In the summer, there is no such thing as a slow night for the Tisbury ambulance association.
A recent busy evening sent Jeffrey Pratt, ambulance coordinator for the association, down a long dirt road to respond to a person having an allergic reaction. Mr. Pratt and his fellow emergency management technicians were able to treat the patient without a trip to the hospital. On their way back out the road, a young mother flagged the ambulance down. “She said, ‘I was just driving to come see you,’” said Mr. Pratt. “She had a child who had fallen down. So we took them.”
The volunteer Tisbury force usually keeps three emergency medical technicians on call in the summer months to respond to bicycle accidents, barbecue mishaps and swimming scares, up from one or two in the off-season.
“The volume [of calls] increases with the population and as the weather gets better,” said Mr. Pratt. “May’s busier than April. June’s busier than May. July, all hell breaks loose and August is very, very busy. September is almost as busy as August anymore.”
The Island population nearly quintuples in the summertime. According to the Martha’s Vineyard Commission, there are 15,800 residents on the Vineyard in winter and 75,000 in summer. Over the past few weeks, Island health care providers and emergency responders began expanding their hours and beefing up staff to handle the anticipated influx.
“People come from all over the world to get sick on Martha’s Vineyard,” said Dr. Timothy Tsai, director of emergency medicine at the Martha’s Vineyard Hospital.
Emergency room activity triples in the summer months. Last fiscal year, the emergency room had 14,524 visits. The busiest month was August with 2,291 visits. The slowest was December with only 767 visits. The numbers were similar the previous year.
To accommodate the increases, the emergency room opens a fast-track area for patients with non-critical complaints like insect bites, abrasions and poison ivy outbreaks. The fast track is open from 10 a.m. to 10 p.m. from June to September. “The average fast track volume is 25 patients per [12 hour] shift,” said Dr. Tsai. “But the range can be anywhere from a dozen on a slow day to 40 on a busy day.”
The fast track supplements the central emergency room area for patients with complaints that range from chest pain to abdominal cramps to tick bites.
The emergency room also adds staff in the summer. Eight additional physicians have been hired this season. The number of nurses working each shift has doubled since winter and nursing students have been hired as assistants.
There are many unique challenges associated with running a hospital emergency room on a resort Island. “It is a challenge in the summer, seeing so many patients from other parts of the country and the world,” Dr. Tsai said. “Getting the medical records can be very time consuming. It can be logistically very, very difficult to get a complete medical picture of someone who is from elsewhere.”
To accommodate patients whose first language is not English, the hospital utilizes Portuguese translators and a telephone translation service.
“The biggest demand is on the emergency room and that from the summer population,” said hospital president and chief executive officer Timothy Walsh. “A lot of these cases are people who, at home, would go see their primary care doctor, but if they are on the Vineyard on vacation, they are coming to the E.R.”
Dr. Tsai agreed. “The annual volume for the emergency room is somewhere a little less than 15,000 visits a year. However, a lot of that is seasonal,” he said. “We go from a very quiet off-season volume to extremely busy. For a small emergency department, we are seeing the activity of a much busier department.”
Although much of the activity occurs in the emergency room, the rest of the hospital also adds summer staff. “We have a pretty good routine for getting ready,” said Mr. Walsh. “We fill up in the summer. It puts a great burden on the physicians who are trying to see people in the office.”
Two physicians, extra nurses and laboratory and radiology technicians have already joined the hospital staff, which Mr. Walsh estimated grows by 30 each summer. The hospital rents houses around the Island to accommodate the seasonal staff and they attempt to hire the same practitioners each year. “We like to get the same people coming back if we can because they are familiar with the hospital and we get familiar with them,” Mr. Walsh said.
Private medical practices also change their operations in the summer months. “The volume of patients that we see increases probably by a third and the kinds of illnesses that we see changes dramatically,” said Dr. Michael Jacobs who runs Vineyard Medical Services with a walk-in clinic on State Road in Vineyard Haven. “Summer is interesting. There are different illnesses, different kinds of medical problems. It’s always a challenge,” he said. He said the staff members pay special attention to fevers which could be associated with tick bites and they see more rashes, stings, infections and allergic reactions to foods like shellfish and berries.
The office operates the walk-in clinic and offers scheduled appointments year-round, but hours are extended in the summer months. Both Dr. Jacobs and his partner, Dr. Gerry Yukevich, as well as a nurse practitioner staff the clinic on summer days and the office sometimes increases support staff as well. Dr. Jacobs said his year-round patients are often busy with their own expanded work hours in the summer and routine health care appointments are postponed until the off-season. But the demand for walk-in services grows.
The demand extends beyond the doctors’ offices. Across the Island, ambulance services have swung into high gear.
“The season is getting longer,” said Tri-Town Ambulance coordinator Martina Mastromonaco, who arrived early to Lucy Vincent Beach in Chilmark on a recent morning. Tri-Town Ambulance covers the three up-Island towns of Aquinnah, Chilmark and West Tisbury and hires three paid full-time EMTs from Memorial Day through the end of September.
This summer, Mrs. Mastromonaco faced an unforseen challenge: erosion has made it increasingly difficult for emergency responders to reach the beach.
And she is now busy preparing to be ready for calls during an all-day music festival planned for the Aquinnah Cliffs on Saturday. “That’s about as far away from the hospital as you can get,” she said. Her ambulances will be on call and the squad will set up a first-aid booth to cater to crowds.
She will also borrow an ambulance from the Oak Bluffs squad and two of their EMTs. Once the music festival is over, there is the Chilmark Road Race to think about and then the Agricultural Society fair in August.
“June was pretty quiet and then yesterday it was like, whoa: July is here,” she said.