etcetera
1. A number of unspecified additional things; 2. pl. additional items, odds and ends

BOARD APPROVES SUBDIVISION ATMADAKETMARINE Madaket Marine secured unanimous Planning Board approval on March 24 for a preliminary plan to build up to eight dwellings on the site of Nantucket's last remaining waterfront boatyard.

It also received Planning Board endorsement of a three-lot approval-not-required plan - a failsafe move that would provide the Hither Creek boatyard with an alternative development plan, should Madaket Marine's four-lot subdivision plan for the 17- acre property at 20 North Cambridge St. be denied at the definitive plan level.

Madaket Marine is considering houses over boats because of the difficulties encountered in trying to add 66 slips to its existing 60-slip marina and additional boat racks on its property. A site visit in February by members of the Massachusetts Environmental Policy Act office, the Nantucket Conservation Commission and Health Inspector Richard Ray revealed seemingly insurmountable permitting challenges, forcing Madaket Marine to reconsider its options for remaining solvent.

Kim Sparks, chief administrative officer for Madaket Marine, said that the owners have yet to decide what to do with the property, noting previously that the existing operation needs to expand to survive.

"It's one of their options," said Sparks. "The owners have not given me a definitive answer as to which way they are going, but this is one of their options."

There are, however, issues that would need to be worked out in the definitive plan stage of the process should Madaket Marine choose to file a residential development plan. Because its property and frontage is narrow, access to the two southernmost parcels will be over large portions of salt marsh. The driveway of Lot One will require a 12-foot easement running parallel to the outside of the western boundary of the property. Although all three lots in Madaket Marine's approval not required plan have the minimum frontage of 40 feet on North Cambridge Street and meet minimum lot size and upland area requirements, the board and the Nantucket Land Council have concerns about wetlands being filled in for road construction because "practical access" is needed to reach the lots.

"The long thin corridors that stretch from the way to the presumed buildable portions of Lot 1 and Lot 2 cross extensive portions of salt marsh and therefore cannot be considered to offer practical access," said Land Council Executive Director Cormac Collier in his March 18 letter to the Planning Board.

Planning Board Chairman Frank Spriggs agreed, saying that the ConCom would have to deal with road building through a wetland.

"Having their driveways cross wetlands to get to their houses, that's going to be their problem," said Spriggs

However the issue is resolved, Madaket Marine attorney William Hunter assured the board that his clients would not build a bridge through the salt marsh and that there would be a proper driveway. Planning Board member Sylvia Howard suggested that the driveway be paved instead of built as a rural road.

Before approving Madaket Marine's preliminary plan, the board recommended to Hunter that his clients not build a rural road to their lots, that they allow no further subdivision and that they build only one dwelling on each lot.

HINSON, BRADLEY JOIN PHYSICIAN'S ORGANIZATION Yesterday, the computer system in the doctors' office of partners Greg Hinson and Craig Bradley was tied directly into the computer system at Massachusetts General Hospital. The linkup is part of their new membership in the Massachusetts General Physician's Organization.

On Feb. 1, Hinson and Bradley, who share a family medicine and obstetrics practice, officially joined approximately 2,500 other doctors as members of the MGPO, making them employees of the organization and no longer independent, private practitioners. Last Thursday, new hardware and software was installed in their office to create a direct link to the MGH electronic record system - just one of the advantages the doctors see in becoming part of the private company that was founded in 1983 with headquarters in Boston. Its parent companies are Partners Healthcare System and MGH itself, which became affiliated with Nantucket Cottage Hospital a year ago.

"The primary advantage is that it lets us use their management and billing expertise and take some of the hassle away from us as small businessmen," Hinson explained. "Instead of us being individually responsible for insurance reimbursement, now [the organization] will handle it, which should free us up to be able to provide better patient care. The loss of independence is also the loss of the administrative headache."

Beyond reducing the doctors' paperwork burden, membership in the MGPO also opens up close communication with the specialists at any of the partners' hospitals via their electronic medical record system. Hinson said that if an island patient of his is referred for care on the mainland he can easily track the treatment through the record system and the treating physician has access to the patient's history at Hinson's office.

Further, through the organization's buying power, Hinson and Bradley will benefit by a lower cost for supplies, medications and vaccines. "It has the potential to keep more stuff in stock and be more convenient to people," said Bradley.

Hinson emphasized that he and Bradley are under no contractural obligation and are free to leave the MGPO if they choose. The two will now receive an annual base salary, though they will remain on the staff of Nantucket Cottage Hospital. In addition, there will be no outside mandate as to how they manage the care of their 4,000 or so year-round and summer patients, which means they may send them to specialists at any hospital besides MGH.

"In the end, I think it will be better," Bradley said of the new arrangement. I