The Island Medical Center: A Short History of a Big Idea
On May 24, 1966, a group of concerned men and women came together at the Legion Home in Stonington to advance the idea of a medical center on Deer Isle that would provide year-round primary healthcare for the Deer Isle-Stonington community. The four essential components of their vision included locally-based doctors and dentists; relationships with regional hospitals; a local medical building; and a local non-profit organization to develop and execute the vision, as an advocate on behalf of the Deer Isle-Stonington community. (Note: The non-profit became known as Island Medical Center, and is here referred to in italics to avoid confusion with the building and the medical and dental practices on Airport Road in Stonington, which are themselves also referred to as the “Island Medical Center”.)
The resulting Island Medical Center has a number of compelling histories: the years of quality healthcare provided; the dedicated doctors, dentists and their staffs who have served this community so well; the community and its volunteers who built the medical center buildings and have helped to fund the work there; the ebb and flow of healthcare services available, to name a few. A somewhat different history to consider is that of the idea of the Island Medical Center itself: one which identifies the basic components of the idea, the interactions among them over time, the division of roles and responsibilities, what has worked well and what not so well, etc.
The 50th anniversary of the Island Medical Center is an opportunity for the Deer Isle-Stonington community to reflect, amid an ever-changing landscape of healthcare, on how this big idea has evolved. Today the local medical providers, the regional hospitals, the medical building, and Island Medical Center are each as relevant and necessary as they were 50 years ago. The question is this: what can we learn from their history, as the community defines its Island Medical Center going forward?
Island Medical Center 1.0 – 1966-1976
The first 10 years of the Island Medical Center were marked by determined but often frustrated efforts to acquire doctors and dentists, and by a more successful effort to acquire a dedicated space for their practices.
Recognizing that a successful medical practice on the Island would have to be associated with an accredited hospital, Island Medical Center discussed acquiring doctors’ services with both Blue Hill Memorial Hospital and Maine Coast Memorial Hospital in Ellsworth. Maine Coast, which unlike Blue Hill Hospital had a salaried staff of primary care doctors at that time, posted Dr. Wessel to the Island to establish a medical practice in mid-1967. Dr. Wessel saw patients in temporary space in the former dental office of Dr. Tewksbury in Stonington, while Island Medical Center developed plans and raised funds for a medical building on Airport Road, on land generously donated by Wallace and Althea Knowlton – the site we know today as the Island Medical Center.
Dr. Wessel’s Island practice lasted just a year, however, as Maine Coast terminated the affiliation due to insufficient patient load.
At the withdrawal of Maine Coast, Blue Hill Hospital agreed to make available on the Island several of its affiliated doctors on a rotating basis, each working one or more half-days per week to provide five-day a week coverage. In early 1969, the hospital notified Island Medical Center that this arrangement would be terminated unless an upgraded medical facility could be made available, which accelerated plans to complete the original building on Airport Road. An open house for that community-funded medical facility was held in October 1969. As the new building was being completed, the hospital’s doctor coverage on the Island dropped to three days a week from five, and from 1969-1976 the new building was host to a changing cast of doctors, nurse practitioners and paramedics as Blue Hill Hospital and Island Medical Center worked to establish a stable and effective complement of providers. In 1969, Dr. Lundin opened a full-time dental office at the Island Medical Center.
Island Medical Center 2.0 – 1976-1993
The subsequent 17 years at the Island Medical Center saw a significant increase in the stability and number of medical and dental providers, interrupted for a time in the late 1980s by challenging changes in funding arrangements for doctors’ services, and a substantial community-funded renovation and expansion of the medical center building to make room for the expanding services.
After years of effort on the part of Island Medical Center, Blue Hill Hospital and others, the successful recruitment of Dr. Garland in August 1976 provided the Island Medical Center with its first full-time resident doctor. Prior to Dr. Garland, doctors at the medical center were affiliated with, but not employed by, Blue Hill Hospital; their income came from billing patients for services. On Dr. Garland’s arrival, the hospital instituted annual grants to provide his salary, and the practice was operated as a branch of the hospital. In 1980, Dr. Rissi and then Dr. Howes joined Dr. Garland at the Island Medical Center, expanding and solidifying the full-time medical practice. Dr. Alpaugh established a dental practice that same year, replacing Dr. Lundin who had left several years earlier.
In March 1983, with an expanded complement of providers and services at the Island Medical Center, Island Medical Center began to address the need for additional space. In October 1987, it dedicated an upgraded facility, fully f
unded by the Deer Isle-Stonington community at a cost of $384,000, which included a remodeled upper floor for the medical practice and a renovated ground floor for the dental office. In April 1988, however, a financially stressed Blue Hill Hospital terminated its sponsorship of the Island Medical Center doctors, requiring Drs. Garland, Rissi and Howes to establish and manage a private practice, funding their own salaries through patient billing and absorbing rent and other expenses previously covered by the hospital. Fee levels for medical services were increased; personnel were reduced; doctors’ income fell 15-20%. The resignation of Dr. Howes in 1989 forced a reduction in services, exacerbating concerns about the viability of the practice and its ability to attract both his replacement and a much-needed fourth doctor.
