With Nuvance, the health care conglomerate, shifting the employees at its Boiceville location to its Woodstock clinic, nurse practitioner Brian Callahan is peeling off to join the Phoenicia office of Medical Associates of the Hudson Valley (MAHV) as of April 8. He will continue to see patients at Nuvance in Woodstock until May 12. With pharmacist Ed Ullman making plans to open a new apothecary on Main Street, and a primary care practitioner at last reinstalled at the clinic, Phoenicia residents will once again have access to truly local health care.
In the 1990s and early 2000s, Callahan worked for over a decade at the Phoenicia clinic, located on Mt. Ava Maria Drive, across the street from the hamlet’s post office. In 2004, the clinic was taken over by Maverick Family Health, the Woodstock-based practice that eventually moved the Phoenicia clinicians to larger quarters in Boiceville. “It’s good to be back,” Callahan remarked by email this week. “It’s a great community. However, just as we had problems previously, the space is limited.”
In a 2005 Phoenicia Times interview, Callahan, originally from Kingston, explained why he liked working in a small country clinic instead of following the ambitious route laid out by his doctorate in public health. “It’s the relationship I have with the people. I’ve seen kids grow up. I have more friends than patients. It’s what you have to do to accomplish things here. It’s just them and me, and we work out what it takes to make them healthy. When you’ve been out there in the world, you really appreciate this.”
Explaining his forthcoming move back to Phoenicia, he wrote, “I have nothing against Nuvance. They still have excellent services and specialists where they are located. I’ll still recommend their specialists and their facilities to our patients. I’m leaving Nuvance because they no longer have a primary care location that’s easily accessible to many of our patients. Many patients use rural transportation. Many travel from Delaware, Greene, and Schoharie Counties.”
Economics of scale
In 2014, Maverick Family Health founder and co-director Dr. Randy Rissman merged the practice with Health Quest, a Poughkeepsie-based primary-care network. He explained that the economics of modern health care make it challenging to maintain a small country practice. He expected Health Quest would offer clinicians more bargaining power with insurance companies, and patients would benefit from access to more specialists and technology at the offices and hospitals affiliated with Health Quest.
Three years ago, Health Quest joined the Western Connecticut Health Network to form a $2.4 billion, not-for-profit system called Nuvance Health. The merger was projected to save both companies’ hospitals more than $100 million over the first two years. However, the Center for American Progress, a progressive think tank, says studies show that such conglomeration does not result in savings for patients, as it reduces competition to just a few large organizations.
Dr. Cornelius Ferreira of Nuvance Health assures patients that the transition of Boiceville primary care services to the Woodstock location will produce “enhanced physician collaboration and expanded services, including telehealth and other subspecialties. We will also make improvements to the Woodstock office, including modernization of the facility, upgraded technology and more.” With the move scheduled to be completed by March 7, the facility will be “available to accept new patients and will continue to partner with Northern Dutchess Hospital in Rhinebeck for acute care needs.”
The values of serving
MAHV, which has offices in Kingston, Poughkeepsie, and Woodstock, was the first health care practice to reopen in the town-owned Phoenicia clinic after Maverick moved to Boiceville. In the interim, the Phoenicia Library occupied the space during fundraising and reconstruction of its Main Street building after it was gutted by fire in 2010. Once the library reopened, the clinic building was empty for several years, as the town sought physicians who might want to take it over. There were no takers until 2019, when neurologist Paul Mullin decided to leave yet another health care network, CareMount, to join MAHV.
“We’re extremely excited to have Mr. Callahan join our practice,” said Mullin, a native of Margaretville. “There is a tremendous need for primary care practitioners and specialists in western Ulster, Delaware, and Greene Counties. I have to give credit to Dr. Craig Moss, one of the founding partners of MAHV, for having the vision to revive this office, which has been here since my youth.” Despite the small size of the clinic building, Mullin said, “We still have room for additional practitioners.”
Moss, the son of a Saugerties physician, said MAHV has turned down offers to join several of the larger health care associations. “One of them said, ‘Every time you do a test, you’ll get a percentage of the profit,’” explained Moss. “From an economic point of view, that makes sense, but it didn’t hit us as correct.” Ten years ago, his employees created a culture statement emphasizing the values of serving the community, delivering high quality service, and helping practitioners achieve their full potential. “That culture statement attracts certain doctors. Others would rather work in one of the larger groups. Some people are not out to make millions of dollars but want to help people. Something like 80 percent of people don’t like going to work. We want to be the 20 percent who do.”
Pharmacy aims at summer
Meanwhile, Ed Ullman is progressing with his plans to open a Phoenicia branch of his community pharmacy, Wellness Rx, which now has one store, located in Tannersville. He is converting his business to what he calls “the first not-for-profit pharmacy in America,” and he expects the presence of a primary care practice in town will offer opportunities for collaborative projects. “It works perfectly with what we’re doing. An independent practice gives more flexibility. We can present them with ideas and do some good work.”
At the moment, Ullman and his construction team are submitting site plans to the Town of Shandaken Planning Board, for renovation of the space he’s renting in the former Ricciardella’s Restaurant on Main Street. He’s received approval for a new drugstore from the Board of Pharmacy, and he hopes to open this summer.
“I underestimated the enthusiasm of the community,” Ullman noted. “When a community loses an essential service, whether it’s a doctor, a pharmacy, or a library, you get excited when you’re going to have a shot to get it back. The bar is raised, and I have to deliver, and that’s okay.”
Brian Callahan, N.P., is accepting new patients starting April 8 at Medical Associates of the Hudson Valley, 9 Mt. Ava Maria Drive, Phoenicia. His current patients may choose a different primary care practitioner, or they may switch to MAHV. To inquire about health insurance when switching, call MAHV at 845-338-7140.