Examining Career Options
By Kelly Hannon

Lynchburg News and Advance
Thursday, April 10, 2003

A career in medicine seems glamorous — rushing down hallways with gurneys, racing against time to save lives.

Eighth-graders who shadowed workers at the Free Clinic of Central Virginia learned medicine can mean doing all these things. They just learned it’s a lot of other stuff, too.

“The paperwork,” said Tommy Bryant, 14, his eyes widening.

“The insurance really shocked me — just how much people have to pay for health insurance,” said Tiara Anderson, 13.

More than 200 students from Paul Laurence Dunbar Middle School spent Wednesday morning learning about the benefits, downsides and realities of careers in the Lynchburg area. Accompanied by an adult chaperone, the students fanned out to more than 60 area businesses and clinics.

Called Groundhog Job Shadow Day, it was co-sponsored by America’s Promise, Junior Achievement, Lynchburg City Schools, Lynchburg College and Region 2000 Economic Development.

Anderson, Bryant and Jessica Graham, 14, chose to spend the day at the Free Clinic in downtown Lynchburg. All three are considering becoming doctors. Anderson and Bryant want to be pediatricians, while Graham is wavering between gynecology and neurology.

They received a crash course on the state of health care in America, and a heavy dose of reality. The students were surprised to learn 21,000 people in Central Virginia have no health insurance. Furthermore, they learned 80 percent of these people work.

“A lot of people think our clients don’t work,” Robert “Bob” Barlow, executive director of the Free Clinic, told students. “Most of them do.”

Sitting in the clinic’s waiting room, Barlow explained how health insurance works. The average monthly cost for insurance for one adult is $500, he said.

Companies pay most of this for employees, Barlow said, but some companies don’t. Workers in service industry jobs, like fast food restaurants, usually don’t have health insurance benefits.
If someone doesn’t have health insurance through his or her company, they have to pay the monthly $500 fee if they want coverage. Barlow said a fast food restaurant employee earning $6 an hour, working 40 hours a week, will earn roughly $960 a month, before taxes. The $500 fee for health care will be more than half the worker’s monthly income — before they’ve paid for rent, food, gas, car insurance and other living expenses.

“They either have to go without, or use a free clinic, or use more than half the amount of money they make a month,” Barlow said. “So you can see how people get caught in situations.”

Clinic patients cannot have health insurance or be eligible for Medicare or Medicaid. Also, their income must also be at 150 percent of the poverty level. The poverty level, set annually by the federal government, is $12,000. So an individual making $18,000 a year or less is eligible to use the Free Clinic. Couples and families with children can have higher income levels.

The Free Clinic has a full-time nurse practitioner, but operates mostly with the assistance of local doctors and health professionals who volunteer to work. The nurse practitioner takes appointments throughout the week, but patients can see doctors and dentists during the clinic’s twice-weekly walk-in hours on Tuesday and Thursday nights.

“We see everyone who comes in,” Barlow told the students. “The downside to a clinic is it’s walk-in. It means as you come in, you are seen.” An average of 30 to 40 people are seen on walk-in nights.

Students were shepherded through the clinic’s white brick building on Main Street for a tour. Afterward, each student spent 15 minutes with the clinic’s nurses, office staff and pharmacy workers.

Graham wondered how the Free Clinic pays its staff if it doesn’t charge clients money.
“Do the people who work here have full-time benefits?” Graham asked. “How do you get the money to pay for their salaries?”

Barlow said the clinic’s employees have health care insurance and benefits. The money to pay for it comes from the clinic’s annual $500,000 budget. The clinic receives $125,000 each year from the United Way, about $45,000 from the state, and the rest from grants, fund raisers and individual and business donations.

Centra Health also donates about $1 million a year in medical services, Barlow said.
Students peppered staff members with questions about how much education it takes to become a nurse, doctor or pharmacist. They also wondered about work-life issues.
Graham asked staff nurse Hanna Burruss if it was easier to have a family as a nurse practitioner instead of a doctor.

“You can still be a physician as a woman and have a family,” Burruss said. “You can always go out for a few years and work part time. I’m not sure it’s any easier as a nurse practitioner.”

By noon, the students hadn’t lost any of their enthusiasm for medical careers.

“I thought it was amazing to see that people can be so passionate about their work,” Graham said.

This was the first year the Free Clinic served as a job shadowing site. Barlow said he thought the program gave students valuable exposure to health care careers.

“I’m very impressed with the group of students,” Barlow said. “They’re all bright. They asked questions.”

Whether they end up working in a hospital or hotel, Barlow told students they should find a vocation that makes them happy.

“I’m happy going to work in the morning,” Barlow said. “Some people dread going to work. You don’t want to be in that situation. You’re going to be there for 40, 50 years of your life. Do you want to be in that situation?”

All three students shook their heads: No.

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