Nurses recall days working for area's first HMO

June 29, 1994|By Dolly Merritt | Dolly Merritt,Special to the Sun

Twenty-five years ago, before Howard County General Hospital opened its doors in 1973, Jane Trolinger, an Ellicott City resident, worked as one of three nurses at what was then the county's only HMO.

It was located in a building off Banneker Road in Columbia and operated by the Columbia Hospital and Clinics Foundation, Inc., a health maintenance organization owned by Connecticut General Hospital and Teacher's Insurance, recalled Mrs. Trolinger, 70.

That HMO, started by Columbia developer James Rouse and then-president of the Johns Hopkins Hospital, Russell A. Nelson, evolved into what is now the Columbia Medical Plan.

"When we opened the facility to members in October of 1969, there was some publicity about it being the first HMO in the area," said Mrs. Trolinger, a retired nurse in Ellicott City. "It was a new concept and the membership grew rather slowly for some time. . .

"From the beginning, we had a minor emergency room set up in the back [of the building]. Anyone with a broken bone or cut could come in and get treated; it was not restricted to members of the plan."

Today, Mrs. Trolinger, who has six children and four grandchildren, is still using some of the skills she learned at the county's first HMO.

She volunteers every other week at Chatham Mall in Ellicott City, monitoring the blood pressure of morning walkers. And she looks back fondly on the years she spent working at the HMO.

"I'm hoping there will be a 25th anniversary celebration and that we will be remembered," she said.

The HMO's team of 16 included eight full- and part-time physicians, one X-ray technologist, a radiologist, administrative personnel, and three nurses: Mrs. Trolinger; Adriane Weaver, of Clarksville, and Ruth Toth, of Columbia.

The three nurses had responsibilities that included answering phones and making house calls to HMO members who had recently been discharged from Johns Hopkins Hospital in Baltimore.

Whenever a patient was in the makeshift minor-emergency room, one of the nurses was always needed to assist.

"Whoever could be there, would be there," said Mrs. Trolinger. "We used to have a gurney in the emergency room and I remember an orthopedic doctor who used plaster around its wheels to keep it still, because none of us was available at the time."

When more serious medical emergencies occurred, most county residents traveled to St. Agnes Hospital in Baltimore, or Montgomery General Hospital in Olney, said Mrs. Trolinger.

Eventually, as the number of HMO patients increased, Mrs. Trolinger said all three nurses were acting as nurse practitioners, examining patients independently for routine physical examinations.

"We always had the physicians, nearby, as a backup," Mrs. Trolinger said.

Each of the nurses worked 40 hours a week and rotated being on call in the evenings for the minor-emergency room.

A few incidents stand out in Mrs. Trolinger's mind from her five years of working for the HMO.

There was the young man who was given typhoid vaccine after having been trapped in flood waters on South Entrance Road in Columbia during Hurricane Agnes in 1972.

There was the construction worker who received an antitoxin after having been bitten by a snake.

And there was the woman who delivered a healthy baby in one of the examining rooms because there wasn't time to get to the hospital.

Mrs. Trolinger said that she and her co-workers were included in the planning sessions when the Howard County General Hospital was being designed.

Years later, the experience of working for the county's first HMO still brings back strong memories for the nurses.

"We were a very small group and we had a strong sense of community," said Mrs. Toth, 61, who worked for about 10 years at the HMO. "We were starting a whole new way of delivering health care and we all felt a lot of responsibility for making it work."

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