The financial situation of the medical practice was stabilized through grants by Peninsula Health Development Inc., a non-profit healthcare funding group in Blue Hill, and by a commitment on the part of Island Medical Center to annual fund-raising campaigns to offset building operating expenses and provide rent-free space for the doctors. In late 1990, Peninsula Health Development’s grants in support of the medical practice were replaced by grants from the Blue Hill Memorial Hospital Foundation.
Growth of the medical practice resumed in mid-1991 as Dr. George and Dr. Reynolds joined the practice, bringing the number of full-time doctors to four. With a nation-wide shortage of primary care doctors, one key to their recruitment was a financial incentive package funded jointly by Island Medical Center and Blue Hill Hospital which included ongoing support for the doctors’ medical education loans. Dental care at the medical center expanded as well, as Dr. van Emmerik opened his practice alongside that of Dr. Alpaugh in mid-1992.
Island Medical Center 3.0 – 1994-2011
The next 17 years at the Island Medical Center were marked by fundamental changes in the relationships between the medical practice and Blue Hill Hospital, and between Blue Hill Hospital and Island Medical Center; by another substantial expansion and renovation of the medical facility; and by a significant decline and finally a recovery in the size of the medical practice.
In mid-1994, the doctors’ practice at the Island Medical Center was merged into Blue Hill Hospital’s new Peninsula Primary Care Association, along with practices in Bucksport, Blue Hill, Castine, and Tenney Hill, and the hospital became owner and manager of the formerly private practice. As part of this transition, grants to the Island Medical Center from the Blue Hill Memorial Hospital Foundation were terminated, the hospital agreed to lease space at the medical center from Island Medical Center, and Island Medical Center agreed to assume part of the repayment of medical education loans for new permanent doctors, a continuing necessity in recruiting providers for the Island Medical Center.
The initial years of the hospital’s ownership of the medical practice were robust in terms of both providers and services. By 1999, four full-time doctors were experiencing growing patient demand for an expanding list of services, providing support for other Island healthcare organizations, and beginning to outgrow the existing medical building once again. Additional requirements included more exam rooms, space for nurse and lab services, enhanced privacy and other improvements. Island Medical Center began advanced planning for the completely renovated and 40%-expanded medical facility we know today, which was completed in 2008 and fully funded by the Deer Isle-Stonington community at a cost of $900,000.
As the expansion and renovation effort was taking shape, however, the number of doctors at the medical center entered a period of decline, such that when Dr. Zelnick joined the practice in 2008 he was the only full-time doctor. The decline coincided with the financial difficulties at Blue Hill Hospital that culminated in the hospital’s 2004 economic integration into Eastern Maine Healthcare Systems, with which it had been loosely affiliated for a decade. Reflecting on that period of provider decline at the medical center, an Island-wide healthcare survey by Island Medical Center in 2009, and subsequent focus groups conducted by Eastern Maine Healthcare Systems in 2013, highlighted community concerns about limited access to doctors and doctor turnover. Under the strong leadership of Dr. Zelnick, however, the medical practice began to rebuild, including additional providers and significant new services.
Island Medical Center 4.0 – 2012-present
This most recent period has seen a continued strengthening of the medical practice at the Island Medical Center and its leadership in addressing a severe health crisis within our community, and an expanded focus on the part of Island Medical Center, exemplified by a change in its name.
Over the last several years Island Family Medicine, as Blue Hill Hospital’s practice at the Island Medical Center became known, has introduced extended hours and additional urgent care appointments, additional mental health and substance dependence counseling services, a care manager for patients as they are discharged from the hospital and those with chronic illnesses, and new minor surgery capabilities, among other services available there. Most recently, Dr. Zelnick and now Dr. Bugbee have become among very few doctors in this area certified to treat prescription opioid and heroin dependency, a critical health issue in our community. With the recent resignation of a doctor, however, the practice is once again in recruiting mode, and may soon need to address succession planning for its two senior doctors.
With the stabilized financial situation of Blue Hill Hospital, Island Medical Center and the hospital were able in 2012 to agree on the first lease price adjustment for the medical practice space since 1999. With a lease price now covering its ongoing building expenses, Island Medical Center funds were one again available to help recruit healthcare providers and to support them with funding for medical education loans and housing allowances, as well as to help defray the costs of free and reduced-fee patient care at the Island Dental Offices, and to purchase medical equipment. Funds were also available to support important community wellness programs like Island Family Medicine’s “Men’s Boat Overhaul”, Island Community Center’s “Camp Kooky”, and Healthy Island Project’s “Move It to Lose It”, and, in 2016, to fund the startup of a free local medical transportation service.
In recognition of an evolving healthcare landscape that includes the consolidation of medical providers, family clinics and hospitals; the importance of community-based “wellness” opportunities beyond providers’ offices; and the scourge of prescription opioid and heroin dependency in our community, Island Medical Center changed its name to Island Health & Wellness Foundation and embraced an expanded vision that includes increased emphasis on the wellness infrastructure of the Deer Isle-Stonington community, on recruiting and retaining local healthcare providers, and on targeted health crises within the Deer Isle-Stonington community.