Putting on a Clinic

Nearly one-third of Americans are uninsured or underinsured. In Columbia County, the Volunteers in Medicine Clinic is meeting the needs of more than 1,500 patients who otherwise could not afford medical care.

LORI REESE CAN’T FORGET the man who came into the Columbia County Volunteers in Medicine Clinic looking for a way to help control his adult son’s high blood pressure. The man’s wife had died and he was the sole caretaker for his mentally disabled son. He was struggling financially, and it soon became clear that he wasn’t able to afford his son’s blood pressure medication or his own.

“They were trying to decide what they could do on very little income. They actually asked me, ‘What medication do I absolutely have to take and what can I let go?’ Even the ones he needed, he was taking every other day to stretch them out. Sometimes they would go a week without medicine until they could afford to have it refilled,” says Reese, who graduated from Bloomsburg University in December 2011 with a degree in nursing. Reese did a shift at the clinic as part of a class in public health nursing.

“I knew there were these problems,” says Reese of Millville. “But I never had anyone say they were forced to skip medications for financial reasons until I was in the clinic, and it really struck home.”

Since opening its doors in early 2007, the Columbia County Volunteers in Medicine Clinic has provided the only option for ongoing health care assistance for many of the area’s uninsured and underinsured.

The Mifflinville-based clinic was founded by Bette Anderson Grey ’81, who experienced firsthand the possibility of not having insurance to help with a serious illness. The setting also provides a unique educational opportunity for Bloomsburg University’s nursing students, who can choose to spend at least one shift in the clinic as part of their studies.

“I think it’s very much an eye-opening experience for students to see the people that come through; some- times they are amazed that the people are their peers, people that haven’t had the opportunities that some of our college students have had and don’t have insurance,” says Lori Metzger, assistant professor of nursing. “As nurses, we care for patients and need to be in front of them. The students need to see a real example of someone who is in a quandary of having to buy heart medication or groceries that week. I can tell them about it, but it will never make an impact unless they experience it.”

While the plight of Americans without insurance has received national attention, many who have some insurance also are forced to go without care because they can’t afford high copays and deductibles. According to the federal Centers for Disease Control and Prevention, more than 30 million adults between 18 and 64 had been without insurance coverage for at least 12 months as of early 2010, despite the fact that one in three had an income between $44,000 and $65,000. Roughly half suffered from high blood pressure, diabetes or asthma — all conditions which, if left untreated, can result in expensive emergency hospital care.

Sherry Burke’s first experience with the clinic was four years ago, when she thought she was having stomach problems but, after testing at the clinic, found out she was pregnant. More recently, Burke, 35, was diagnosed with high blood pressure during a routine checkup. Burke’s husband works as a welder and insurance isn’t available through his temporary jobs. The clinic has helped the Berwick mother of two obtain the medication she needs.

“I don’t have a doctor and I can’t afford the copays and stuff like that,” Burke says. “If it wasn’t for the clinic, I don’t know where I’d be.”

The clinic is one of 86 such sites in 25 states affiliated with Vermont-based Volunteers in Medicine. VIM is a nonprofit agency that grew out of a clinic Dr. Jack B. McConnell opened in 1992 in Hilton Head, S.C. When McConnell realized a large number of working people in the region were forced to go without medical care because they didn’t have insurance, he recruited volunteer doctors and nurses, many of whom were retired, to help.

It’s a formula the clinics follow today.

Grey, a Berwick native, didn’t plan on running a clinic, but she always had an interest in medicine.

After earning a bachelor’s degree in biology from Bloomsburg, she trained at nearby Geisinger Medical Center as a respiratory therapist. But after her husband lost his job in 2003, she became ill and ultimately needed a hysterectomy.

Luckily, she still had COBRA supplemental health insurance from her employment at Sunbury Community Hospital.

During her recovery she saw a television report about a free clinic in New Jersey and called Volunteers in Medicine for infor- mation. She didn’t pursue it at the time, instead going back to work at the hospital. Then, in August 2004 — on the same day the hospital announced it was ending its pulmonary rehab pro- gram, leaving Grey jobless — she received another call from VIM asking if she was still interested. She was.

