Pediatric Medicaid practice in Lakeland continues despite doctor's death
By Marilyn Meyer
LAKELAND — When longtime pediatrician Karen B. Schick, 59, died Feb. 5 after a brief illness, 10,000 to 15,000 children lost their doctor. The death of the caring, energetic physician was personal for her family, friends, staff of 11 and the three generations of patients she had cared for, but it was also a loss to the community health care system.
Schick was unusual among private-practice pediatricians in that she accepted Medicaid, a government program that pays very low levels of reimbursement for seeing low-income patients. An estimated three-quarters of her caseload was Medicaid and the health care community would be severely strained to find new medical homes for thousands of children from low-income families.
But in a month's time, Schick's former practice reopened as part of Central Florida Health Care, a federally qualified community health clinic that serves Polk, Highlands and Hardee counties. On Monday, the clinic resumed seeing patients at its longtime site, 601 S. Florida Ave.
“This was not a purchase of her practice, but an assumption,” said Ann Claussen, chief executive officer of Central Florida Health Care. Because of its status as a federal clinic serving low-income patients, Central Florida could not purchase Schick's practice.
Within days of his wife's death, Mark Helms, a child psychiatrist with a private practice in Lakeland, began talking with staff from Central Florida Health Care about taking over her practice.
“It is what she would have wanted,” said Mona Edwards, Schick's office manager of nearly 29 years. “One of the things she kept saying in the hospital was she wanted to keep her patients together. She was worried about her patients. 'They need me.'”
“Dr. Schick was quite selfless,” said Dr. J. Michael Ham-Ying, chief clinical officer for Central Florida Health Care. “She went for the need in the community. That is our organization's mission as well.”
Schick's staff shut the office Feb. 5, a Friday, as soon as they were officially notified of her death. The following Monday, Edwards called a friend who is a nurse practitioner with the Central Florida Health Clinic in Mulberry. That started the conversation. The next day, Helms and a friend met with the management team from Central Florida Health Care, Claussen said.
“We shared what we do, our vision,” Claussen said. “Dr. Helms saw that her passion for serving was the same as ours and that our patient population was similar.”
Last year, Central Florida Health Care, which accepts Medicaid, saw 32,600 patients on a sliding-scale payment schedule. It operates nine clinics in Polk, Highlands and Hardee counties. Services include pediatrics and adult primary care, obstetrics and prenatal care, chronic disease care, laboratory and non-invasive X-rays, pharmacy and primary dental care.
Assuming Schick's practices involved taking care of lots of details, said Lawrence Best, the chief financial officer for Central Florida Health Care. Among the details completed in a month's time were changing the lease and insurance, hiring Schick's former staff and notifying federal officials of the expansion, he said. The staff consists of three advanced registered nurse practitioners, four medical assistants and four office workers, Best said.
“The focus on everyone involved has been on the kids,” Ham-Ying said, “and that helped the process move fast.”
Schick “truly, truly cared about her patients," Edwards said. Unlike some of the multi-physician pediatric practices, "she never wanted to get really big because she wanted to know her patients.”
And she was so committed to serving the under-privileged community she set up a check box on computer forms so that “if someone really did not have enough money, we'd click charity,” Edwards said.
Schick specialized in behavioral pediatrics and many of her patients have attention deficit hyperactivity disorder so the office, with its nine exam rooms, was often hectic, “but she loved it,” Edwards said.
Nurse practitioners are required by law to work under the supervision of a licensed physician and they cannot dispense the class of drugs many ADHD patients take, so a Central Florida staff pediatrician is stepping into that role.
Dr. Mary D'Aunoy currently is splitting her time between Schick's former practice and the pediatric practice at Central Florida Health Care's Lakeland clinic, which is a few blocks away at 1129 N. Missouri Ave.
Eventually, the pediatric patients being seen at the Lakeland clinic may be shifted to the new site, which would open more space for obstetrics and maternal care at the Missouri Avenue clinic, and perhaps even for much-needed dental care, Claussen said.
Edwards said Schick “would love what happened.”