A clinic out of practice

By Sharon Salyer

Herald Writer

Susie Borovina remembers her first day of work at Everett Family Practice Center with the same vivid clarity of major life events such as high school graduation or the birth of a child.

It was July 18, 1977.

"It was a beautiful summer day," she said. "I was so glad to be there."

Glad enough to accept a $4.05 hourly wage as one of the clinic’s registered nurses. Glad enough to work another part-time job waitressing on weekends at Taylor’s Landing in Mukilteo to help make ends meet.

"It was wonderful," she said of joining the team of employees at the clinic, which had opened its doors just three months before. "We were all young and full of hope, really wanting to make a difference in the community, and we did."

Twenty-four years later, on another July day, Borovina walked out of the clinic for the last time. Although another four months would pass before the clinic formally closed its doors on Friday, leaving about 10,000 patients to find other clinics or doctors, "the process of demise had already started to occur," she said.

"There was a lot of uncertainty, with many (employees) starting to leave."

Borovina, whose husband is a commercial fisherman, seems resigned to the fishing industry’s uncertainty and apparent eclipse. She struggles, though, with the thought of independent medical clinics like the one she used to work at sharing the same fate.

"I don’t think things will ever be quite the same for (independent) family practice clinics," she said. "I think it’s becoming bigger business now."

The formal announcement that the clinic, which in its heyday had 30,000 patients, was closing came last month. It was blamed on a steady loss of clinic physicians to other practices, the uncertain economic climate and tight insurance reimbursements.

Dr. Julie Komarow, who has served as clinic president for the last five years, had a simpler explanation: "The (corporate) tests came, and we flunked."

Diagnosed with stage four breast cancer three years ago and now in remission, Komarow calls presiding over the clinic’s last year and its ultimate collapse tougher even than the year she spent in chemotherapy.

"We have been on the brink of disaster for a year," she said. "We tried every possible avenue — extra hours, trying to recruit new physicians, trying to negotiate better reimbursement … merge or be bought out by different groups.

"Because of our failures, we had a continual loss of physicians. The continual loss of physicians is what finally killed us."

Both patients and employees say they remember the clinic as a place where people were treated as if they were family.

Komarow delivered Abbi Little’s son Owen nine months ago. "I feel (Komarow) was a friend as well as a doctor," she said.

"We had a receptionist who had been there for years," said Borovina, who now works at Medalia Women’s Care in Everett. "She knew the patients. We would get very familiar with the families. You just don’t get that any more."

Carol Jensen, an administrative assistant who first began work at the clinic in February 1981, slowly paged through two photo albums Friday that included pictures of the clinic’s groundbreaking, summer staff picnics and Christmas parties.

"You can see by the pictures we were a very close group," she said.

Cathy Dunican, a patient at the clinic for 20 years, recalled that when she was in labor with her second child, hospital staff left a message on the home phone of her doctor, who was on vacation.

"He got home, heard the message, turned around and came to the hospital to deliver me, even though they had called another doctor," she said.

Maryann Trengove, a nurse who worked at the clinic for three years, now works at The Everett Clinic.

The Everett Clinic has survived and thrived because of good business decisions, she said. "There’s a comfort level in working for an organization that is run really well. But it is a big change to go from a clinic where we all sat in the lunchroom together to a huge organization where you don’t know everybody."

Personal conflicts, low reimbursements, poor business decisions and even the Sept. 11 terrorists attacks led to the Everett Family Practice’s demise, she said. People stopped their normal routines and stopped even coming to doctor’s appointments.

The fallout: The daily schedule went from 25 people on a doctor’s appointment list to 13.

Even as the business faltered, it remained true to its character, she said, "taking care of their employees in the end." Her last paycheck not only included her wages, but vacation and personal leave pay as well.

"When there was nothing else to do besides pass out the life jackets, they did it," she said.

Even with her front-row seat on what was happening at the clinic, Trengove sounds stunned at its collapse.

"For a while we were growing, growing, growing," she said. "It was crazy. You couldn’t walk through the hallways" because of all the patients.

"Then, it was gone."

You can call Herald Writer Sharon Salyer at 425-339-3486

or send e-mail to salyer@heraldnet.com.

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