By Darryl Fears
Washington Post Staff Writer
Monday, August 2, 2010; B01
In the run-up to this week's giant free clinic in the District, Nicole Lamoureux, the lead organizer, could tell that hearts were racing, blood pressure was increasing and tension was rising. Calls from patients scheduling appointments were starting to pour into her office, but there weren't enough volunteer medical workers to see them.
"Right now we're in full sprint mode," said Lamoureux, executive director of the National Association of Free Clinics, host of the day-long event Wednesday at the Walter E. Washington Convention Center. "We will just be running. We're at the place now where adrenaline kicks in and you pray that it holds out until the end."
About 800 doctors, nurses and support staff members had volunteered by Sunday to test and prescribe treatment for about 1,200 people, most of whom are expected to come from the District, Virginia and Maryland, Lamoureux said. One thousand volunteers are needed for the city's first large-scale free clinic. Although the list grew steadily by about 100 a day as medical workers signed up on the association's Facebook page, organizers worried that the growth could taper off.
The association has to staff 76 examination rooms to test for cancer, HIV, diabetes, hypertension and heart disease, as well as conduct physicals for people who haven't seen a doctor for years. In other cities where the association held its Communities Are Responding Everyday (CARE) free clinics, doctors aided a woman who had congestive heart failure and couldn't breathe, Lamoureux said.
Another woman discovered that she was pregnant. A man who had lost his job couldn't afford the $77 ointment to treat the rash on his face. And volunteers fished a lethal combination of pills out the pockets of a man who said he wanted to kill himself.
"We're here to make sure people understand what the face of the uninsured looks like," Lamoureux said. "They're our neighbors. They're just like us. It's the person who sits next to us every day."
More than 90 million Americans live in communities in which doctors and facilities are scarce, which the federal government designates as medically underserved areas. That includes more than 2 million Virginians, more than 1 million Marylanders and more than 200,000 D.C. residents.
Mark Busby, a federal information technology employee in the District who volunteers often at events nationwide, said free-clinic waiting rooms are always packed. As a "floor colonel" charged with keeping the lines moving and getting patients to the correct exam rooms, Busby expected to pound the convention center's concrete floor as an escort.
He recalled a clinic run by the association in September in Houston that saw 1,800 patients in a day and another in December in Kansas City, Mo., that saw 2,200 patients in two days. "We probably walk eight to 10 miles," he said.
The treatment was underwritten by 44,000 donors, who contributed $300,000. The donations will pay the discounted $30,000 rental fee. The clinic is open from 11 a.m. to 7 p.m.Other groups' attempts
Large-scale free clinics haven't always been welcome in the District. Last year, Remote Area Medical (RAM) sought to stage a similar event at the D.C. Armory but withdrew after its founder, Stan Brock, rejected a $77,000 rental fee.
"From the very beginning, it was rather clear that they didn't want us there," Brock said of city officials. Health Department officials said his event would have created a spectacle in a city in which 90 percent of residents carry health insurance, Brock said.
"But some people still can't afford" doctor visits, Brock said. RAM events in places such as Wise County, Va. drew thousands of people from as far as Indiana and Florida. He was certain that a D.C. event would do the same.
RAM wanted to offer treatment that included minor surgery, dentistry and eye exams and to make glasses on site, services that require more government oversight. Worried D.C. officials told RAM to produce at least one doctor approved by the city's State Health Planning and Development Agency for every five doctors at the clinic.
"What Remote Area Medical does, as opposed to what other groups do, is we provide real treatment to the patient," Brock said. "The event you're talking about is more likely to be screening for medical problems and education, imparting very useful information, letting them know your blood pressure is on the high side and you're showing signs of diabetes."Misconceptions
Lamoureux took issue with that. The CARE clinic will offer many of the services RAM does, she said. City health officials might have been more favorable to the national association's clinic because organizers approached the Health Department early and worked with officials to address concerns, she said.
"There is a common misconception of what free clinics provide every day across the nation," she said. "We give each patient real, live medical exams. We offer HIV tests and counseling on site."
Natasha Powell, a George Washington University Hospital emergency medicine fellow, said she will do whatever's needed. "I volunteered," she said excitedly after signing up on Facebook. "I'm expecting a lot of chronic conditions. I think it's going to be busy, a little like a marathon, like an emergency shift," she said last week.
Wednesday's clinic will be Powell's first foray into one of the association's events. She has traveled to places such as Haiti as a volunteer because "my mother instilled in me the importance of giving back" during her upbringing in Upper Marlboro.
"To give back to the population is important to me. But I don't know if I need to go to Africa or India to take care of people in need," Powell said.
To read about a recent RAM open-air health clinic in Wise, Va., see Tuesday's Health and Science section.