The Free Clinic of Central Virginia celebrates 20 years of serving the community
Lynchburg News and Advance
Sunday, October 28, 2007Fifteen years ago, Helen Callahan was temporarily unemployed and without medical benefits coverage. She heard about the Free Clinic from her late sister, Robbie Bowling. “I came with her one night, and asked, ‘Could I see a doctor?’ And I’ve been coming ever since.”
On Friday, The Free Clinic of Central Virginia is culminating a series of small celebrations of its 20th anniversary with a sold-out gala event.
Since its founding in 1987, the Free Clinic has treated more than 16,000 patients, now at the rate of 3,000 to 4,000 people a year.
Through its pharmacy program, it has provided more than $15 million in free or low-cost prescription drugs. Savings are estimated at about $2 million a year for the past several years, said the clinic’s executive director, Bob Barlow.
Today, a volunteer roster of more than 200 physicians, 60 dentists, and 25 pharmacists staffs the clinic. Volunteers include nurses, medical assistants, dental hygienists, dental technicians and pharmacy assistants.
Dr. Tom Eppes, who became the free clinic’s first medical director in 1987, said it represents “the purest outreach that physicians have - where patients readily identify that what’s being extended to them, at no cost, is something to be really grateful for … they know we’re giving time and talent to them.”
Eppes, who was followed shortly by Dr. Richard Stowers as medical director, stayed on the board for 10 years and still volunteers at the clinic. He’s not surprised to see the concept flourishing.
The reason is “because of the way our health-care system is structured in this country, people will always fall through the cracks - people trying to make it, who don’t qualify for Medicaid, or need to bounce back up.”
Helen Callahan said that sometimes a crowd of patients is waiting to see a doctor at the Free Clinic, “but I’m a patient person and I wait my turn.”
Her sister was a diabetic, and so is she. She gets her medicines every three months, going through screening to assure that she’s still qualified through the pharmacy program.
“I’m tickled to death with the help I get,” she said.
Lynchburg’s Free Clinic was one of the earliest formed in the state, but now Virginia has more than most others.
The Virginia Association of Free Clinics, which has 49 members with more than 60 sites, says on its Web site that 63,000 low-income and uninsured people were treated by the clinics in 2006 - up 35 percent from 2004.
Free Clinics have moved “from the innovative and even radical propositions of 20 years ago” to a component of the way health care is provided, “an important thread in the safety net,” said Dr. Mohan Nadkarni, a founder of the Charlottesville Free Clinic and a UVa faculty member.
Virginia has so many Free Clinics, in part, because “Virginia has one of the strictest eligibility to get onto Medicaid, a traditional form of insurance for the very poor,” said Nadkarni, who did some research on free clinics as the Charlottesville facility reached its 15th year.
Free clinics, he said, serve the working poor - people who have more assets than the government allows in order to qualify for Medicaid, but not enough income to pay for health insurance for themselves.
At 61, Callahan is still working, now employed as a helper to a frail older person. “I clean, take care of the house and cook supper and lunch - I am busy.”
She calls to make an appointment if an illness comes along, but with every visit to the diabetic doctor, she said, the clinic gives her the date of that next appointment. The downtown clinic building, on Main Street, is the only free clinic site she’s been to.
“It is set up so good,” she said. “I think it’s wonderful.”
When the Free Clinic of Central Virginia was founded, said Glenn Moseley, its first executive director, the nation had more than 30 million uninsured people. Now that number is more than 40 million.
The clinic’s first days were in a downstairs area of Westminster Presbyterian Church on Floyd Street.
Moseley, who is now administrator of Culpeper Medical Associates, said the Free Clinic in Lynchburg has been a success because of board leadership - “their commitment to the Free Clinic and their commitment to the community.”
And that, he said, has helped make it more financially sound.
A lot was going on the year the Free Clinic of Central Virginia was founded - including the merger of the two hospitals, Lynchburg General and Virginia Baptist, which formed Centra Health.
Thomas Jividen, Centra Health senior vice president, said that when the Free Clinic was formed it was part of a long history of medical staff volunteering in the city.
“When the idea came along, there was a groundswell of interest in it,” he said.
Helen Callahan also gets dental care at the Free Clinic.
Callahan says that it comes pretty close to painless dentistry, too.
She’d had a bad experience when she was younger, but at the Free Clinic dental program, “They don’t even hurt you,” she said. “They really work with you.”
The dental program has always been a component of the Free Clinic, in part because of the persistence and insistence of several Lynchburg dentists, including Dr. Augustus Petticolas, longtime board member and volunteer.
In 2003, the Free Clinic negotiated a partnership with the Virginia Commonwealth University School of Dentistry, which has brought dental students and dental hygiene students into supervised internships at the clinic. An expansion opened earlier this year, the Greg Sheehan Arthur Dental Suite.
Centra Health and the Centra Health Foundation have been instrumental in the success of the dental program, as well as the entire Free Clinic.
“From the very beginning, we were involved in some of the committees that talked about starting the Free Clinic, and made pretty strong resource commitments to various programs - most notably the dental clinic,” Jividen said.
While the manpower came from the dentist-volunteers, “What the Centra Foundation did was essentially provide capital for dental operatories,” he said.
VCU dental students stay without charge in rooms in the former School of Nursing building at Virginia Baptist Hospital where free meals are provided.
Another crucial issue for uninsured patients is prescription medications, and the clinic has addressed that as well.
“We knew one of the biggest needs would be pharmacy,” said Gene Erb, then a pharmacist with Centra.
The day the clinic opened in the basement of the education building of Westminster Presbyterian, “I saw this line of people going out of the building, down the sidewalk and around the corner,” Erb said. “The first night, we were overwhelmed with people.”
The pharmacy opened with donated medications from hospitals, pharmacy companies and local doctors.
“We had no money to get started,” he said. “The doctors were really good about prescribing medications we had on hand - a limited formulary.”
Over time that supply grew. The Free Clinic became a United Way Agency, and drug companies continued to develop ways of helping free clinics.
Erb said that from the beginning, “I knew (the clinic) was going to be around a long time.”
Erb, who left the Lynchburg area in 1997, is now senior vice president and chief operating officer of Shore Memorial Hospital in Nassawadox on the Eastern Shore.
He said the Free Clinic succeeded “because of the dedication of the people, the health care workers, who pulled together and made it work. We saw a real need in the Lynchburg area for health care for people who otherwise can’t afford it.
“There was so much commitment of the core group,” he said, every time an obstacle came up, “we figured out how to make it work.”
Nursing services were essential to the Free Clinic success, and Anne Bishop, RN and Lynchburg College faculty member, helped set up the structure. Bishop was interim executive director while the board searched for a new executive director.
In those early times, nurses took patient histories, did vital signs, determined what the problem was, and called the patients into the exam rooms.
The first rooms were bays surrounded by a curtain. “It was a different day from today, thank goodness,” said Bishop.
The Free Clinic has flourished because of the need “for people who have no money even though they work, no money for health care - they have to eat, have a roof over their heads, a way to get to work, and clothes to wear,” she said. “There’s not much left over for medical care.”
The Clinic has also always worked to provide an environment that is personable, not judgmental, not demeaning, “but an environment where people are accepted for who they are, or where they are in life, no matter what circumstances got them there.”
Return to Newspaper Articles