Even with the implementation of the Affordable Care Act, tens of thousands of Rhode Islanders still have no medical coverage - often going without, or winding up at a local hospital emergency room. For the past 15 years The Rhode Island Free Clinic has been the safety net for some of the state’s most vulnerable residents, through a vast network of volunteer medical professionals and corporate donors.
Click here for more information about the Rhode Island Free Clinic.
I’m Jim Hummel and this month’s Rhode Island Spotlight profiles the Rhode Island Free Clinic. Since 1999 it has been a lifeline to medical care for thousands of Rhode Islanders who had no other options for coverage. This Spotlight is made possible by CVS Health, a proud partner of the clinic.
Manuel Guzman has been having persistent back pain, serious enough to keep him out of work. But with no health coverage he hasn’t been able to see a doctor and figure out what might be causing the problem.
Guzman, who is 41, recently discovered The Rhode Island Free Clinic - which last year treated 2,000 patients who had no insurance and could not afford to pay for any health care.
Troise: `` When you have nothing, you’re just out there. You don’t get care.’’
Dr. Caroline Troise has been a volunteer at the free clinic since it was founded in 1999, an effort spearheaded by former first lady Stephanie Chafee. Dr. Troise, who practices internal medicine at Anchor Medical Associates, has been the volunteer medical director here since 2001.
Hummel: ``How have things changed since you began in 2001?’’
Troise: ``Then we had very little we could offer the patients besides just a good history and physical and some basic blood testing.’’
Over the past 15 years the clinic has grown into a million-dollar-a-year operation, privately funded through donations with no taxpayer money. More importantly, it leverages an additional $5 million of in-kind donations: from doctors to hospitals to supplies and contributions from nearly four dozens corporate donors.
But this is no emergency room or urgent care center. The clinic operates like a doctor’s office, with patients scheduling regular appointments and getting care from specialists and medication as needed - but with no bill or co-pay at the end of the visit.
Ghazal: ``Today we have a psychiatrist here, we have orthopedics, we have dermatology, we have GI doctors…’’
Marie Ghazal has been the clinic’s CEO the past six years.
Ghazal: ``We raise every penny and it’s through the generosity of donors, companies, businesses.’’
Manuel Guzman, like all new patients, got a full workup on his first visit, administered by Marvin Vasquez, a medical assistant who serves as the clinic’s traffic cop and interpreter when necessary. With basic information in hand Guzman meets with a team that includes Dr. Remuel Briones, a primary care volunteer who give four hours of his time a month to the clinic. Natasha Freeman is a pre-med student at Brown who also volunteers her time as interpreter and Emmanuel Danso is one of half a dozen AmericaCorp Vista volunteers. Danso hopes to be a primary care doctor as well.
Dr. Briones will order some tests and medication - and schedule an appointment for a followup. If Guzman needs lab work, x-rays or a CAT scan he can get them at Lifespan; women can get mammograms at Women and Infants Hospital.
Troise: ``If we have a need for hospitalization they take of the hospitalizations- the specialists are typically Lifespan specialists.’’
Hummel: ``All donated?’’
Troise: ``All donated.’’
Hummel: ``That’s a mindblower isn’t it?’’
Troise: ``It is.’’
Hummel: `` I mean it adds up, does it not?’’
Troise: ``It does, it does add up.’’
Over the past decade the clinic moved up to the third floor of this building on Broad Street in South Providence and word has travelled through the medical community about the effect the organization is having on some of Rhode Island’s most vulnerable residents. More than 100 medical professionals, including doctors and nurse practitioners volunteer their time here.
On the day we were there they included Dr. Nicholas Califano, a renowned gastroenterologist and Dr. Peter Baute, who practices family medicine on Block Island.
Troise: ``Over the years we’ve been able to do…obviously move to a larger space, we have state-of-the-art equipment here, we have an ophthalmology room. We have a whole colcort of specialist that are willing to take patients for free. If somebody needed neurosurgery we have a neurosurgeon who will donate that time and his expertise for free.’’
A group of physical therapists also volunteers here on Friday - sparing patients from having to travel to another office for treatment.
In 2012, CVS Health began providing medication - free of charge - to patients of the Rhode Island Free Clinic. Dr. Troise says that partnership has been a significant turning point for the clinic, which used to have its own pharmacy, but the donated pharmaceuticals weren’t always consistent or available.
Troise: ``We see a large number of our patients have diabetes, hypertension, the bread and butter medicine that require medications so it’s really important that we have a supply that we can give patients. The demand was so great that we couldn’t handle all of it and that was when CVS stepped in and is now providing free medication to our patients. Which means that if I prescribe a medications for blood pressure that patient can have that for the next year or however long he’s on that medication.’’
Hummel: ``Filled at a CVS pharmacy.’’
Troise: ``Filled at a CVS pharmacy.’’
Hummel: ``And he or she would walk in like anybody else and they would know from the paperwork that this is covered by CVS.’’
Troise: ``That’s correct.’’
Lambert: ``It was fated that I needed to be here because without the Rhode Island Free clinic I would not be here at all talking to you.’’
Pamela Lambert is an actress who for years had no health insurance - until she became a patient here a decade ago. A routine eye exam and a subsequent conversation with an ophthalmologist led to a cancer diagnosis. Yes, an eye exam.
Lambert: ``You have what is known as `bear tracks’ across your retina. I strongly suggest you go get a colonoscopy as soon as possible. Those are indicative or colorectal cancer.’’
Lambert survived advanced colon cancer and now is an advocate and ambassador for the clinic.
Lambert: ``I started going to all of my artist friends saying you have to try and get in the clinic, because none of us had health care, we’re going through with the black rep or Trinity or AS 220 we’re doing shows here, there and everywhere and nobody had healthcare. It’s not like it was just me. There shouldn’t be a stigma, people in this economy…’’
Hummel: ``A lot of people in the same boat, aren’t there?’’
Lambert: ``They’re out there, they’re working every day at two or three different jobs, but each one is part-time. And they still don’t have insurance and they have families.’’
For the doctors volunteering here has an added bonus they don’t often see in their own practices.
Troise: ``As a primary care doctor in practice now, it’s very frustrating because of all of the things you have to juggle in the office. A large part of time is spent on non-medical things, non- doctor things; insurance companies, pharmacies, trying to get you to change medications.That’s one of the things I find even after a long day at the office at 6 o’clock, when I come here all I can think about, all I need to think about is taking care of my patient. I don’t have to worry about: is he going to be able to afford this medication? Where am I going to get the test done, do I have to get authorization from the insurance company to order this test?’’
Ghazal: ``There is not a sense of entitlement that you may think people have about the free clinic. I think people are just so pleased and just so appreciative and kind to the staff and to the volunteers, because to many of them this is their lifeline.’’
Ghazal says the Affordable Care Act has allowed hundreds of the free clinic’s patients to obtain medical coverage elsewhere, opening up spots for new patients over the past year. She said with all the talk about improving the state’s economy and bringing jobs to Rhode Island, many overlook the critical role healthcare plays in that formula.
Ghazal: ``Healthy Rhode Islanders mean they can work, and a healthy economy as well, and they can take care of their families.’’
Hummel: ``What do need going forward?’’
Ghazal: ``To continue the partnerships that we have and to have more sustained partners to continue the generosity of our supports, to continue to leverage the resource that we can.I think if we continue to do that we will continue to make a difference to every Rhode Islander.’’
In Providence, Jim Hummel for The Rhode Island Spotlight.