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Originally published: 2012-08-30 15:47:27
Last modified: 2012-08-30 15:47:27

Poor rankings spark efforts to improve clinical care in Avery County

Matthew Hundley / (

Avery County Health Department is working with Toe River Health District and Cannon Memorial Hospital to address the startling findings of a study that ranked Avery County as having the worst clinical care of any county in North Carolina. The county health rankings study was sponsored by Robert Wood Johnson Foundation and University of Wisconsin, which rank every county in the nation against other counties in the same state.

In overall health rankings, Avery County was not in last place, but actually placed 15th in 2012. The 100 ranking is specific to the availability and quality of clinical care. In other words, whether or not citizens can go to the doctor and receive the care they need.

During the second regularly scheduled meeting for Avery County Board of County Commissioners on Monday, Aug. 20, Roger Wise, of the Board of Heath, made a presentation detailing the clinical care ranking, the factors that were used to determine the ranking and the steps that the health department, hospital and Toe River Health District are currently taking to address the problems that the study identifies.

The Clinical Care ranking is based on several factors, but Wise identified three as the primary concerns for the county: the number of uninsured, the ratio of population to primary care doctors and preventable hospital stays. 

According to Wise, the number of uninsured in Avery County topped out at 26 percent, much higher than the state average of 18 percent. The report also showed that, in Avery County, 137 out of every 1,000 hospital stays could have been prevented. The statewide average for preventable hospital stays was only 64 per 1,000. 

The final measure Wise identified, and the one which the various agencies have chosen to focus on is the ratio of population to primary care physicians, which was 1,629 to one, which means that for every 1,629 people in Avery County, there is only one doctor in Avery available to treat them. Avery’s patient to doctor ratio stood at nearly double the state average: 859 to one.

Wise reported that the various agencies were working to improve the doctor to patient ratio by implementing clinics within the county. Inside the health department, a part-time clinic is already in place, thanks to funding from the Kate B. Reynolds Charitable Trust. The clinic in the Health Department is designed to be phased out as a hospital sponsored primary care clinic is implemented at Cannon Memorial Hospital and a Federally Qualified Health Center is established in Avery County, though a location for the FQHC has not yet been determined. 

Doctors employed at these clinics should improve the ratio of physicians to patients, allowing patients shorter wait times and physicians more time with each patient.

President of Cannon Memorial Hospital Carmen Lacey noted that the current lack of physicians in Avery County creates a sort of self-fulfilling cycle, in which doctors are less inclined to come to stay in an area with such a daunting ratio of patients.

Commissioner Scott Heath noted that the other side of that problem is that the more the ratio is improved, the easier it will become to improve further. 

The clinics would also help address the difficulties faced by the uninsured by providing care at reduced rates depending on income.

County Manager Robert Wiseman spoke briefly to ensure that the board and audience were aware that should federal funding for the FQHC ever be cut off on the federal level, it could fall to Avery County taxpayers to ensure the future of the clinic. 

In other news and notes ...

Mathis appointed to Fire Commission

Following a vote at the most recent meeting of Avery County Firefighters Association, Johnny Mathis was selected to serve a two-year term on Avery Fire Commission. Avery County Board of Commissioners voted unanimously to approve the appointment. 

Courthouse renovations to begin soon

The renovations to Avery County Jail are nearing completion, which opens up the courthouse for stage three of its overall renovation. 

“Now we are free to give our attention to the renovation of the existing courtrooms,” said Wiseman. Stage three includes renovations to the Clerk of Court’s office and to the buildings courtrooms. Wiseman warned that the logistics of ensuring that court can continue and keeping the court records safe and close at hand will be daunting, creating complications, including dust, security changes, noise and relocation as different departments are shifted to accommodate the construction.”

Banner Elk VFD to proceed with parking

Avery County Board of County Commissioners gave County Attorney Michaelle Poore the green light to proceed with a lease granting use of some of the property around the former Banner Elk School to serve as parking for Banner Elk Fire Department, which currently suffers from extremely limited parking. The lot will be graveled rather than paved in order to ensure that Banner Elk can make changes to nearby storm water runoff infrastructure with minimal impact on the new parking area.