Grey worked with the Columbia County Commissioners and human services department and in March 2007 began holding clinic hours one night a week at the Columbia Montour Family Health offices. “The first night we had 10 patients and, of course, there were only five seats in the waiting room,” she recalls.

Grey had looked at the clinic’s current home in Mifflinville, but there was no way the fledgling operation could afford the lease. Fate stepped in again when Bloomsburg area businessman Myles Katerman, who knew McConnell from Hilton Head, offered to buy the building. At first Grey asked him to only lease thefacility, since she wasn’t sure the clinic would survive. But when the landlord wanted to sell in August 2009, the automobile carpeting executive bought the property.

The clinic now offers daytime appointments Monday through Wednesday and evening hours on Thursday. It employs a receptionist, nurse and physician assistant, who is able to prescribe a pre-approved list of medica- tions. A retired Geisinger oncologist, Dr. James Gallagher, volunteers as the clinic’s medical director and other doctors and medical professionals pitch in to see patients. Grants and donations keep the clinic afloat, and Grey is always reaching out to pharmaceutical and medical equipment companies. Funding is a constant struggle, she says.

There’s never a shortage of patients, however, and Noreen Chikotas, associate professor of nurs- ing at BU, is working on an arrange- ment that may give the clinic some staffing assistance. Chikotas, director of the university’s nurse practitioner program, wants her students to help at the clinic as part of their studies. Because her students already are nurses, they’ll be able to share in the work while they learn.

Grey estimates that 35 percent of patients come to the clinic for “runny noses and not feeling well,” but most have serious ailments. The most common chronic conditions the clinic’s staff sees are diabetes, asthma, high blood pres- sure, anxiety and depression. A needs assessment completed as part of the process to open the clinic revealed 28 percent of Columbia County’s residents were uninsured.

The clinic has also diagnosed cancer in 48 patients. Some, because they didn’t have insurance, only sought help after their symptoms became severe. “Some of the cancers we saw, it was unbelievable that the people were walking around feeling like this, but they couldn’t go for care,” Grey says. “Lots of them live on a shoestring, minimum wage jobs, and they say, ‘Oh, I’ll be OK, I’ll be OK,’ but the reality is they’re not OK.”

Susan Kelley, VIM’s director of operations, says Grey is not alone in seeing a real need for their services. “Each year we hear from our clinics that there is more demand. Certainly, with the economic situation, there have been more people who for one reason or another no longer have insurance,” Kelley says. “So there is a higher demand at the clinic level and, at the same time, it is harder to raise funds.”

The 52-year-old Grey has come to see the clinic as a calling, one she shares with her family. Her son David, 25, is on the board of directors and son Jeffrey, 19, often brings his guitar to the clinic to play for patients in the waiting room. Recently, the clinic also began a food pantry.

“I didn’t suddenly wake up to do this. This was not a life goal, but something happened to put me on this path,” Grey says. “I look back on all my medical experiences and everything I’ve done and it all came to fruition here.”

Chris Minnier of Berwick already has an undergrad- uate biology degree from the University of Pittsburgh and is taking additional science classes at BU to prepare himself for training as a physician assistant. He volun- teers at the clinic most Thursday nights.

“I really never had much patient contact before, even in school, so dealing with patients was important to me,” the 25-year-old says. Spending time in the clinic has made him appreciate the need for such services.

“I was really surprised at both the range of things that we see and the range of people that we see,” Minnier says. “I know it’s not the most affluent area and there’s always going to be people in need of help, but I didn’t know it was nearly as dire.” •

Jack Sherzer is a professional writer and Pennsylvania native. He currently lives in Harrisburg.

Visits Increase
Since the Columbia County Volunteers in Medicine Clinic Inc. opened its doors in 2007, the numbers of patients seeking care has steadily grown. Patient visits for the past three years: 2011: 2,248 visits 2010: 1,234 visits 2009: 906 visits In addition to general medical treatment, the clinic offers help to those with depression and other mental health issues, as well as skin disorders. In 2011, there were 41 patients who sought help from the volunteer dermatologist and 99 patients who received mental health counseling.

How to Help
Donations may be sent to the Columbia County Volunteers in Medicine Clinic, Inc., 310 East Third St., Mifflinville, Pa. 18631 or made through All donations are tax deductible.


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