Grays Harbor will soon be without the services of its only local on-call pediatrician. A rift between Dr. Sean White and Grays Harbor Community Hospital administration is a factor in his decision to relocate his practice, the doctor said. White and his family will be moving to Dickinson, N.D., shortly after the start of the new year.

News of his imminent departure fostered rumors of a possible closure of the hospital birthing center. The hospital is adamant it has no intention of closing the birthing center and has released a plan that address the on-call pediatrician issue temporarily while it looks for a permanent solution.

Asked about Dr. White closing his practice, hospital CEO Tom Jensen said, “Dr. White’s decision to leave came down to simple math. Seventy-four percent of children born in the hospital are Medicaid eligible.” (Typically, Medicaid reimbursement to doctors is less than private insurance). “Doctor White just wanted his practice to survive, but with the Medicaid population so high there is nothing he could do about it … if you will … he’s actually being punished for taking on a population in which he could potentially go bankrupt … so he couldn’t have stayed if he wanted to.”

That’s not the way Dr. White sees it. He said the Medicaid population Jensen spoke of was not a factor in his decision to leave.

“No one comes to serve in an underserved area to make money, you come because you have a heart to serve,” he said. “In January, I submitted a letter of resignation of my hospital privileges, which would remove me from the call pool for pediatric services. After spending two weeks a month the past six and a half years as an on-call pediatrician at the hospital and working full time at the clinic I became exhausted. I realized I was spending too much time at work and not enough time with my family.”

White knew resigning his active privileges would come with a heavy price tag; one he was willing to incur. “There was an agreement in place when I signed my contract in 2009. The hospital would make my monthly student loan payments as long as I was a physician in the community with active privileges and taking part in the on-call duties for the pediatric service,” White said. “After I gave my letter of resignation to the hospital giving up my privileges, Tom Jensen sent a letter gently ‘reminding’ me that the hospital would stop making the payments.”

Faced with the decision to remain in the call pool or pay his own student loan payments but have more time with family, White chose the latter. “My goal is clear,” he said.

His goal was clear, but there was something he forgot to consider prior to submitting his resignation of hospital privileges.

“What I didn’t realize at the time was that insurance companies that credential physicians require in the contract with a provider that they maintain privileges with the local hospital,” White said. “They are willing to waive this requirement if the physician has an agreement with the local hospital stating their patients can be admitted and taken care of by another doctor who works at the hospital.”

When White was “informed of this caveat” he amended his paperwork from resignation to a formal request to change his admitting status from “active” to “courtesy” status.

“That would’ve allowed me to be associated with the hospital, have admitting privileges, but not be required to be in the call pool,” White said. The request was denied, he said.

The hospital administration did “offer me the option of taking a 90-day leave of absence to, ‘deal with my stress,’ ” White said. He availed himself of that and found the time off to be the “most therapeutic three months for me in the last six-and-a-half years,” White said.

With the denial of requests and the handwriting on the wall, White began making plans to leave.

His voice trembling, White told The Daily World, “When I left this community to go to medical school, I never intended to practice anywhere else. And when the time came to interview for my first job, I never entertained the idea of interviewing at another hospital besides Grays Harbor. I truly love this community. My wife and I are, and were vested here. We have 10 children — some we’ve adopted here — many are special needs kids. We had no plans to leave here whatsoever.”

White is originally from Hood River, Ore. He and his wife Dawn moved to Aberdeen in the late 90s.

“I graduated from the University of Washington in 1999 with a degree in psychology and zoology. I asked my wife where she wanted to live when I finished. At the time she had a sister who lived in the area who was pregnant. Dawn wanted to be close to her. So we moved to Aberdeen and I started working as a social worker (in the field of children and family services). We bought a house and started taking in foster kids,” White said. “Two years later, I applied and got accepted to medical school. I started my training in 2002, graduated in 2006, completed my residency in 2009, and returned to start my practice here in Grays Harbor.”

“The last two weeks have been really painful,” White said. “My heart is heavy with the thought of having to leave so many wonderful families, so many precious lives and so many dear friends.”

His departure means the community will be devoid of its lone local on-call pediatrician. Dr. Tracy Russell was taking calls with White, but gave her notice last July and is no longer a part of the call pool.

Jensen vows the hospital will continue to provide on-call pediatric service to the community, and added there are no plans to shut down the birth center.

“The hospital will do whatever it takes to cover the on-call shifts and keep the birth center open,” Jensen said. “It’s a need in the community that needs to be met. I personally do not want to run a hospital in a community like this that doesn’t provide that service.”

One of the biggest obstacles that rural hospitals like GHCH face, Jensen said is the recruitment of doctors.

“This is a hard place to recruit — not just for physicians but for health care providers too,” he said. “We are routinely looking for qualified applicants through a variety of methods, including recruitment firms, online searches and word-of-mouth recommendations.”

“The hospital, like many agencies in the Harbor, struggle recruiting professionals who understand the specialized needs of Grays Harbor County, Jensen added. “The right professional needs to have compassion and skills that allow them to work and live in a town that is economically stressed. It is difficult to have a successful practice in an area where the payer mix is not profitable.”

Beginning in January 2017, the hospital has secured pediatric coverage for the Family Birth Center for the first six months of the year while Jensen and administrative staff work on a long-term plan to provide pediatricians for the hospital and community.

“We’re going to do the best we can to put together a Ped’s program. But its’ not going to be fast. … It wasn’t fast the last time … but we will do as much stop-gap stuff as we can,” Jensen said. “There is no quick fix to this … I know that’s not what everybody wants to hear. I’m sure they’d prefer providers not leave the area, but it’s tough for them to stick around in this type of market.”

In the meantime, Grays Harbor Community Hospital has provided a link to a list of Family Birth Center providers on its website who are available to take pediatric patients: http://www.ghcares.org/patients-visitors/providers-accepting-pediatric-patients/.