After 37 years, Mike Witte announced that he will step down as the medical director of the Coastal Health Alliance in the fall, and ramp up his work with a Sacramento-based nonprofit that advocates for health care reforms.
“One patient said, ‘Thirty-seven years and you’re gonna leave me?’ I said, ‘Well, maybe I should leave while you’re doing so great,’” he joked. Dr. Witte, who helped found the clinic that eventually became the Coastal Health Alliance, started his career in West Marin at Michael Whitt’s practice in the 1970s, after working at an Oakland clinic for the poor. He home delivered thousands of babies in West Marin and the Bay Area in the earlier part of his career.
His departure from the health alliance comes at a time when it is bursting at the seams. Its clinic in Point Reyes Station—one of three in West Marin—was built in 1989 and supports around three times as many staffers as it did when it first opened. It now provides care to over 6,000 patients.
Steven Siegel, the alliance’s executive director, said space is so tight that “we don’t even have ideal staffing, because we have no place to put them.”
At the moment, the alliance is pursuing short-term solutions: a little more office space, a mobile dental van and group health sessions at places like the Dance Palace Community Center. The nonprofit started offering dental services last year, but it can only serve people twice a week because of limited access to a fully stocked dental office, and the wait list for appointments is about three months. A van, hopefully, will be operational by the fall.
The nonprofit is also pursuing group health visits; for patients with ailments like diabetes, for instance, clinics could see multiple patients simultaneously for a two-hour session. Patients would sign a confidentiality agreement and talk about both the problems they experience and how they cope.
As for long-term solutions to the space plight, Mr. Siegel explained that it’s tough to locate space in town, but that the issue is being considered as part of the board of director’s strategic planning process. “It will take patience, for sure,” he said.
Dr. Witte started advising the organization with which he plans to spend an increasing amount of time—the California Primary Care Association—on policy issues about six months ago. (The health alliance is a member of the association.) The group represents and advocates for nonprofit health clinics by keeping tabs on how policies, legislation and programs affect its members.
Dr. Witte said he has advised them on issues like health care financing, a matter that particularly frustrates him. Many doctors, particularly specialists, work under a “perverse incentive” wherein they make more money by prescribing expensive treatments instead of advising patients on how stay healthy. “It’s work I feel strongly about, in a good way,” Dr. Witte said. “It feels like a way to work on whole, systemic change in health care.” He will continue to keep some limited clinical hours at the health center.