There was a time when Kathleen Robinson couldn't count on the Loudoun Community Free Clinic to open as scheduled, but these days it's a sure thing the doctor -- in fact, doctors -- will be in.
"Coming here is saving my life," said Robinson, 50, who had a heart attack three years ago and is asthmatic.
On a recent visit, the Leesburg resident was treated by Ray Hoare, a retired cardiologist from McLean. Hoare, a volunteer for more than 30 years at free clinics in Washington and Arlington County, wrote a refill for Robinson's prescription, discussed her medical condition and answered her questions with patience and humor.
"It's obvious they care about the patients," said Robinson, who, though employed, cannot afford health insurance. "Most places care about money. They care about people."
The latest and most successful attempt to establish a free clinic for uninsured Loudoun County residents has been in business since January 2000. The current board of directors credits Lyle Werner, the executive director, for turning around an effort that had failed repeatedly.
"Lyle has been tremendous in garnering stability," said Kelly F. Hymes, vice president for human resources and guest services for Loudoun Healthcare Inc. and chairman of the clinic's board. "I don't worry about our survival any more. Before we hired her, we were on the verge of closing our doors."
Now the clinic is growing so rapidly that the demand for services is straining its capabilities. Werner said the clinic saw 1,300 patients in 2002, 1,800 in 2003 and 1,500 so far this year.
The clinic treats patients ages 18 to 64 for non-emergencies. "When any free clinic starts, you fill the gaps in health care first," Werner said. "If you're over 64, you're eligible for Medicare. There are services available for kids under 18."
Werner said the success of the clinic is a result of the involvement of the business community and nonprofit organizations. She also credits the board of directors for being farsighted enough to realize someone was needed to run the clinic who could pursue that support.
"My background is not not-profit, not medical. The board understood the importance of hiring a business person who is networked to the community," she said.
Werner has proven she is up to the task. For the year ending in June, she took a $391,000 budget and turned it into nearly $2 million in health care services, thanks to a far-reaching network of donors. "That's $5 for every $1 spent," she said.
There's no need to spend any money on advertising. "Everyone knows where to find us," Werner said.
In February 2003, the clinic, which had been seeing patients at the health department and borrowing office space from the Loudoun Medical Group, moved to the old Loudoun Hospital complex. The four-column, white stucco building on Cornwall Street looks more like a home than a medical center, with its front-porch benches and gardens flanking the entrance, both donated by the Woodlea Garden Club.
It is a pleasant, cheerful place, catering not only to patients but also to the families who invariably accompany them. Children are encouraged to take something home from a box of donated books near the waiting room. At Christmas, Leesburg Boy Scout Troop 1550 decorated a tree, leaving wrapped presents underneath for young visitors. Kohl's employees come by regularly to put up themed decorations. The current harvest-and-Halloween decor features black cats, witches, pumpkins and cornstalks. A life-size skeleton in the volunteers room wears a white gown, red robe and braided wig, replacing the summer outfit of grass skirt, sunglasses and flip-flops.
Patients arrive as early as 2 p.m., waiting in the parking lot or on the porch until the doors open at 5:30 Wednesdays and Thursdays. They are seen on a first-come, first-served basis until 9 p.m. Werner said as many as 25 to 28 patients can be seen in an evening. Recently, an appointment-only session was added from 10 a.m. to 3 p.m. Mondays, and there is an appointment-only diabetes clinic on the first and third Thursdays of the month from 12:30 to 4:30 p.m.
Werner is always on the lookout for ways to expand the clinic's donor network. "Lyle needs to strike a delicate balance between being politically astute and obnoxious enough to garner the support she needs," Hymes said. She said Werner once talked a doctor into donating an art deco examining table and medical case she spotted in the hangar where he kept his private plane. "She gets people to give things away that you can't even imagine," Hymes said.
Dena Willett, a registered nurse who is the clinic's coordinator and the only other paid employee besides Werner, recalled a recent patient, a young woman with an abdominal tumor. "We managed to get her free surgery donated by the University of Virginia. We've diagnosed several cases of malignant cancers. The folks we see aren't likely to seek out medical care."
One of the reasons for patients' reluctance to seek medical help is a lack of health insurance. Werner said the majority of clinic patients come from the Hispanic community, working in low-paying service jobs.
Others have lost jobs in telecommunications layoffs or are employees of startup businesses with no health insurance plans. Though Loudoun's average household income of nearly $85,000 is nearly 40 percent above the national average, more than 30,000 people, or about 15 percent of the population, are uninsured.
There is a 15-minute patient screening interview every six months to verify age, residency, lack of insurance and income, which cannot exceed 200 percent of the federal poverty level. This translates to $37,700 a year for a family of four, for example.
The heart of the clinic is the volunteer staff of actively practicing and retired doctors, nurses, clinicians, phlebotomists, interpreters and administrative staff.
In 2003, volunteers donated more than 3,500 hours of service for patient care. Werner makes the phone calls herself to more than 125 volunteers to set up the roster for each clinic session.
Off-site, a cardiologist, dermatologist, gastroenterologist and orthopedist and other specialists see referrals pro bono. Lab work is provided by Quest Diagnostics and Fairfax Medical Labs, and imaging services are donated by Reston Hospital, Reston Radiology Associates, MRI of Reston and Fairfax Radiology.
Several pharmaceutical companies donate medicine -- the biggest expense -- but there is a huge gap between demand and supply, so the clinic finances the difference.
Fundraising is a nonstop task. Werner's current project is a "Harvest of Hope" barn dance Sunday at Great Country Farms in Bluemont. This summer, the clinic was one of the charities that benefited from the Loudoun Summer Music Fest at Belmont Country Club.
"We in the free-clinic business used to believe that our job was to work ourselves out of a job," Werner said. "We've come to realize that it's a new era and that's not true any more. We've come to realize that we're in business to stay."
The Harvest of Hope barn dance will be held from 3 to 8 p.m. Sunday at Great Country Farms, off Route 734 in Bluemont. The dance will feature music by 4 of a Kind, pork barbecue and gourmet fixings, and beer and wine. The festivities will also include a country auction and line dancing. $75. For more information, call 703-779-5412 or visit www.loudounfreeclinic.org.