Planned Parenthood Broadens Services Local Affiliate Offers Primary Care, Considers Expanding Into Idaho

While Planned Parenthood affiliates across the nation grapple with the question of whether to expand into primary care, Spokane’s just did it.

The local branch is the first in Washington to offer more than reproductive care - a dramatic change for an organization known for its gynecological and abortion services.

Some say the shift is key to survival. But others worry Planned Parenthood is abandoning its mission: providing reproductive services on a sliding-fee scale that is affordable to everyone.

At the Spokane clinic, the changes have just begun. This month, even vasectomies join the list of new services, while a physician and nurse practitioners are treating everything from sprains to sore throats.

Eventually, predicted board President Stanley Purdue, “We’ll have more doctors on staff full time. We’ll be providing care for children.”

Planned Parenthood of Spokane and Whitman Counties also is considering expanding into Idaho, Montana and other Washington counties, Purdue said.

“I envision us bigger geographically and bigger in gross revenue and bigger in patient loads.”

The local clinic moved into primary care Jan. 1, just before the Planned Parenthood Federation of America officially recommended the same for all its affiliates as a way to remain competitive in a changing health-care world.

The King County branch, meanwhile, is divided on whether to focus on political activism or women’s fullservice care.

The expansion decision was not without turmoil in Spokane, where some board members “see it as a shift in focus or a distraction from the mission,” said Sandra Meicher, executive director.

One board member suggested closing the clinic and becoming just an educational group, said Purdue. “There were strong opinions and good opinions on both sides.”

Several Planned Parenthood employees have left recently, although officials say that had nothing to do with the changes.

Talk of health care reform and universal coverage that could scoop up their patients finally convinced board members to favor primary care. Health care reform revolves around a managed care concept that would route patients to certain doctors and specialists.

Planned Parenthood is a nonprofit organization, and half its patients are at or below the poverty level. Nevertheless, officials worry that even its birth-control services could be jeopardized by a loss of patients.

Meicher said she also sees a wider variety of services as a way of keeping patients as they grow older.

The mean age of patients at the Spokane clinic is 24, and 93 percent of patients are under 30. Eight percent are under 18.

“Where do they all go when they turn 30?” Meicher asked.

Probably to other clinics that can tend not only to their reproductive needs but also to their sore throats, stomachaches and other medical problems, she decided.

“We need to become mainstream,” she said. “We (currently) can’t serve the whole family.”

James Mullen, a primary care doctor, began working one day a week at the Spokane clinic in January. More doctors will be hired as his patient load expands, Meicher said.

Also in January, nurse practitioners at the clinic began treating such ailments as influenza, mononucleosis, food allergies, chronic fatigue syndrome, sprains and strains as well as other less severe problems.

Until then, the clinic had to refer patients to other doctors, even for a sore throat.

Now both men and women are welcome, although so far, no men have come in.

Goals include more services, such as hormone therapy, for older women. Pediatric care also would bring children to the clinic.

The Spokane affiliate doesn’t intend to stop offering birth-control services and abortions. Even now, the affiliate is lobbying against legislation to restrict teenagers’ access to birth control and establish a 24-hour waiting period on abortions.

“It’s the reason why most of us serve, because we think the mission is important,” said board member Gayle Ekins, an accountant.