Although they could be seen as health care competitors, representatives of the three medical services in Powell say they work together cooperatively to provide the best options for patients.

“I actually see us complementing each other,” said Arleen Campeau, vice president of patient care at Powell Valley Healthcare. “There may, in time, be more competition, but right now, we’re working together, complementing each other.”

Powell’s health care landscape changed significantly last year. Drs. Mike Tracy and Bob Chandler parted ways with Powell Valley Healthcare to start 307Health — their own practice under a new a direct primary care model — in August 2015. Then the long-planned Heritage Health Center — a federally funded community health center that charges patients on a sliding-fee scale — opened in September 2015.

Now more than a year later, Drs. Tracy and Chandler of 307Health and Dr. Juanita Sapp of Heritage Health Center all say a good relationship exists between those clinics and Powell Valley Healthcare.

They refer patients to Powell Valley Healthcare for lab, radiology and other services, and to each other when one model of care works better than another for those individuals.

Since the Heritage Health’s opening last year, the hospital has provided the center with $102,614 in discounted services — primarily lab and radiology, said Terry Odom, chief executive officer for Powell Valley Healthcare. Odom said Powell Valley Healthcare also provides diabetes counseling services.

Meanwhile, Heritage Health has helped Powell Valley Hospital by reducing the number of inappropriate visits to the emergency room, she said.

Campeau — who also serves as a liaison on the board of Heritage Health Center — said the hospital’s emergency room doctors are seeing fewer people with sore throats and colds and other illnesses that can be treated in a doctor’s office.

“So they’re using different services more appropriately, and being able to use services in a more optimal manner,” Campeau said.

Added Odom, “Heritage has provided assistance where patients didn’t have resources. Several times, people have come here that didn’t have a way to pay, and we sent them there to sign up for Medicaid.”

“They definitely serve the underserved with their sliding fee scale,” Campeau said. “One thing they do very, very, very well is, they’re really bringing resources to the community to get people on insurance, or to get the financial assistance they need to get health care.”

Despite the changes, Odom said the amount of charity care provided by the hospital has not decreased since the opening of the two new clinics.

Odom said she believes Powell Valley Clinic has lost some patients to 307Health, particularly those who followed Chandler and Tracy from the clinic to their new practice.

“But I think we have replaced those patients with other patients,” she said.

The addition of 307Heath and Heritage Health Center, as well as new medical providers hired recently for Powell Valley Clinic, helped reduce the wait time for patients to get needed medical appointments, Odom said.

“I think we’re fortunate in Powell that we have (different heath care) models. For a town this size, it’s unusual,” she said.

“I think a common theme here is cooperating for the best interests of patients,” Sapp said. “We’re actively working with 307Health; they’re a good resource for us. We refer to them; they refer to us.”

“Having other options to help keep people healthy — and if we can meet their needs locally — that’s what we all want to do,” said Chandler.

Instead of charging a fee for each doctor visit, Tracy and Chandler charge a monthly fee for access to the family practice medical care a patient may need.

Some say the new direct primary care model will increase the primary care physician shortage because a doctor using that model is able to care for fewer patients than in a fee-per-service model.

But Chandler said that is short-sighted.

Tracy said many family practice doctors ages 50 and older are burned out and looking for other options for their careers. They may decide go into urgent care or take an administration job instead, taking them out of family practice.

With the direct primary care model, “they can continue to care for people well on into their career,” he said. “I would look at it more as, ‘Let’s try to make primary care more functional, so people can stay for a longer part of their career.’”

In addition, this model is attractive to medical students who, before learning about that option, often decide early on that primary care is not for them.

Tracy said not one medical student at the University of Wyoming for the last two years had an interest in primary care before he and Chandler visited with them about the direct primary care model.

“After we talked, they expressed more interest,” he said.

The new model “is a game-changer in terms of the primary care shortage, long-term,” Tracy said.

Sapp said, “By having options for Powell, perhaps primary care is even less of a problem. Your ability to spend time with them allows them to spend less time over the years by meeting their needs up front, and eliminate crowding in waiting rooms later on, because those needs have been met.”

Sapp said she’s also referred patients to other providers, such as chiropractors and massage therapists, and pharmacists are working to help patients get the medications they need.

“We all want to work together,” she said. “We’re so lucky to be able to pick up the phone and talk to each other. That’s really what it’s all about — not being territorial, but being community minded.”