"They also told us that when they'd received care in the past from either a physician's office or emergency room they felt looked down upon-they felt like second-class compared to the others being treated.
What came through loud and clear was their yearning for dignity and respect. So we determined providing that was going to be an important component of the facility."
Magazine
Fall 1998
Healing a Community
When the health care providers and citizens of Columbus,
Indiana came together to ensure care for the uninsured, they brought healing
to their underserved citizens and themselves.
For 13 years, Karen Yarnell had been unable to afford
or receive medical treatment. Blackballed by her Illinois employers' insurance
company because she is an insulin-dependent diabetic, Yarnell considered
buying her own health insurance policy. But the insurer demanded a pre-existing
condition clause that would exclude any treatment for eyes, heart, kidney,
or circulation problems in her extremities-the very treatments she was most
likely to need.
So the only medical care the 47-year-old Yarnell received were her own blood sugar monitoring and frequent visits to the emergency room-visits that took an emotional and financial toll and did little for her long-term health.
But when Yarnell moved back to Columbus, Indiana last year, her mother told her about the Volunteers in Medicine Clinic. She made an appointment.
"I was hesitant at first," she recalls. "Taking free treatment didn't feel quite rightyou don't want to have to take from someone else. But everyone was extremely professional and very kind there. Not once did I ever leave there feeling embarrassed."
VIM even picked up the $200-per-month cost of Yarnell's prescriptions-medicines she had always needed but could not afford.
In the ensuing months, Yarnell's health and situation have steadily improved. A document processor in patient accounts at Neurology Neural Sciences, she now has her own insurance. She remains a grateful endorser of the doctors, nurses, and staff at VIM.
"I'd walk in, I'd get hugs from people and they'd ask me how I was doing," Yarnell says. "Somebody from Volunteers in Medicine should go on 60 Minutes and tell the whole world how to do this."
Dr. Sherman Franz '59 may be just the man they should talk to. But for his part, the psychiatrist and president of VIM's board won't take much credit. Instead, he calls the opening of the VIM Clinic in September 1996 a "true community effort."
The idea was born in 1993 when a town hall meeting of 225 Bartholomew County leaders produced a list of priorities for creating a healthier Columbus community. High on that list was the need for every citizen in the county to have a primary care physician, and the leaders formed the Healthy Communities Council to make that goal a reality.
The council then turned to another group-Leadership Bartholomew County-to conduct a study to find out how many of the county's 67,000 residents were not covered by either private or government health insurance and couldn't afford health care. That study found between 6-8,000 people met those criteria-10 percent of the men, women, and children in the county. The council conducted five focus group meetings with a number of these people to find out exactly what was preventing them from receiving health care and how the community could best meet their needs.
"Of course, finances were a major factor," Franz says. "But we also got some rich perceptions from these people during these meetings that gave us direction for the type of clinic we needed."
Most people said transportation was not a problem, so the council decided on a central clinic rather than several branch operations.
"They also told us that when they'd received care in the past from either a physician's office or emergency room they felt looked down upon-they felt like second-class compared to the others being treated," Franz says. "What came through loud and clear was their yearning for dignity and respect. So we determined providing that was going to be an important component of the facility."
At about the same time, Franz attended a professional meeting at Hilton Head Island. There he listened to Dr. Jack McConnell describe a free clinic he was operating on the island utilizing the community's retired physicians.
"It was surprising to hear that about 8-10,000 people on that island-people who do the service work there-have the same need for care as the group we were trying to reach in Bartholomew County," Franz says. "So I spent a half-day at his clinic and saw some things we could transfer to our situation."
A month later, Franz sent a questionaire to the 130 physicians at Columbus Regional asking if they'd be interested in serving in a free clinic. Only 25 doctors said "yes," but that was enough to encourage Franz to form a steering committee and move ahead with the project.
