Category:Outpatient

Overview

YKHC Outpatient clinics provide care for approx. 6,000 Bethel patients as well as another 22,000 patients who come in from 48 surrounding villages. The outpatient clinics are busy and provide about 45, 000 visits a year. There are three hospital based outpatient clinics that are staffed by Family Medicine, Women’s Health, OB GYN, and Pediatric physicians and midlevel providers. There is also a Specialty Clinic where a variety visiting specialists, who are each scheduled ‘field clinics’ 2-6 times a year. Specialty clinics include ENT, Surgery, and Ortho physicians who provide adult and pediatric care; adult and pediatric neurologists and cardiologists as well as pediatric endocrinologist and pulmonologist clinics. Clinics are scheduled M-F 9-5pm.

Approximately 50% of the clinic volume is made up of village patients who have arrived by plane, boat, snow machine, river taxi, or hovercraft. Village patients often arrive early or late for scheduled appts because of plane schedules and weather etc. Village patients do not get seen often in Bethel because they have less access to our Bethel clinics due to the cost of travel, weather, work or personal responsibilities in their village. Because it is harder for village patients to get into Bethel for care, often providers will try to get as much done as possible in each visit. The other 50% of the clinic appointments are Bethel patients, who are seen more frequently and come into clinic an average of 6 times a year.

Our clinic patients are generally sicker and have a higher acuity than patients normally seen in lower 48 outpatient clinic settings. This population is highly susceptible to bacterial and viral infections. We have ten times the rate of strep pneumococcus, which leads to more septic workups in neonates and increased amounts of pneumonia for the entire Delta. There is rampant TB in villages intermittently, invasive HiB and HiA infections, MRSA boils , RSV is a huge Health aides in villages have already prescreened 50% of the patients seen in the Bethel Clinics and only the sicker ones have been sent on to Bethel. These sicker patients are more complex and time consuming. They often require more evaluation and treatment than other clinic patients. It is not unusual for clinic providers to function like a specialist and find themselves needing to contact several sub specialists during the day. It is important to talk to other experienced Bethel providers and consult about complicated patients.

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