for now, according to clinic manager Kathy Henke, and the Vashon Women’s Health Center — which only sees women — requires that Medicare recipients also have a supplemental policy, Konrad said.

Naturopathic physicians are not eligible to be covered through Medicare, but Kelly Wright, owner of Vashon Natural Medicine, said that the medical doctors who work at her office, Kim Farrell — who left the Vashon Health Center two years ago because of the prolonged heavy workload — and Carolyn Brinkley, do not accept it either, as reimbursement rates are too low.

Naturopath Nicole Maxwell said she is feeling the Medicare crush at her clinic, as she has several patients who are getting close to Medicare age, and she feels that options are limited for where to send them.

It is a situation Gornall and other members of the group take seriously.

“Everyday one of us on the island is getting over 65, and we need to address this,” he said.

In looking for ways a nonprofit organization might support the delivery of local medical services, the collaborative is also exploring creating a lab, which local providers could rely on instead of sending their blood work off-island. Having such a lab would provide a level of health security, supporters say, for example, if tests are needed in the middle of the night or in case of disaster.

Now, with the survey distributed to 15 providers, collaborative members are hoping to get responses back by Friday and evaluate the results. With this information in hand, Gornall said they will know better how to proceed.

“What does the audience really want?” he said. “What (services) would be used or not used up front, or is there sufficient interest at all?”

For her part, Maxwell, who is not a member of the collaborative but has attended some of the meetings and completed the survey, said she would like to see independent providers sharing large resources, such an an X-ray machine. Her clinic does not have one, she noted, and her patients must travel off-island to get an X-ray. The situation arises about twice a month, she said, and can be burdensome.

At Fulton Family Medicine, Henke said that clinic’s largest need is staff. It has been a difficult year there, she said, as the clinic has routinely been short staffed, and they have found it difficult to find people who want to work on Vashon. A clinic may have 5,000 patient charts, but if there is not enough staff to treat them, some people will not have access to timely care, she added.

“I think the crisis is personnel,” she said.

Gornall and Jenkel say they are well aware of staffing concerns on Vashon, and have heard about it from many quarters, including real estate agents.

“The fact is you have people moving off the island because they cannot get the care they want, and some people do not want to move here because the lack of services,” Gornall said.

But before the collaborative would try to bring new providers in, they say they believe they need to fix the system and alleviate some of the challenges of practicing here.

In the coming weeks, with the survey information in hand, group members will look closely at the financial component of what they are attempting to do. Providers would pay to take part in any new program, but it would likely require a community contribution as well. They will also continue talking with health care providers and meet with political officials at the county, state and federal levels. They would like to have a business model in place by the end of January, Gornall said, and come to the community with more information by the end of February.

“Every day that goes by, the needs get greater,” he added.

The men noted that they are not conferring with providers at the Franciscan-owned health center because that clinic is part of a large entity and gets support from it. Their focus is the independent providers, a group that is becoming increasingly rare as consolidation in the health care industry is now the norm.

“Does that mean every community should just give up?” Gornall asked. “We are going upstream against a trend. If not here, where?”