The people selected for that committee and the people with whom it met proved pivotal to the creation and eventual success of the clinic. The committee included physicians, other health professionals, lay people from the community, two people who were potential users of the clinic, and representatives from the group that had done the initial study. The medical director of the public health clinic and driving force behind free medical program in the city for two decades, Dr. Charles Rau, was also asked to bring his expertise to the group.
In two years of meetings, the committee met with county commissioners, city councilmembers, the media, and the hospital and public health boards.
"We wanted their input," Franz says. "But we also needed their support."
And they got it. The hospital foundation decided to underwrite the whole Healthy Initiatives project and conducted a capital campaign to raise $5 million to create an endowment for the clinic and other projects.
The clinic opened in September 1996-one week ahead of schedule-and in two years has received over 10,500 visits from about 2,900 different patients. Three key people from the former public health clinic-Medical Director Charles Rau, Office Manager Janet Poe, and Nurse Coordinator Wanda Hadley-brought their expertise and patients to the new clinic, and they were joined by Clinic Director Lisa Maple and Lay Volunteer Coordinator Beverly Wilson.
There are now 41 physicians who volunteer on site, including Wabash pediatrician Stephen Loheide '67, who also serves on the board of directors. Ninety doctors and eighteen dentists volunteer to see VIM patients at their own offices. Eighty nurses and seven nurse practitioners serve at the clinic, and they are supported by more than 150 community volunteers. Even the local pharmacy has gotten into the act, offering sizable discounts on prescriptions to VIM, which gives its patients free vouchers to cover the cost of all medicines. And the hospital, offering inpatient stays, x-rays and diagnostic testing free of charge, continues to champion the project.
"I believe this is something the community is truly proud of," Franz says. He says doctors are finding the work rewarding, too.
"It's a delight to be there, and I always feel like I get more than I give," he adds. "And I've heard other physicians say the same thing. There's such a feeling of freedom at the clinic. You're relating directly to the patient, and there are no external agencies impacting that very personal doctor-patient relationship. There's something that reaches into most of us and grabs hold of the initial motivation we had when we first went into medicine."
Besides receiving needed treatment, patients are finding that the respect and dignity they'd hoped for are a part of the clinic-its building, its process, and the attitude of its personnel.
The new waiting room is comfortable, clean, and as well-appointed as any primary care office. There's a children's play room with books and toys and an adult self-care reading library adjacent to the lobby.
Each patient is interviewed as they leave the facility to determine his or her satisfaction with the service. Franz says patients rate the clinic on average between four and five on a five-point scale.
That interview is conducted after the visit so that patients won't be intimidated on their first visit.
"We don't want there to be a barrier when people enter the door," Franz explains. "So our qualifying interview is after, not before, the first visit. We will see anyone that first time, and then we find out if they qualify."
The most frequently diagnosed conditions include hypertension, depression, ear infections, and diabetes-the sorts of problems doctors expected to see at the clinic. But one of the benefits of the clinic's care is more surprising.
"We see many children who weren't going to be able to participate in school sports because their families couldn't afford the required physical," says Nurse Coordinator Wanda Hadley. "When they're able to have that done here, it makes the parents happy. And it makes the children very happy."
An editorial in the The Republic, the city's newspaper, called the opening of the clinic significant far beyond the services it will provide. It is "part of the community's coming of age"-recognition of the problems of poverty in the county.
"A group of volunteers has stepped forward not only to detail the problem but to do something about it . . . it can be said that the larger community has removed its blinders."
The long-term effect of removing those blinders is summed up best in VIM's motto, which is printed boldly on the clinic's wall:
We welcome those in need-to come without fear, And we invite those who serve, to come without pride, So that their meeting may bring healing and hope to both.
Wabash Men at VIM:
Dr. Sherman Franz '59
Dr. Stephen Loheide '67
Dr. Mark Hatfield '82
Dr. Rolf Loescher '81
Dr. Cleve Francoeur '83
Dr. Gregory Millis '76