SWAN’S ISLAND — Spending in this sector represents one-sixth of the domestic economy and a recent Congressional debate over it shuttered the federal government, but for Donna Wiegle, health care means something less political and more practical.
For Wiegle, who operates the island’s Mill Pond Health Center, it’s about taking blood, arranging for practitioners from Mount Desert Island to travel to the island to treat locals and creating support groups for those who want to lose weight or quit smoking.
Though you can’t get her to say it, Wiegle’s high-energy personality and sunny, but no-nonsense demeanor is a big part of the health center’s success.
Wiegle is a trained phlebotomist, but she’s so much more, taking vital signs, facilitating tests, following up with patients, even meeting lobstermen early in the morning to take blood.
Wiegle has lived on the island since 2002, moving from her and her husband Charlie’s native Pennsylvania after a fateful vacation visit that ended on the morning of Sept. 11, 2001. Watching the second plane strike the World Trade Center at a friend’s house in Belfast, during a stop on their way home, they resolved to find a home on the island. And they did.
Wiegle sat down with The Working Waterfront at the Island Institute’s offices in Rockland on Nov. 8; she was in town to attend a meeting of the Maine Islands Coalition for which she serves as co-chairwoman and a representative of Swan’s Island.
WW: What kind of educational background do you have?
Wiegle: I have a degree in medical technology, so my college degree prepared me to work in laboratory medicine—a laboratory type job, or pharmaceutical medicine or a hospital. And that’s what I did, I went to work in a hospital laboratory.
I would do everything”¦ go in early in the morning and draw blood and then go back in and do the analysis on the blood.
I did that in Pennsylvania.
WW: In your current job, what’s you job title?
Wiegle: Well in my current job, the title I’ve given myself—I’m the only paid employee there at the health center—I call myself the director of services. It sounds very important. Basically, I do everything —sometimes I clean a toilet, I mow the grass, I take the trash out—to draw your blood, take EKG, injections.
The training I have is more like a health aid, similar to medical assistant, the person that works with your doctor instead of them having a nurse.
And when the doctors come”¦
WW: And how often is that?
Wiegle: They come twice a month from Mount Desert Island Hospital. They always bring their assistant with them. But I’m always over there, as the receptionist on those days, giving a hand wherever I’m needed.
And I do all the other stuff in between. We have telemedicine equipment there, sponsored by the Maine Seacoast Mission, so I’m the health aid there, and get the patient ready to present to the doctor, get the equipment up and running.
WW: How’s the center funded?
Wiegle: Exclusively through town taxes. This past year, 2013, was the largest budget that I was able to persuade the selectmen to give me. I would always prepare a budget and they would always trim it back.
So this year I did get full approval on the budget, I got $25,800. That includes my salary, so you know I don’t make very much money. That’s heating oil, propane for our generator, that’s maintenance on the building.
I pay all the transportation for the doctors, the nurses, all the visiting providers that come out. That’s probably over 10 percent of my budget, that goes to ferry expenses, to get the providers out to the island.
From toilet paper to tongue depressors, everything comes out of that budget. It’s hard to do.
WW: What are the top health care issues, as you see them, kind of day-to-day, and then I’m curious, too, which are sort of island specific.
Wiegle: We have a pretty large elderly population out there. And so they’re probably not having their health care needs met as well as they should be. But we’re trying to improve that.
We have a podiatrist that comes out and provides foot care for elderly people, in particular diabetic patients. We have a pretty significant population with diabetes, which is statewide, nationwide, really. That’s a real health concern out there.
One of the first things we started to do at the health center was be able to offer people a blood test done on the island.
So people can come in every Tuesday morning. They don’t have to go to the mainland, spend their money on the ferries, they don’t spend a half day just to go over there for a 5-minute blood test.
If I have a patient who comes home from the hospital, maybe with some kind of cardiac episode and they put him on a blood thinner, and [the doctors] say, “We need to have that checked three times a week,” we’ll make arrangements.
I have a little finger-stick machine, so we get results in 60 seconds and I just fax that off to the physician. That is probably our most requested use of the clinic.
Every early December I do a discounted blood-screening clinic. And we have a deal with Mount Desert Island Hospital with really discounted rates. It’s for uninsured people or under-insured people with high deductibles. So you can come in and get your cholesterol profile done for like $30, which normally cost you about $150. It’s really a good deal.
I think people are more comfortable coming to the clinic on the island. Everybody knows me. [People say] “Oh, go over and Donna will draw your blood.” So maybe they’re comfortable with me and know me as opposed to going to the hospital and having to have testing done there.
WW: Not to mention the transportation, and the time”¦
And if a fisherman says, “I have to go out and haul tomorrow Donna, what’s the earliest you can meet me?” Well”¦ I don’t like to meet anyone before 7 a.m. If you tell a fisherman 6 a.m., they’ll want 5 a.m. [laughs].
WW: You really accommodate them”¦
Wiegle: I try to accommodate people, because I live 5 minutes away from the clinic, so it’s not a big drive. I think that’s the kind of service that my community deserves. And I think that’s the kind of service that my board of selectmen would want me to provide for the community.
WW: What kind of solutions have you seen that deal with such things as diabetes, obesity, smoking cessation? What has been effective on the island?
Wiegle: We’ve had a smoking cessation program. No one came [laughs].
I don’t usually do a direct mailing campaign, but in that case, I did.
It was not well-received by my neighbors that smoke. A few people came.
I think you have to measure successes in small numbers on an island. So four people came, so that was a success in my mind.
The biggest success that we have had, we are just completing a program that was rolled out through the national CDC [Centers for Disease Control] for pre-diabetes, people who are at risk for developing diabetes.
MDI hospital got a grant”¦ and they chose Swan’s Island to implement this diabetes prevention program. So we started that last January, and it was 16 weeks of weekly meetings. And then after those after those first four months, we have been meeting once a month. Next week is our sixth monthly meeting and then we’re done.
WW: You talk about diet, exercise”¦
Wiegle: Yeah, diet, exercise. The goal was to reduce your weight 5-7 percent. So if you were 200 pounds, 14 pounds was your goal. If you were 300 pounds, 21 pounds was your goal. Very achievable goals.
And adding 150 minutes of aerobic, physical exercise to your week. That’s a lot harder for some people to do.
I am really happy to share with you that on month No. 5, which was last month, 12 people came for our monthly meeting got weighed in, and 12 people collectively have lost 238 pounds on Swan’s Island.
In this group, there are six people in the fishing industry, so lobstermen or stern men. Unheard of to reach out to that population to get them to come to even a one-time preventative health care thing, let alone to make this commitment to the 16 weeks every week, and the once a month afterwards.
WW: They bought into it.
Wiegle: They did buy into it. They knew everybody in the group. And they knew everyone’s story. And it is easy to support one another when you know. Someone would come in and say, “I had a really bad week,” and everyone would know why that person had a bad week, because we know everybody’s business. And she might say, “I ate three pieces of chocolate cake this week,” and everybody would say, “That’s OK. Start fresh today.”
By the end of the time, she would say, “I feel so much better than when I came into the class today. I think I can do it.”