Alysia Peyton / Dispatch Dr. Michael Alexander examines Vanessa Magdalena Hernandez, 5, under the watchful gaze of her brother, Alexis Francisco.

Health clinics straining to serve growing number of needy clients

Thursday, July 5, 2001

Clare Jellick
Dispatch Staff Reporter

Bothered recently by a lingering sore throat, 40year-old Micah Robinson was worried about much more than the pain.

Homeless and unemployed, he lacked insurance to pay a doctor or buy medicine.

He felt fortunate, he said, to have found help at the Physicians Free Clinic at the Columbus Health Department at 181 Washington Blvd.

In other cities where Robinson has lived, "If you don't have insurance, you're out -- out the back door,'' he said.

More than 180 physicians are part of a volunteer pool at the clinic, operated by the Columbus Medical Association and funded by its foundation. Nurses, medical students and high-school students also volunteer there.

The clinic, open Mondays only, is an example of medical care that area physicians provide free or at reduced cost -- locally and globally -- to those who cannot afford it or have no access to it.

Like the Physicians Free Clinic, other low-cost or no-cost medical facilities throughout Columbus also are at capacity.

"Over the last year, it's clear that volumes have been increasing,'' said Phil Cass, chief executive officer of the medical association.

Cass said the increase probably relates to two factors: the recent closing of Columbus Community Hospital on the South Side and an increase in uninsured individuals.

An estimated 126,000 people in Columbus have no insurance.

"We have an enormous population that has no insurance, no doctor and couldn't get to the doctor if they wanted to,'' said Dr. Jim Hoekstra, associate dean for clinical education and outreach at the Ohio State University College of Medicine and Public Health. "They essentially suffer from second-class or no medical care because of it.''

On the last Monday in June, the demand for help was evident at the Physicians Free Clinic.

Even before the clinic opened at 6:30 p.m., about 50 people had checked in and were waiting to hear their names called. Some dozed against the walls; others chatted in various languages. A few leafed through magazines.

By the time the last patient left at 10:30 p.m. -- two hours past the clinic's scheduled closing time -- the eight doctors working that night had seen a combined 96 patients.

Robinson, sitting in a waiting- room chair with headphones on, arrived at 6 p.m.

An hour later, he saw Dr. Ed Bope, a family physician and volunteer medical director at the clinic.

Bope, who helped establish the clinic in 1993, prescribed free medication to reduce the swelling and told Robinson to return in two weeks if his throat hadn't improved.

Beyond Columbus, some Columbus health-care providers have traveled the world to serve those with no access to medical care.

Dr. Robert Michler, chief of cardiothoracic surgery at Ohio State University Medical Center, founded Heart Care International, a nonprofit organization that performs free open-heart surgery on poor children and adults in Guatemala and the Dominican Republic. Group volunteers also train doctors overseas in heart care and surgery.

"Even saving one life is important,'' said Michler, whose organization has served more than 1,000 since 1994. "To do so in an environment where people have no access to health care is very gratifying.''

Dr. Walter Hull, an obstetrics and gynecology physician at OSU Medical Center, spent 25 years as a missionary physician providing free or low-cost care in Congo.

Most of the time, Hull said, he was the only obstetrician-gynecologist in a population of about 1 million, which meant "most people didn't get care.''

Hull, who last visited Congo in 1999, said professionals who can train local doctors are needed most.

"When we went, we had great ideas of healing, teaching, serving and preaching,'' Hull said. "And in fact, we did all of that. But 25 years later, we discovered that we were the ones that were taught, served, in some instances healed and preached to by those very people we went there to care for.''

Dr. Dan Sedmak, vice dean for education at the OSU medical school, said physicians understand the importance of offering free help.

"Volunteerism is part of what makes a good physician,'' Sedmak said. "Everyone does it to a different extent, but they're all involved in one way or another.''

Medical school officials look for volunteerism on student applications, said Dr. Judy Westman, associate dean for student affairs and medical education administration.

"By the time they get to be this age, if they don't have alternative pursuits in life, we're not going to magically create that,'' Westman said.

OSU encourages its medical students to volunteer in programs such as free blood-pressure screenings and speaking to high-schoolers about health topics. The Physicians Free Clinic also pulls volunteers from the medical school.

Dr. Michael Alexander, a third- year family-practice resident at Riverside Methodist Hospitals, started volunteering at the clinic as a medical student in 1996.

"It's more of an inner desire to be of service and provide care to patients who live in underserved areas and are in need of medical care,'' Alexander said.

Hull said he believes a societal trend toward helping others is developing -- one that's highly visible in the medical community.

"There is an emerging great interest in doing things for others,'' Hull said. "It strikes at the core of who we are. Down deep, we feel best when we are touching others' lives.''

cjellick@dispatch.com