Season of change at Dahl Memorial Clinic

More fresh faces at Skagway clinic

Skagway’s Dahl Memorial Clinic is in a state of transformation. New, experienced personnel have been hired and might be new to Skagway, but they are optimistic about the future of the clinic, including its physical makeup and its relationship with people in the community.
Kathie Dawson, the new Clinic Administrator, is the most recent arrival. Dawson has been in the medical field for 30 years. She began as a doctor’s assistant and then “worked my way up” into larger companies.
Dawson applied for the administrator position in Skagway after owning her own business in Juneau that provided a billing service for doctors. She arrived on Sept. 20 but reassures that she “has visited many times,” and so is familiar with the chaos of the summer months.
Dawson is not new to Alaska. “I lived in Fairbanks for three winters,” she said, “I have lived a long time in Southeast - I lived four years in Haines.”
Dawson is optimistic about the future of the clinic but is not immune to the daunting task of facing a new town, a new job, and a new way of life. She relates with a chuckle, “I was scared to death at first, but I like little towns.”
“We were all drawn to her immediately,” says Clinic Chief of Staff Cynthia Farrell about initial reactions to Dawson.
Farrell began working at the clinic on August 1. She was born in Phoenix but has experience in rustic surroundings and worked for some time on a Native American Reservation in Arizona. She describes the setting as “a very rural environment.”
Farrell also spent 12 years in Montana. “I am not afraid of cold weather or small towns,” she said.
Farrell’s experience includes working in a special-care unit for rehabilitation and also in long-term care while going to school for acute care.
One recent success for the clinic was obtaining a grant for a new x-ray machine. This is important for a city with visitors who so often stare up at their surroundings and forget to watch where their feet might be going.
Bids for the installation of the x-ray machine came in too high and were turned down by City Council. The clinic obtained an extension of the grant for one year and Dawson hopes that with time now on their side, a more reasonable bid can be obtained for the project. The extension allows the clinic to explore other options for the x-ray machine.”A mobile unit may be less expensive,” explains Dawson.
With the possibility of the clinic moving to a new facility in the next couple of years, it makes sense to wait. Says Dawson, “We don’t want to put it in and then have to move it.”
Both new caregivers believe that grants offer real potential for the clinic’s future (see adjacent story). “I think there is an excellent chance we can get grants,” says Dawson.
The clinic was recently turned down for a federal grant that could have brought the clinic up to $660,000. The grant went to Wrangell and Yakutat. “I think that Skagway needs it but at this time Wrangell and Yakutat needed it more,” said Dawson.
The clinic will reapply for the grant before Dec. 31, but are waiting on a report that will quantify the weak points of the grant application. “We will work at it harder,” says Farrell.
Dawson adds, “That (grant) would be a huge boost to the community and the staff.”

Clinic staff members Mary Tadic, Cynthia Farrell, Becky Jensen and Kathie Dawson stand outside the clinic. AC

Farrell sees the clinic’s needs as many, partially due to the strain on the infrastructure of a small-town clinic with the growing demands of a summer season that brings hundreds of seasonal workers and up to 10,000 visitors a day.
“It’s frightening in the summer,” she stresses. “We don’t have the equipment for emergency care. If they need a blood transfusion, they’re dead. We don’t have the technology to save lives.”
Another concern for Farrell deals with the public’s demands for the clinic’s ability to diagnose a patient’s condition with enough efficiency to be sure when more immediate care is necessary. Airlifting and ambulance rides to Juneau are expensive affairs that have upset some in the community who ultimately did not need such emergency care.
Farrell is quick to point out why diagnosis at the clinic can be difficult if not impossible. She said, “We don’t have the technology to find the clues that would prevent having to make that decision.”
She admits that it is ultimately their responsibility to err on the side of caution.
A short list of needs by Farrell included: the new x-ray machine, IMED pumps and an electrolyte machine.
Dawson is already keenly aware of one of the biggest problems facing the clinic: “Our relationship with the public.”
Dawson is making an effort to reach out to the community.
“We want everyone to know we are here for them,” Dawson said. “We are qualified. We want what is best for the clinic, not us individually.”
For Farrell, the biggest challenge facing the community has yet to come. She says, “We have an aging population and we are not prepared to handle the rapidly increasing numbers of them.”
This is a real problem facing communities all over America as the baby-boomer generation reaches their senior years. Farrell has a vision for the solution, but feels it needs to be implemented soon.
She explains,”I would like to see the clinic reach out for a wellness program. We need to expand preventative medicine programs including an assisted living program.”
If you’ve been healthy, you may have missed some other recent changes at the clinic. Longtime Skagway resident Becky Jensen was hired this summer as a full time receptionist and billing clerk, as is part-time employee Rayme Eatough. Physician’s Assistant Jim Cassell began working at the clinic about one year ago. His wife is Medical Assistant Nancy Wallander, who works at the clinic with M.A. Mary Tadic.
And yet another new addition is on the way. Howard Martindale will be the “Ready Response” provider funded by the Dept. of Homeland Security and will be arriving in Skagway sometime in December or January.
One thing everyone in Skagway has grown accustomed to are frequent personnel changes at the clinic. Does the new staff have plans to stay in Skagway or are they on the revolving door plan?
“I’m done with the (big) city,” says Farrell. “The new crew is awesome and everyone works well together.”
Dawson agrees and says confidently, “We both plan on retiring here.”