Marty Balogh, 60, owner of Bay Moss Studio in Coos Bay, is among many Bay Area residents without health insurance. She and her husband, Scott - both avid kayakers - joke that if one of them becomes ill, that person would just paddle west in the Pacific Ocean, because they could't afford to pay for the treatments. World Photo by Lou Sennick

Gordon Everett expects a wave of people to come crashing into the emergency room at Bay Area Hospital over the next few months — not because of a disease or a virus, but because of a letter.

A little over a month ago, Bay Clinic sent the letter to 700 people in the Bay Area. The message: Their primary doctor had departed. They had 30 days to find another one because in a month there would be no health care provider available for them at the clinic.

Those 30 days are up and many of those patients are beginning to realize a harsh truth — they’re stuck without a doctor.

“They are in a little bit of shock right now,” the emergency department nursing manager said. “People are seeing how long they can go without seeing a doctor.”

But with the oncoming flu season, he said, he knows it’s just a matter of time.

They’re coming.

“The brunt hasn’t quite hit yet,” Everett said. “But it will.”

At the Waterfall Clinic in North Bend, the nurse practitioners already are experiencing an influx of patients from the doctor shortage.

But many in the Bay Area probably wonder what all the fuss is about. They haven’t had a doctor in years.

“I haven’t had insurance in 24 years,” Coos Bay business owner Marty Balogh said. “Basically, I don’t have a doctor.”

Balogh is just one of the thousands of uninsured people in the county. And more and more they are in a group that is increasingly competing for care at area clinics.

30 days later

After they received the letter from Bay Clinic, Joyce and Richard Tobiska of Coos Bay scrambled to find a doctor.

A few weeks ago, they found one. After reading about the local doctor shortage in The World, a doctor from North Bend Medical Center called and extended an invitation to the couple to be his patients, Joyce said.

“I feel good,” she said. “I think it’s great.”

The Tobiskas found a doctor, but many in the area aren’t so lucky.

And Ian Shull hears from them every day.

Shull works as the patient advocate at NBMC. When the letter first hit mailboxes in the region, she was backed up about 10 days on returning phone calls. Her workload hasn’t improved.

“It’s horrible,” Shull said. “I took a week vacation, and now I’m backed up three weeks.”

With the blessing of administration at NBMC, Shull is directing people to Dr. Megan Holland, a new family practice doctor in Bandon. In addition, NBMC will add internist Jagdev Bhatoya in January. Shull expects his practice to fill up quickly.

Those tired of waiting are turning to other sources for their health care.

And there are very few options.

Waterfall

When it comes to immediate care, people in the Bay Area can visit the hospital emergency room, the public health clinic or the Waterfall Clinic in North Bend.

Waterfall is a nonprofit clinic started by a group of volunteers in the late 1990s, providing coverage primarily to those without or with too little insurance.

“The need is really quite great in Coos County,” said Waterfall Executive Director Kathy Laird. “In the past, there were very little resources for people without health care.”

Doctors at the clinic recorded 6,000 patient visits last year, not including vaccinations and physicals at local schools, she said. Patients pay according to a sliding fee structure.

Now, the clinic is experiencing the ripple effects from the doctor shortage.

“We’ve seen an increase,” she said. “Things are strained.”

While the clinic provides the best quality care that it can, Laird said, it is limited in its reach due to the limited staff it employs. Three nurse practitioners work for the clinic, and administration is currently looking to hire a few more. But in order to do that, the clinic must compete for new staff with Bay Clinic and North Bend Medical Center. And with limited money, it’s tough.

“We’re a small nonprofit without a lot of resources,” she said.  

Friends and neighbors

About 16 percent of Oregonians get by without health insurance, according to research from the 2006 Oregon Population Survey. That’s up from 10.7 percent in 1996. In Coos County, about 15 percent of people are without health insurance, according to the Oregon Office of Rural Health.

The uninsured make up a cross section of people in Coos County — from the well-off and the poor to the young and the old.

And they can be found everywhere.

Balogh is the owner and sole employee of Bay Moss Studio in downtown Coos Bay. The studio is full of bright, colorful paintings, chunky metal jewelry and clothing in a mixture of vibrant and diffused colors.

Just across the street at the Coastal Grind Café, Jen Berry, 29, works as a waitress. She greets customers with a quick smile and a friendly word. She’s a part-time student at Southwestern Oregon Community College studying to be an accountant.

The women have more in common than just a business area. Neither has health insurance.

Because she has no insurance, Balogh said she tries to eat better. She delves into Eastern medicine and is on the lookout for free or reduced-price walk-in clinics.

Balogh hunts for deals like someone might shop for shoes.

“I look for diagnosis deals,” she said.

Berry tries not to think about getting sick. She hasn’t had insurance in a number of years since she got off the Oregon Health Plan.

“I don’t spend a lot of time worrying about what could happen,” Berry said. “I worry about what’s happening as it comes.”

Balogh seems to share the same mindset. She’s not too nervous about her health right now, but she realizes she’s getting toward an age when things are more likely to go wrong.

“Something is going to break down someday,” she said.

Money is the big factor stopping Balogh from getting insurance. The last time her husband, Scott, shopped for health insurance for the couple, it topped out at about $800 a month, she said.

“You still have to be able to eat and live in a house,” Balogh said.

Stepping up

While the current doctor shortage is pushing those without insurance farther down on the health care ladder, a number of doctors in the Bay Area are stepping in to help them by providing care — most of it for free.

Dr. Steven Shimotakahara and his wife, Eva, a nurse, are two local medical professionals trying to make a difference.

One Sunday each month, the Shimotakaharas hold a clinic that allows those who are low income and without health insurance to have free evaluations and referrals. The clinic takes place at the First United Methodist Church in North Bend. They provide the evaluations and treatment, while audiologist Jennifer Scarbrough deals with hearing issues.

The idea for the clinic stemmed from the couple’s interest in providing care in Third World countries.

“My wife and I have always been interested in doing some kind of international work,” he said.

That international focus changed after they realized they could make a difference and help people living in their own city.

About 2,000 patients without health insurance have been treated at the clinic since it began in February 1998, Eva said.  

For United Methodist Pastor Pam Meese, the clinic is a perfect bridge between the church and the community.

“It gives people a chance to see the doctor and a chance to see important outreach done in the name of Christ,” she said.

For the Shimotakaharas, the clinic is a chance to give back to the community they believe has helped them for so many years.

“We have a quote we often say,” Eva said. “To whom much is given, much is required.”

Next: Local, state and national officials have numerous plans to fix the doctor shortage.