Downtown Wheeler, oregon, circa 1940s

Downtown Wheeler, oregon, circa 1940s

Harvey Earl Rinehart, M.D., came to Wheeler with his bride Ella in 1913, after graduating from the University of Oregon Medical School. His son, Robert E. Rinehart, M.D. and daughter-in-law Dorothy White Rinehart, M.D., followed him there in the early ’40’s. In 1950, there were five physicians practicing in Wheeler. In 1953, a new hospital was constructed.

In 1965, Medicare was enacted, clearing the way for medical care to our nation’s seniors. Then in the early 1980’s, in an attempt to put a brake on the escalating costs of hospitalizations, came the DRGs, or Diagnostic Related Groups. DRGs limited reimbursement to hospitals based on diagnosis. By 1989 the hospital in Wheeler was broke and closed, as most of the patients there suffered from arthritis, a diagnosis not often meeting the DRG requirements for reimbursement. After attempting to maintain local medical care for years, the last of the physicians left in 1990. In 2003 the local health district finally paid off the residual hospital debts.

Tillamook County General Hospital (TCGH) graciously stepped in and hired locum tenens physicians, who would rotate in and out of the community every three months. In the summer of 1992 they were seeing seven patients a day. Most locals avoided medical care, waiting for some permanent staff.

Meanwhile, in the winter of 1990, Harry Rinehart, M.D. was in his 13th year of private medical practice in Prineville, and also in the U.S. Army Reserves, when Desert Storm I erupted. He was called up on December 6, 1990, and returned May 1, 1991. It was time for a change. He did emergency medicine in Tacoma, Astoria and Seaside for a year while his wife completed her nurse’s training. Then in July of ’93 he took on the job at the Wheeler Clinic, an employee of TCGH. By September, visits were up to 21 a day. After a year, they were eager to continue, however working for a hospital wasn’t ideal for the hospital or for them, and it became clear another arrangement was necessary. At age 47 Dr. Rinehart was not keen on borrowing the cash it would take to start another clinic. He also knew there would be a lot of people in the area who could not afford healthcare.

An ethical dilemma arose. Dr. Rinehart was not anonymous in his community. He could not drive away from his clinic in the city at the end of the day to his home in the suburbs. Nor could an ambulatory care rural health clinic survive financially, if it provided free and reduced cost care to all community members in need. Furthermore, he couldn’t imagine turning away those patients whom through their work and taxes supported the institutions of higher learning he had access to and benefited from because of his family and advantages it afforded.

Fortunately, in Wheeler there resided a retired college president, Richard Stine, Ph.D. He had spent 40 years in non-profit institutions. While pondering this dilemma, Dr. Rinehart was introduced to Dr. Stine, for whom the solution was obvious and simple. “You form a nonprofit,” he told Dr. Rinehart. “But first you get a community advisory group together, from whom the board of directors will eventually be selected,” he added. “After all, healthcare delivery is a community responsibility.”

By the fall of ’93, they had a community advisory group of nearly 20 individuals, and by winter they had pledges from six community members to support borrowing $100,000 to start an independent practice. Dr. Rinehart resigned from Tillamook Hospital’s employ on December 31, 1993, and opened his practice in the same building and offices on January 2, 1994. The bank loan was to Dr. Rinehart, (with pledges far exceeding the principal), not the nonprofit, as the nonprofit entity had yet to be formed.

The IRS granted the 501(c) 3 status (without this status donors cannot deduct donations off their income tax) in January, 1996. It took two years, but finally the Rinehart Clinic was a full-fledged nonprofit entity. Twelve years later, in 2008, the Rinehart Clinic, became a federally qualified health center, receiving a large grant from the federal government to serve the uninsured and under-insured individuals in our community.

Today, the Rinehart Clinic continues to serve not only our patients, but our entire community.

 

-Created from the writings of Dr. Harry Rinehart, Retired Medical Director