Professionals seek health care solutions

August 15, 2008

By KIM BARTO - Bulletin Staff Writer

Area health care professionals gathered Wednesday to talk about those issues at a Partners in Community Health event at Chatmoss Country Club.

Speakers were Barbara Jackman, executive director of the MHC Coalition for Health and Wellness; Dr. David Lewis, medical director of the Bassett Family Practice; Dr. Gordon Green, head of the West Piedmont Public Health District; and Dr. Edward Snyder, orthodontist and volunteer at the Martinsville Community Dental Clinic.

The Harvest Foundation sponsored the event because “the medical community may not be adequately informed about these programs,” said Grace Prince, Harvest Foundation intern who organized the talk.

“Many of those initiatives operate on referrals from physicians and dentists, and if they’re not informed about these opportunities for patients, then (the programs) can’t have their full effect and reach the people they’re intended to reach,” she said.

These organizations need to communicate openly to succeed as a “health care safety net,” Jackman said. “The number of low-income, uninsured patients is increasing, as is the number of low-income insured patients who may have trouble paying their deductibles and co-pays,” she added.

In Martinsville, Henry, Patrick and Franklin counties, 19.5 percent of residents do not have insurance, she said. The state average is 12.5 percent, she said. “That’s where a center like Bassett Family Practice can be very helpful,” Jackman added.

Bassett Family Practice is a federally qualified health center open to all patients, including those with Medicare, Medicaid, private insurance and the uninsured. Fees are based on income. This week, the clinic saw its 600th patient since it opened in February, Jackman said. Some patients have come back multiple times, and so the center has logged “somewhere around 1,000” visits so far this year, Jackman said.

Traffic at the clinic has been gradually building, and new staff has been hired to compensate. A new nurse practitioner will start next week, and another part-time family physician will join the practice later in the month, she said.

The current staff of 10 includes outreach workers who help enroll eligible patients in Medicaid or help patients get medications through the MedAssist program, which is funded jointly by the Virginia Health Care Foundation and Harvest.

Compared with the Free Medical Clinic of Martinsville and Henry County, which the coalition also operates, Jackman said, “Bassett has some additional resources, and it’s a more sustainable model over the long term.” The free clinic is open only to the uninsured working poor and is limited in the services it offers. With the recent loss of the clinic’s paid nurse practitioner, it now depends entirely on volunteer medical practitioners.

Lewis encouraged members of the medical community to volunteer whatever time they can at the clinic. “We need to keep the free clinic functioning,” he said. “Just giving three hours or so every other month would be a big help.” Because they have “only two or three” volunteers, the clinic is open “about one and a half days during the week, and maybe some hours on the weekend,” said Lewis, who has volunteered there in the past.

The free clinic has seen a 9 percent increase in patients over the last year, Lewis said, with 1,299 individual patients seen from July 2007 to June 2008. During this time, 168 people had to be turned away due to lack of capacity.

Basic lab testing and X-rays are available at the free clinic, but close to 240 patients had to be referred elsewhere for specialty services. Of these, most had to be sent to Charlottesville because their lack of insurance meant they could not find local care, Lewis said. “We’re not as a community taking care of our own,” he said.

Dr. Kim Matchett of Isis Women’s Care, a member of the audience, suggested a centralized model that would provide more than medical services to low-income patients. She said she had participated in programs in Washington, D.C. and Philadelphia that offered “a community base with different services,” including social workers, lawyers, doctors, a soup kitchen and other aid workers in one location.

“A lot of (low-income) patients we see, it’s not just medical issues — they need help with education, money management, finding a job outside of the service industry,” Matchett said.

Jackman said the coalition already works closely with agencies such as the United Way and the Virginia Employment Commission and wants to “make it more convenient and accessible for people to get the help they need.”

The concept of centralized services “is very much on our radar screen, but the devil’s in the details,” Jackman said. “We can probably get to a point where we could co-locate.”

Green gave a history of the public health system and talked about services offered locally. The center provides immunizations, AIDS and HIV testing, family planning, women’s services, preventative dental care for children and more. Green added that he hopes more partnerships will form to provide medical care to the community. “Hopefully, this get-together is a start to looking at the bigger picture,” Green said.

Snyder talked about the dental clinic, which “provides care to those who can least afford it” on a sliding fee scale, he said. Eighty percent of practicing dentists in Martinsville and Henry County volunteer at the clinic, where they oversee the work of fourth-year dental students from Virginia Commonwealth University, Snyder said.

Dr. Ben Lewis, who served on the committee that began the coalition, called the concept of the dental clinic “great” and suggested carrying the concept further. “If we could develop a similar medical clinic model with medical students, that would work really well,” he said.


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