As a new doctor, Wes Henricksen wanted to help poor communities. But doing that hasn’t been simple.
Henricksen joined the Child and Adolescent Clinic in Longview, Washington, nine months ago, soon after he completed his residency in Seattle. He had planned to work in global health, but in medical school, he met a pediatrician in rural Georgia who changed his career decision.
“He was addressing a lot of these chronic health issues in terms of obesity, in terms of smoking, in terms of diabetes, in terms of mental health decisions that really impact an adult health in large ways," Henricksen, 33, said, "but he was dealing with them 20 years before they became big adult health problems."
In the South, Henricksen saw firsthand that poor communities in America needed more doctors, so he decided to become a rural pediatrician, hoping to make a difference for kids early in their lives before they developed bad habits.
Rural communities have often struggled with not having enough medical providers. The Affordable Care Act allowed more people to enroll in Medicaid, the health program for low-income families. Doctors who saw those patients received a temporary pay bump.
Henricksen’s clinic used the money to hire two new doctors; he was one of them. He headed to southwest Washington with his young family and strong ideals. “Both my wife and I wanted to go and live somewhere where we felt like we were doing work that actually felt meaningful,” he said.
The feds picked up 100 percent of the Medicaid tab for two years – but Congress didn’t renew that subsidy. Now it’s up to the states to decide whether to continue. Washington was one of 30 states that expanded Medicaid under Obamacare.
“We’ve been scrappy. We’ve been able to find extra funding sources, find extra grants,” he said. “But I’m also really concerned that it’s going to get harder, that it makes our job a lot harder to do.”
On a recent Monday, Henricksen started the morning with a 2-year-old boy who had a bleeding cut on his head. He checked the wound.
“I really think it’s a bad scrape and nothing that really needs to be sutured up,” Henricksen told mom Vanessa Gavino. He tried to patch the wound with a kind of super glue.
The next patient is Lysa Coleman, 20.
She’s at the clinic for a follow-up. A few months ago she started treatment for ADD because she was struggling with school.
“Any weird moodiness or emotional changes?” Henricksen asked her.
“Sort of,” she said. “I’ve had a couple of days where I just want to break down and cry and freak out. But I’ve kept it cool.”
There have been disruptions at home. Her sister is visiting with her babies, and sleep has been tough for Coleman – she’s had to sleep on the floor. On top of that, her boyfriend just moved to Seattle. And then there’s school.
“This is pretty normal for me,” she said. “Like when everything kind of gets stressful, I try to find an escape, but I can never escape.”
“What are you trying to escape from?” Henricksen asked.
“My family,” she said. “But they can always find me.”
She’s trying to get her degree: “And then I’m going to leave as fast as I can.”
Henricksen suggested she see a counselor. He asked her to come back in two months.
How long the Longview clinic could continue accepting Medicaid patients is uncertain. About 73 percent of the clinic’s patients are on Medicaid.
Washington Gov. Jay Inslee asked the state to pay the Medicaid bill in his budget proposal, but it hasn’t gone anywhere. That’s making doctors in rural areas nervous about their ability to continue seeing poor patients. Henricksen hopes the state Legislature will have a change of heart, but he said if not, the clinic will have to come up with a backup plan.
Elsewhere, providers are already dropping Medicaid patients. Henricksen’s clinic has seen a recent surge of new patients from nearby Centralia and Vancouver, Washington. Many have driven more than an hour to his clinic because it doesn’t turn away patients based on their health plan.
Henricksen said he still would have come to Longview even if he had known of the financial uncertainty.
“But there are other doctors in the state that aren’t making that same decision,” he said.