A Clinic's Gift: Free Specialty Care
Saturday, December 15, 2007
The first woman arrived with seesawing high blood pressure. Another walked in with a handful of pill bottles and a history of chest pains. Yet in the clinic's small waiting room in Bethesda, they and half a dozen other people shared more than worries over heart problems.
None had insurance.
Their lack of health coverage was of strikingly little concern to the doctors and nurses taking medical information and administering EKGs and other tests. The reason: These patients and providers are part of an unusual collaboration that is delivering sophisticated specialty care to individuals with no means to get it on their own.
"This is an important mission," said Richard Cannon, a cardiologist who volunteers for several hours nearly every week.
In tackling one of the tougher issues in health care, three very different partners have invested effort and money. And if the MobileMed/NIH Heart Clinic at Suburban Hospital succeeds, backers believe it could be a model for other equally needed specialty care.
The clinic links a private facility, Suburban, and a federal entity, the National Heart, Lung and Blood Institute, with MobileMedical Care, a grass-roots group that relies almost exclusively on volunteers to staff 21 primary care clinics across Montgomery County.
That approach is behind the new venture, which began in mid-October in a cozy suite of rooms down a hallway off Suburban's main lobby. The medical recruits are a dozen cardiologists, plus nurses and technicians, from the hospital, the heart and lung institute and the community. A former Suburban doctor even comes from his job at the State Department.
All enthusiastically signed up for the Thursday afternoon and evening duty, which deals with a stream of grateful humanity.
"I can't even describe the level of satisfaction in helping people who literally would not have any other recourse," said Philip Corcoran, a cardiovascular surgeon.
Like many health-care providers serving a disadvantaged population, MobileMed has gone begging at times on behalf of patients requiring more than general care. Yet finding willing doctors was becoming increasingly difficult. In some instances, long waits for appointments and tests could put lives at risk. So the organization took a different approach.
"Either we say specialty care is part of primary care and we're in the business and let's do so in a planned way," said the group's executive director, Robert Spector, "or we say let's get out of the business and refer [patients] to the county, and if they wait six months, they wait six months."
The heart clinic's clientele, many of whom are among the working poor, pay nothing for their appointments and state-of-the-art diagnostic exams and treatment. Several have had heart bypass surgery, a heart valve replacement or an artery-clearing angioplasty. A few have gone across the street to the National Institutes of Health for cardiac catheterization.