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Looking to the Future with Commissioner Marie Michnich, Islands' Sounder, October 2023

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Photo credit Ayn Gailey

In 2012, Marie Michnich and her husband bought a piece of land on Judd Cove and spent the following years building their house and living part-time on Orcas. In 2019, they decided to move to the island full-time. The next year, Michnich was diagnosed with breast cancer. The concept of healthcare on a remote rural island quickly became a lot more personal. With regular ferry trips to Seattle for radiation and other treatments, it became clear Orcas did not have even close to the same, easy-access healthcare that she had been accustomed to. With a Doctorate in Public Health and a long career in healthcare at the federal level with the United States Senate, and the National Academy of Medicine, Marie was perfectly suited for an appointment as a Commissioner on the Orcas Island Healthcare District (OIHCD) board, a position she has now held for a year and a half and concludes in December. Marie began her journey in the medical field as one of the first family nurse practitioners in the U.S. in the seventies. Later, she taught Health Administration at the University of Washington, before shifting to the world of health policy. While primarily focused on federal policy in Washington D.C., Michnich also participated on several professional and hospital boards and mentored young health professionals. All experiences that helped her to shape her passion for policy and governance at OIHCD.

What is unique about the Orcas Island Health Care District (OIHCD)?
In 2018, Orcas citizens voted OIHCD into existence to protect and improve the health of our community and Michnich has had a front seat to watch it evolve. "The District doesn’t just own the clinic like a lot of residents think," Michnich shared. "While the District itself does not deliver direct care, that job has been filled by Anacortes-based Island Health, the District is a convening authority with the ability to bring together key players in healthcare in a neutral way. And that is extremely valuable."

When asked which new clinic services she's most excited about, Michnich lit up, and listed a number of impressive additions. "Since I've been on the board, the clinic has added an additional phlebotomist, which increases the number of blood draws it can conduct for patients. A few years ago, island resident and remarkable centurion Fanny O'Leary donated an X-ray machine, and the clinic added the personnel and operating expenses. Now, with this new personnel and services, our island can provide lab and X-ray services to clinic patients and, as a courtesy, to other local health care providers and non-clinic patients."

According to Michnich, what's happening with cardiology is a game changer. “We islanders are now able to receive remote virtual care for specialized cardiology. The clinic provides a technician in the room with a patient, positioning the stethoscope for a cardiologist who is off-island. The cardiologist can direct and listen with remote monitoring guided by the technician. In fact, our first appointments using this system took place three weeks ago and it was a huge success." The district also contributed to purchasing an ultrasound machine, which will greatly expand the kinds of services offered to Orcas Islanders and broaden the range of diagnostic tools available for those in need of ultrasound diagnostic services.

The clinic offers after-hours assistance with calls channeled to a doctor on call who will meet patients for urgent matters and, Michnich shared, OIHCD brought together a coalition that is working to add dentistry for islanders with Medicaid. "Dental problems are related to many other consequences including heart conditions, lower self-esteem, and more. This new service availability could have a significant impact on our island children." Michnich was also happy to report that the clinic now employs three physicians: a female and male primary care physician and a pediatrician. "That’s darn good for our small island community."

Michnich looks forward to the future and tackling other areas of need, such as home care for the aging and adding other virtual-remote specialty care. However, the road to change is not without its challenges. She explained that there are still gaps that need to be closed: social services, accessible care for the elderly, and addiction services to name a few. The Health Care District hopes to increase the accessibility of healthcare for all and, as she puts it, "develop ways of being more efficient at keeping people from needing to go off island for care."

The Health Care District is currently looking at two new, incoming board members, which, while terrific and exciting, will require more planning, mapping, and envisioning on what the District's next steps should be. Michnich's two wishes are for a strong and diverse board. She hopes that candidates are not "merely the loudest voice or the kind of person who focuses on the topic du jour. A strong skill set is required, and the understanding that within our homegrown governance, we sometimes have to make brutal decisions because funds are precious and finite."

As you finish up your term, what are you feeling absolutely positive about?
"We now have a sustainable, community-owned and community-accountable healthcare district thanks to the Orcas Island Health Care District and good things are happening." Michnich looks forward to helping the new commissioners transition and is proud to have been a part of the growth and improvement of the voter-approved Orcas Island Health Care District.

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