The bad old days of early 2022 seem like a lifetime ago for the WahZhaZhe Health Clinic.
Back then, employees and patients alike were fleeing what can only be described as a toxic and chaotic workplace that left some traumatized, “almost like they had Stockholm Syndrome,” as one person put it.
Since July of 2022, however, change has been afoot: It was then that, for the first time since the clinic became autonomous and spun off from the Indian Health Service in 2015, it hired a dedicated chief executive officer – and an experienced one at that.
Mark Rogers, Cherokee, was lured to the Osage Nation from the Absentee Shawnee Tribe, at whose clinic he quadrupled revenue in eight years – and reduced employee turnover from a whopping 300 percent to a measly 2.5 percent.
In just a year, the Osage clinic has achieved similar successes and growth: The number of employees has more than doubled from 65 to 151, staff turnover is virtually non-existent, patients are returning in a steady stream, services have been expanded to include neurology, nephrology and endocrinology – and patient satisfaction is unbelievably high.
In June, 173 patients filled out surveys – and each and every one of them said they had been given clear and detailed information about their ailments and treatments.
“That’s phenomenal,” said Dr. Tony Little, the Chief Medical Officer who was hired on in September from St. Francis Health System in Tulsa.
Some praise for the clinic is quite unsolicited: “Me and the kids switched over to the WahZhaZhi Clinic as our primary care provider and I have been so freaking happy with the care we’ve gotten,” Dana Bear effused on Facebook recently. “We saw a nurse practitioner today and she was so sweet. It’s such a nice direction the clinic is moving in. Even the girl who made our appointment yesterday was super kind.”
Another patient, Chris White, rejoined: “It’s amazing, isn’t it, when they put an actual administrator in charge of administration!”
If patient satisfaction can go higher, it should. More specialists are being brought on board in orthopedics, cardiology, dermatology, rheumatology and podiatry, and two mobile medical units – jokingly referred to as the clinic’s “mobile ministry” – are being deployed to go to patients, and hours are going to be expanded.
Once the Native American population is being well cared for, the clinic will start allowing non-Natives with insurance to seek health care, too, which will help its bottom line.
Common sense at the top: Hire seasoned practitioners
At last month’s meeting of the health board, Si-Si A-Pe-Txa, Dr. Little said the clinic has been taking a hiring approach that is unusual in Indian healthcare: It has been hiring primarily “gray-haired, seasoned” healthcare providers instead of young doctors and practitioners fresh out of school, “kids who are electronically stunted by their phones.”
Gradually, younger doctors will be woven in to work with the older providers, who will mentor their younger colleagues and train them how to maintain good patient care, creating a sustainable legacy.
As CEO, Rogers has three essential rules for employees: “Take care of the patient, and take care of each other. Rule No. 3: Refer to Rule No. 1 and Rule No. 2.”
Rogers constantly encourages everyone at the clinic to be cheerful, to be respectful, and to seek solutions to any problem they come across.
“I have an open-door policy so people can come talk to me anytime,” said Rogers, who also freely shares his cell phone number with patients and others. “If someone finds their supervisor intimidating, go get the supervisor, hash this thing out and fix it right now.
“I had a lot of that when I first got here, but nothing for the past seven months. A lot of it is just being available; 90 percent of people just want to vent and feeling like someone is listening to them.”
Between Rogers and Little, the top two executives at WZZHC have several decades of experience, and both want to retire with the new clinic as a crown jewel in the world of health care – and as their legacy.
“We want to retire in a way that we can look back and say, ‘Dang, look what we did,’” Rogers said.
Rogers and Little will lead as the Nation builds a soaring modern clinic on Pawhuska’s Main Street that, with 60,000 square feet, will be more than six times larger than the existing clinic that was built in the 1970s.
The $50 million clinic construction is expected to begin in January on the site of the old Safeway grocery store and is scheduled to open early summer of 2024. The design of the clinic has been tweaked since renderings of it were first released last year: Some interior changes have been made, and the arched roofs that were a feature has now been replaced with flat roof panels, which are considerably less pricey.
The new clinic will have an expanded pharmacy, a state-of-the-art lab, radiology and new imaging along with expanded dental and optometry services as well as space for physical therapy, diabetes care, and dietary services.
Boosting care for elders
Outside of the clinic, Osage Nation Health Services is also expanding. It recently hired two women as activities and benefits coordinators at the two senior nutrition sites in Pawhuska and Hominy: Margaret “Maggie” Gray and Sadie Patterson.
The clinic is in talks with Green House Project to open a turnkey assisted living facility with 12 beds in Hominy that will be built alongside the new senior housing units for which the nation broke ground last month. Green House is a non-profit that has pioneered modern assisted living for elders, steering away from the traditional institutional nursing home for a happier place where elders can socialize, cook their own meals and have private rooms and baths – as couples when appropriate. This will be the first Green House Project executed with an Indian tribe, Rogers said.
It is also building a new primary residential treatment facility west of Pawhuska, and is in the process of buying the land cattycorner from the Pawhuska Post Office, where it will erect a building for clinic procurement that will be headed up by Melissa Cole, who has been the assistant to the Si-Si A-Pe-Txa board and has a background in accounting.
Some changes not obvious to those outside
Other changes at the clinic are major but not noticeable. Since the Nation compacted with IHS to run the clinic itself, it has always rolled over a few million dollars of IHS funding from one year to the next. That, said Rogers, is foolish, because it effectively tells the federal government that the clinic doesn’t need the entire amount that IHS funds every year, and eventually IHS simply whacks the budget.
“It’s been going on way too long,” Rogers said. “I couldn’t care less what happened before I got here, but I own it now.”
As a result, the clinic now exhausts the IHS money and finishes the year spending third-party revenue – income it receives from insurance billing.
Rogers said that another huge difference that the health board made was also key to progress: Having a separate CEO, CMO and clinic manager.
“You have to have someone in the CEO role who’s paying attention to the long-term goals,” Rogers said.
“Dr. Little works sunup to sundown, and he doesn’t distract me with clinical stuff and I don’t distract him with administrative stuff. And I’m not worried about what’s happening today or tomorrow. I’ve got Mr. (Kirk) Shaw (the clinic manager) to worry about that.”
Another big change that is largely invisible to the patient population: Weekly meetings for the top staff and monthly meetings for the entire staff. At the last monthly staff meeting, Rogers updated the staff on clinic news and construction, introduced new employees, named the staff-chosen awards for unsung hero, special leadership, and employee of the month, celebrated birthdays, praised the staff for vast improvements in phone etiquette and patient care, and noted that his door was always open.
“Life hits everybody,” he said. “If you need help, ask.”
Dr. Little also weighed in with a pep talk, referring to Ted Williams, the Boston Red Sox baseball great and last to bat .400 in a season.
“He could see the seam on the baseball and know what kind of ball the pitcher was going to throw,” Little told the 150 or so employees gathered at the community center west of Pawhuska.
“We’ve thrown a lot of balls at you guys this year: Curve balls, fastballs, spitballs. And you guys handled them great.
“About 25-30 percent of patients respond to satisfaction surveys, and they’ve been 100 percent positive for providers and about 95 percent positive for others.
“You guys are catching a lot of balls. You’re doing great.
“We’re setting the standard.”