By CRAIG FREILICH

From a new cancer treatment center and a major Canton building expansion to creation of a Potsdam physician’s office complex and a Brasher Falls physical therapy clinic, Canton-Potsdam Hospital is nearly finished with a $15 million construction spree.

“It’s all based on need,” an effort to fill longstanding gaps in the kinds of care the community gets, said Canton-Potsdam Hospital’s Vice President for Administrative Services Marlinda LaValley.

While that is a lot of money in a time when the general economy is slow and health care costs continue to rise, LaValley says it’s just good business.

The $8 million cancer center, at the front of the hospital’s Leroy Street building, is nearly complete and on track for a late-September opening.

The roughly $2.7 million Noble Hospital extension in Canton was built to provide more space for doctors’ offices, an outpatient physical therapy clinic, and imaging and blood sample laboratory services.

Some emphasis has been placed on providing space for specialty physicians. Some of the services are hospital-sponsored, and some are private practices. The second phase of the project, a connector to the original Noble Hospital Building and some work on parking space, is proceeding.

The hospital bought the old St. Mary’s School on Lawrence Avenue in Potsdam and has turned the classrooms and other spaces into physician’s offices and specialty clinics in physical therapy, obstetric services, cardiology, ophthalmology, and an orthopedic surgery clinic. Some of those spaces are used on a rotating basis. That project came in at about $4.5 million.

And in Brasher Falls, a primary care clinic opened a couple of years ago, and a physical therapy clinic is nearing completion in leased space.

That’s $15 million in an effort to improve and expand service.

Facility, Equipment, Staff

“As in any business, you have to maintain a dedicated facility, equipment and staff to meet the customers’ needs,” LaValley said.

To decide what those needs are and how to try to fill them requires a lot of work going over a lot if numbers.

“We have a CEO and a board of directors who are very data driven and their decisions are based on data that form the basis for a strategic medical staff plan and a master facilities plan,” said LaValley.

“Medicine is a business where technology changes so quickly and you have to strike a balance with respect to staying up-to-date and staying fiscally responsible,” she said.

The decision to build the new cancer center was made in part because the older building in the SeaComm Plaza in Potsdam “was aging, and the equipment has a useful life, and that was aging too.”

The latest radiation therapy equipment needs more shielding to keep stray radiation contained, and there were doubts that the old space could be adequately renovated. Even if it could, the building probably would have had to be torn up to install the new linear accelerator.

In addition, there is a benefit to having both radiation oncology – the radiation treatment of cancer – and medical oncology – chemotherapy and other services – in one place, which has not been the case until now.

“It makes sense, for patients and doctors, to have it all in one place,” said Jackie Dow, Director of Oncology Services at CPH. But before a decision was made, “we looked at the whole service and decided on the best way to provide the service.”

“If you are going to meet the standard of care there has to be a constant evaluation of patient needs and organizational resources,” LaValley said. “Our plans and budgets are based on external objective evaluations.”

Figuring into those evaluations are an array of needs that can fall short of desired standards set by the federal government.

Medically Underserved Area

The U.S. Health Resources and Services Administration has designated the area served by Canton-Potsdam Hospital as a Health Professional Shortage Area (HPSA), meaning there are insufficient numbers of providers of primary medical care, dental services or mental health care.

It is also designated a Medically Underserved Area, with too few primary care providers, high infant mortality, high poverty and/or high elderly population.

The shortage of primary care providers is a nationwide problem that is more keenly felt in low-income regions. These doctors, also known as general practitioners or internists, are the kinds of doctors to whom one would go first, to have a professional get a look at a problem, take some tests, and begin treatment or refer the patient to a specialist.

Too often people who don’t have a primary care physician or no insurance or no money end up going to an emergency room for treatment, frequently when the problem is fairly far along; if they had treatment earlier, before it was an emergency, the patient’s health would be better and the community – the hospital, Medicaid programs -- might have saved some money and the patient would be better off.

“We are designated a HPSA. We have unmet needs,” LaValley said. “Access to care can be a challenge.”

The challenge extends to doctors practicing specialties such as cardiology.

“I can’t think of a single specialty that is saturated here,” said LaValley. “There are numerous specialties where there are significant shortages. This is not Marin County or Westchester County.”

Recruiting a Priority

That makes recruiting physicians a challenge and a priority. One way to draw physicians is to guarantee them space to work, such as the offices in St. Mary’s School. Another way is to work with nearby health centers to share some services.

LaValley points to the alliance with Fletcher Allen Health Care in Burlington, which supplements Canton-Potsdam Hospital cardiac care services with a clinic in St. Mary’s.

“I think as changes are occurring in health care, we all are going to be looking to see how we can recreate ourselves to meet the need,” LaValley said.