The History of Dr. Harvey in Hawarden

Drs. Eneboe and Harvey in 1979In July of 1979, I joined Dr. Daggett and Dr. Eneboe in the clinic next to the hospital, what was then simply called Hawarden Medical Clinic. We each had an independent practice with individual staff and some common expenses. It wasn't always harmonious, but we managed. Throughout my 17 years in the clinic, it was profitable and we generated revenue to the hospital through rent paid. At no time during my years at what the Hawarden Clinic was any money from the hospital necessary for clinic operations. The only money from the community was for the expansion and remodeling of the clinic in 1981. That doubled the size of the clinic and attached it to the hospital.

Dr. Eneboe retired in 1982 and Dr. Daggett and I worked with the hospital to find additional health care providers for Hawarden. Through the years we shared the clinic with Ken Miller, DO and Roland Fajardo, MD. And during this time we hired Gerard Bouthillier, PA-C and Jeanne Kleinhesselink, ARNP as physician extenders. It was the loss of Jeanne that brought this episode to a head. But first, a little history...

During 1994, the hospital board turned the management of the hospital over to Marian Health Services (now called Mercy.) Marian Health Services immediately turned their eyes to the clinic, and discussions were held regarding Marian providing management services to both the hospital and the clinic. The board's main objective in retaining Marian was the recruitment of physicians. The only way Marian would do this was if Marian controlled the clinic.

In 1995, Dr. Daggett suffered a heart attack and couldn't work. On two occasions in 1995 I spend weeks as the only provider in town, working 24 hours a day, seven days a week. Throughout 1994 and 1995 I requested some relief from the on-call schedule. The hospital board would not provide any on-call help.

In 1995 Dr. Daggett and I sat across the board table from Mary Kaptain-Dahlin and some "hit man" from the home office in Illinois and were told that we were not good enough doctors for the Marian Clinic in Hawarden. Perhaps if I went to Sioux City and followed their doctors around for six months or a year she would reconsider me, but wanted nothing to do with Dr. Daggett. As soon as I was gone, those requirements mysteriously vanished and Dr. Daggett quietly continued at the new and improved Marian Health System, Hawarden.

In January 1996, Jeanne Kleinhesselink resigned to take a job in Sioux Center. I informed the Board that I could not work the current on-call schedule. I would continue to see my patients, but could not provide night and weekend coverage for the hospital, especially since at that time, the clinics in Akron, Beresford and even Sioux Center and LeMars did not always provide local coverage on the weekends.

The board was unwilling to even discuss it and I was forced to either return to providing all on-call coverage or I would no longer be an "active staff member."In February 1996 I was forced to accept a "courtesy staff" designation at the hospital. As soon as that was accomplished, the board decided that the clinic building was only available to "active staff members."

The members of that board were:

(None of these people are on the hospital board today)

I only wanted a break from the continuous on-call requirement and the board would not hear of it. However, at the same time they were evicting me for not taking unlimited on-call status, they agreed to limit Dr. Daggett to only one weekend a month and two week nights a week. This after they would not even discuss it with me.

I thought long and hard about my options. The simple answer was to leave; to find a place I could work in peace and where I was appreciated. But then the support started. It became obvious that the only people that wanted me out of Hawarden were Marian Health; their employees, initially Mr. Voran, and subsequently, Mr. Katz; and the hospital board, taking their marching orders from Marian Health Systems.

I think Marian was (and is) afraid of the competition. In all the other communities they had invaded, Marian was never faced with competition. They were able to modify the manner and style of health care in a community because they were 'the only game in town.'

Clearly, getting me out of town was the main motivation of the actions taken during this time. During a phone call, the hospital board president, George Rehder told my wife that the goal of the board was to "...get Dr. Harvey out of Hawarden."

My staff, my family and I decided to stay and fight. We chose to build a clinic, near downtown next to the legal and insurance office that was under construction. It would take us six months to build a clinic and we wanted to remain in Hawarden during construction. I asked the hospital board for permission to remain in town while the building was constructed. The board would not consider that option.

During March, 1996 the community started a petition drive to allow me to stay in the clinic until the building that became HFMC was completed, about six months. The petition drive was spearheaded by Joi and Marv Ebel and they have my sincere thanks. The petition contained over 1500 signatures, with over half from Hawarden residents. The board completely ignored the petition and stood by the eviction. Considering the ultimate motive was to get me out of town and assure Marian complete control of health care, it was the only thing they could do.

We were evicted in May 1996. In the continuous battle to make my life as difficult as possible, Marian even forced us to contact all of our patients and get their permission to copy their medical records. I don't know who decided the records belong to a building, not the patient. Rather than hire lawyers, we hired people, rented copy machines and spent $5,000 copying over a thousand charts. We moved the entire practice to our satellite office in Ireton.

In April 1996 I hired Kim Brands, ARNP and shortly after I hired Ruth Siem, PA-C. A building made for one provider and one staff member was suddenly home to three providers and seven staff members. We were cramped, crowded, inefficient, and clumsy. But still the patients came. We certainly didn't have a good winter, but a lot of people braved the worst winter in years to drive the ten miles to continue their care with us.

Shortly after this, Marian, through their managed clinic in Sioux Center opened a satellite office in Ireton. Have you been to Ireton? It is a very nice town with about 700 people. I have been in that location in Ireton since 1981. Why would Marian choose now to add another clinic in Ireton? Simple; to force us out of the area. If they could dilute my patient base enough to make it impossible to make a living, I would leave. Fortunately, people in Hawarden and Ireton are much more intelligent than Marian ever realized. We survived in Ireton and we were heading back to Hawarden. [By the way, you won't find that Sioux Center based clinic in Ireton today. It didn't last three years.]

Mercy Clinic No Doctors SignSince our eviction from the building at 1122 Ave. L (currently called the Hawarden Community Clinic) the Hospital has struggled through many Mercy selected physicians. The list would include -- (sorry if I forgot someone):

We finished the building and moved into Hawarden Family Medical Center on February 11, 1997. The road for HFMC has not been without bumps. Ms. Brands and Ms. Siem have left. I hired Teri Osterkamp in 1999 and Cheryl Barglof in 2001. Cheryl left after a couple years so now it is Teri and me.

At this point, in 2007, the Hospital's tax supported clinic is losing about $250,000 per year. Doesn't seem to me that the Marian (now Mercy) experiment has performed real well. At yet it continues, and Hawarden continues to throw hundreds of thousands of dollars down the rat-hole that is the management of Mercy Medical Services.