Dr. Bourne's office may close
Will Baker
2007-09-20
Dr. Margaret “Molly” Bourne sits behind a desk cluttered with papers and photographs. Above her on a bookcase, a statue of Mickey Mouse, dressed in a lab coat, smiles contentedly. Bourne’s own smile seemed weary as she addressed the possible closure of the West Marin Medical Center at the end of the year.
As of Wednesday, Bourne did not know if she would be closing the practice entirely, leaving the practice with another physician, or none of the above.
The rumored closure date of January 1 is not set in stone, Bourne explained. By law, she must notify her patients 30 days before leaving or closing her practice. If it comes to that, Bourne wants to give her patients even more advanced warning, although she’s waiting until plans are firmer.
“I just don’t want to send out 4,000 notes and then have to go back and do it all over again,” she said. “I’m still in the information-gathering stage.”
The crisis at the center is financial, part of a trend in West Marin. In recent years, clinics have closed in Bolinas and San Geronimo Valley.
The culprits are also familiar.
“Insurance companies don’t pay very much,” explained Bourne. “They decide how much to pay you, or how much not to pay you. Sometimes, patients come in twice for the same problem. The insurance company tells us we shouldn’t have helped them more than once, and they won’t cover it.”
The insurance companies have also demanded that the center switch to computerized charts, an expensive and difficult undertaking for a small office. Add in the upkeep on the center’s aging building and you have a recipe for financial hardship.
In fact, Bourne has not taken a salary in six months.
“People think that doctors are just rolling in money,” she said. “It’s just not true.”
Bourne grew up in Mill Valley, “back when it was not chi-chi,” she said with a grin. After attending Tamalpais High School, she went UC Berkeley as an undergrad and then to UCSF for medical school before doing her residency at Stanford.
But Bourne wanted to return to Marin, and in 1999 she came to work for Dr. Michael Whitt. Their understanding was that eventually Dr. Whitt would retire and sell her the practice. However, the two doctors found they liked working together. Five years ago, Whitt sold Bourne the practice and stayed on as her employee to share some of the workload. A year ago, Bourne also bought the building from Whitt.
This week Whitt was out of town and unavailable for comment.
Foreseeing a large reaction, Bourne set up a separate line at (415) 663.9174 to take calls about the possible closure. Bourne said she has received dozens of voicemails, almost all supportive. She gestured to the answering machine. A red 29 blinked on its screen, indicating unchecked messages. Bourne will listen to them all, although she may not have time to answer everyone’s questions.
Especially when the future is so uncertain. The center could become what Bourne terms a “boutique shop,” a cash operation that accepts payments directly from patients. But this would mean turning away patients with financial hardships. Another possibility would be to become part of an HMO or a large medical group. But that would mean seeing many more patients and losing the familiarity of a small practice. Currently, the center subcontracts for Kaiser.
Those are options Bourne has tried to avoid.
“It just widens the gap between rich and poor,” she said. “There are very few practices like mine left.”
Local residents are forming a committee to look for ways to help the center. Fundraising has been discussed, but Bourne wonders if that would just be a short-term solution.
“They could raise money initially, but how to sustain it…?” she said, shrugging her shoulders.
Bourne’s biggest worry is her patients, especially those who are elderly or infirmed.
“I think about the old folks who don’t drive,” she said. “It’s unreasonable to ask them to go over the hill. If at all possible, I want to keep the office open. Hopefully we can get a funding source to keep a physician here, even if it’s not me.”
Jeanne Kehoe from Inverness, whose daughter-in-law is Bourne’s office manager, has been coming to the center for over 40 years. She said she was “shocked and upset” when she heard last week that the center might be closing. Even with her family connections, she said she heard the news from an acquaintance.
“Somebody told me out of the blue,” she said.
Kehoe has been a patient of both Dr. Whitt and Dr. Bourne, describing them as “just great.”
When asked about her options if the center closes, Kehoe shook her head.
“That they continue is all I hope.”