The Wander Journey
Updated: Sep 27, 2020
When anyone enters the healthcare industry, the first thing they notice is how complex things are. Poorly designed electronic medical records, an increasingly ill population, massive sub-specialization of providers, poor communication, and systems that do not make the job easier seem to be the "norms" of modern medical care. Add on the complexity of insurance billing, with the resultant paper trail, and things really get messy. It is hard to know exactly why things are the way they are in healthcare these days. It seems obvious that money, and not patient care, has driven many of the changes.
Since my first year of medical school at the University of Colorado, I have been thinking about opening my own clinic. If you remove all the medical billing complexities, the business of health care gets much easier. On top of this, the massive amount of hands that end up touching any medical insurance billed, no longer need to be paid, making care much cheaper for the patient. I thought if I could remove all the waste and focus on providing excellent patient care, people might really benefit. Add on values like excellent communication, teamwork, and a provider commitment to continued learning, and you get Wander Medicine. A clinic that cares about you, the greater community, and the environment.
During my fourth year of medical school, I met Karlee Ward at a bar in downtown Denver. We talked briefly, she was studying to be a nurse, and immediately I fell in love with her. Love at first sight may actually be real it turns out. Karlee is cool as a cucumber in all situations. She cares about everyone and everything. Additionally her time working on the inpatient adult medical ward and in the pediatric intensive care unit has made her a great nurse.
Three years later, Karlee and I got married in Sun Valley, Idaho. It was the best day of my life. All of our family and friends got together to celebrate.
What Karlee and I have is more than just a relationship though. We are a team, a nurse and doctor team, and together we are stronger. We immediately realized we had everything needed to start a clinic and change the world right in front of us! Since we both have a strong commitment to service, we went on a nontraditional honeymoon.
One week after our wedding, we left for the African country of Ghana with the Montana Dental Outreach group. Our honeymoon brought us to Sister Stan’s Orphanage, formally known as Nazareth Home for God’s Children, located in northern Ghana. The tropics gradually fade into the Sahara Desert on the road there. In northern Ghana, any children that are not “normal” (born with a deformity, have seizures, or other neurological problems) are killed. This is because the children are believed to be possessed. By killing the child, they are believed to be freed from the evil spirits. Sister Stan started her orphanage by convincing families to let her keep and raise these beautiful, forgotten children.
The dentists we traveled with had a well-oiled operation. They had been traveling to Ghana for several years. After just one week, they cleaned thousands of mouths and pulled over 100 diseased teeth. However, this was the first time they had ever brought a nurse and doctor with them. Karlee and I were asked to set up a medical clinic. We were told that many people would come. We had no labs, $800 worth of medications, a stethoscope, an ultrasound, tools for checking vital signs, and our clinical exam skills.
Over the next week we saw over 50 patients a day. We put a nasogastric tube in baby Kelly, an orphan with severe protein malnutrition (Kwashiorkor), so that she could start eating again (she did!). We debrided a large Buruli ulcer (mycobacterium ulcerans infection) on a 17 year old girl’s foot named Elizabeth. She had been living with this ongoing infection for the last nine years. The wound was so large we had to use ketamine to sedate her. We removed extra fingers from one child’s hands. Another child was wheelchair bound, and with some therapy and braces, we were able to walk with him.
We helped the local nurse, Sandra, adjust medications to obtain better control of many of the children's seizures. On top of this, we saw countless villagers and diagnosed conditions such as high blood pressure, anxiety, acid reflux, as well as many musculoskeletal conditions. We put up a clinic in 12 hours that made a meaningful impact on the villager’s lives. Many of these individuals will likely never see a doctor or a trained nurse ever again. This experience gave us the confidence to move forward with creating our clinic, Wander Medicine. It also embodied the idea of removing all waste, while only providing treatments that will bring value to the patients being served.
Karlee and I both love to travel. She has been to every continent but Antarctica. I have always been interested in wilderness and travel medicine, even doing research in both disciplines. We have logged years of our lives traveling. When we first started contemplating opening a clinic, travel medicine seemed like a natural fit. Initially, travel health was the cornerstone of our clinic. This is where our name, Wander Medicine comes from.
After I graduated from the Family Medicine Residency of Idaho, Caldwell rural training track, we bought what was initially The Star-Lite Motel (built in 1930) and then later an insurance building located on the busy street corner of Federal Way and Kootenai Street in the Depot Bench neighborhood of Boise, Idaho. We planned to turn this old concrete building with a red tile roof into our medical clinic. We knew very little about commercial real estate, however, we were willing to get our hands dirty and do many of the repairs ourselves. We felt good about restoring this old office building, it had so much charm. Had we not purchased the office, it would have been torn down to make room for high density apartments.
We planned to have the building repaired and the clinic open by January of 2020. This was wishful thinking. Gutting the interior, installing new electric, plumbing, HVAC, constructing an ADA bathroom, widening every door to >32 inches, putting in new ADA floors, painting, repairing the roof, rehabbing the parking lot, and landscaping ended up taking a lot of time. Thank you to Sulpicio Rangel, Innovator Construction, Danny Roop, Janet Brown, Patrick Mckeegan, City Lights Electric, and Complete Air for all your hard work! After getting the actual work done, we still had to complete our inspections with the City of Boise. We managed to pass, and obtained our Certificate of Occupancy. By the time we were ready to open it was late March of 2020.
I do not need to tell you what came next. It changed all of our lives and continues to affect the way we live and do business. SARs CoV-2 (COVID-19) came to Idaho and people were being asked and then told to stay at home. After almost three months of construction delays, we were again delayed, this time by the global pandemic. Opening our elective outpatient clinic seemed irresponsible at the time. We decided to hold off on ordering supplies so that they could be reserved for hospitals treating patients on the front lines. I picked up more shifts at the rural hospitals I work at in Mountain Home, Idaho; Winfield, Kansas; as well as Delta and Rifle, Colorado. Karlee let every hospital in the Treasure Valley know that if they need nurses, she could help. Thus far, thank goodness, none have needed her.
Six weeks later, what we had initially been worried about became more apparent. People were neglecting their own medical care and deferring preventative treatment in order to stay away from hospitals and clinics. This, of course, was and is being done to avoid a COVID infection. However, as COVID cases have fallen, the benefits of avoiding healthcare are being outweighed by the risks. People are literally dying of strokes and heart attacks at home, they are deferring vaccination, and neglecting their chronic conditions. Additionally, mental health conditions are flaring on an epidemic level, likely due to the stress and isolation of quarantine.
It became apparent to us that people do need clinics like ours, maybe now more than ever. Additionally, as more people lose their jobs, their insurance will be lost as well. This could make a clinic that offers direct affordable pricing an invaluable community resource.
On Monday, May 18, 2020, Wander Medicine will be open to the public. Since travel will be slow for a while, Wander has adjusted its services accordingly. We are now a wellness clinic focused on keeping people healthy in any environment. We offer direct affordable pricing and believe that bankruptcy should never be the result of healthcare costs.
Wander offers physician visits for wellness and acute care, ketamine therapy for depression and pain, intravenous infusions, occupational and travel medicine consultations, immunization services, laboratory checks, and now COVID-19 testing (no prescription needed). We still like to joke with our friends and family, “at least you are not trying to open a travel clinic during a global pandemic.” However, the reality is that Wander Medicine is, and always has been, so much more than just a travel clinic. Nevertheless, the name has stuck. Stay brave Boise and come Wander with us!