Top Care: Oak Harbor physician assistant's caring ways draw statewide praise

"For nine years, Physician Assistant Richard Gerlach has been caring for Oak Harbor's disenfranchised - treating sore throats, broken bones and far more serious ailments for thousands of uninsured or under-insured men, women and children who have fallen through the cracks in the managed health care system. Regularly working 50-hour weeks at the North Whidbey Community Clinic, Gerlach says his goal, in part, is to treat the AIDS victim, addict, homeless person or single mother with the same energy and compassion, the same sense of mission.That sense of mission was reward recently.On March 23, Gerlach was awarded the Outstanding Contribution to Rural Health Award by the Washington Rural Health Association in Spokane. The only higher award in the state for rural practitioners is for lifetime achievement. But at 51, the compact, intense and energetic Gerlach isn't even considering retirement.Thousands of rural health practitioners across Washington state were eligible for the award, said association president Moe Chaudry, but Gerlach's nomination stood out. So much in fact, Chaudry said, that Gerlach was originally nominated for a lesser award - Outstanding Rural Health Practitioner Award - but the committee decided he deserved more prestigious recognition. As a PA, Gerlach has been bringing health care to rural areas in the Northwest for more than 25 years.By his own definition, a Physician's Assistant, is licensed to practice medicine in a limited capacity under the supervision of a physician. But that leaves a lot of latitude.On an average day, Gerlach sees 15 to 20 patients, ranging in age from two days to 96 years. He stitches cuts, treats sore throats, sets broken bones, counsels AIDS victims and helps treat the health-related consequences of drug addiction, or too little medical care for too long. Many of his patients are either poor, unemployed or strung out on something. And just as many are victims of domestic violence and broken homes.That's why it's vital, he says, for a rural health practitioner to have patience, empathy and a sense of humor. And to not make moral judgements about people because of their circumstances or addictions.You have to have the ability to accept people where they're at, Gerlach says. So they can see that they can come to you with any problem. Instead of giving up, we do what we can and try and change behavior.And patients come back, some long after they've regained financial security and adequate health insurance.In a letter nominating Gerlach for the award, Island County Health Officer Dr. Roger Case said that working with minimal professional supervision, Gerlach ... has been, and remains, the linchpin of the North Whidbey Community Clinic.''Last Friday, Case said Gerlach's abilities are so impressive and so well-known on Whidbey Island that primary care physicians in the area recognize him as a peer.I think it's his humanity, Case said. I think he's really concerned about people.In 1970, when Case was the senior Navy flight surgeon at Whidbey Island Naval Air Station, Gerlach was a corpsman just returned from Vietnam.Gerlach said he joined the Navy specifically to be a corpsman because I always had an interest in helping people.He got his chance, working on a hospital ship off the coast of Vietnam.We got lots of guys right out of the bush, Gerlach said. Lots of head injuries and amputations from land mines and mortars. We had people dying almost daily. You learned how to shut your emotions down. If you didn't you'd go nuts.The problem, Gerlach said, was that it took him a long time after the war to get his emotions back.He noticed ways Vietnam had changed him once he was back, working in the emergency room at NAS Whidbey's base hospital. If the victims of a particularly bloody car accident came into the emergency room, Gerlach said, a few of the newer corpsmen would be put off at first by the gore, or initially upset or reluctant to deal with mangled patients.And I would just be sitting there, working away on them, Gerlach said.Family and faith helped him come all the way back from Vietnam, Gerlach said.He married his wife Karen, a registered nurse, in 1972. They had the first of their three children in 1976.His Christian faith also deepened over the years, strengthening his commitment to serve people, said Gerlach, an elder at his non-denominational Christian church in Anacortes. Gerlach considered going to medical school after getting out of the Navy in 1971 but opted instead to enroll in the Physician's Assistant Program at the University of Washington, graduating in 1975.There followed a succession of postings in rural health clinics - small hospitals, emergency rooms and mobile-home clinics in out-of-the way places like Sumas and Deer Park.In 1991, Gerlach was chosen to be the principal provider for the Island Family Health Clinic, now the North Whidbey Community Clinic.When we first opened nine years ago, people who didn't have health care coverage would never get taken care of, Gerlach said. Or they'd have to wait until they needed emergency room care. So from the very beginning, we've treated people like individuals, not as insurance risks.Apparently, the clinic has also filled a necessary niche. We get new patients every day and it's rare if it's not full, Gerlach said.Gerlach has also developed a thorough enough knowledge of the health care system to plug patients into more extensive treatment than the clinic can provide, Case said.I think he's uniquely qualified in that he can find the care these folks need that he himself cannot provide, Case said. Where to go to get support for housing needs, or rental assistance, or help with paying bills and prescription drug needs and how to plug people into social services.Gerlach said he had no idea he was nominated but is gratified by the recognition from his peers. But the important thing, he added, is that he looks forward to coming to work every day.I enjoy the work and feel like I'm doing a service, filling a need, Gerlach said. If we weren't here, people might have problems that no one would take care of."

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