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The unseen service that keeps the working poor healthy

August 21, 1999

Perhaps the Community Free Clinic's best public-awareness move would be to start the line of care-seeking patients smack at its front door on Franklin Street instead of in a hidden ally aside the building.

Out of sight is out of mind, and it might be an eye-opener if the public were to see 30 or so uninsured people who, by two or three in the afternoon, begin to drift in for a chance at treatment that evening. It would also be a help if the public were to somehow see the doctors and nurses who come in late in the day, dog-tired after already working 10 hours in their own stressful practices, to offer care for no pay.

Hagerstown is blessed to have a clinic, established in 1990 by Dr. Martin Gallagher, that administers to people who, frequently through social or economic circumstances out of their control, find themselves uninsured and with no way to pay for health care. It's believed to be one of only perhaps 200 free medical clinics nationwide. But like many of its clients, the clinic is living paycheck to paycheck, its existence never guaranteed for much more than a couple months ahead.

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This summer, the clinic has been financially pressed as never before. Energy that should be spent caring for clients is devoted to scrambling for scarce cash. Patients slated for follow-up visits worry that by their next trip there may be no clinic in which to follow up.

Administrators and fund-raisers at the Community Free Clinic would obviously like to change that. It's their goal to find perhaps a couple hundred businesses or individuals who would pledge $1,000 a year for three years - a commitment that would give the clinic some breathing room and a little security for the future.

The clinic will handle 8,000 visits this year, four times the load of just three years ago. It's annual budget of $240,000 pays for four salaries, operational funds, patient expenses and medication.

Of course it borders on futility to try to run a medical anything on less than a quarter million dollars a year - but somehow they do it.

One patient alone currently needs medicine that costs almost $250 a month, a pace for $3,000 in a year. So the clinic gets by any way it can. Some medicines arrive stuffed in trash bags, free samples given to doctors by pharmaceutical companies that are passed along to the clinic, where volunteers sort and label them and stack them in multi-colored plastic bins purchased from the dollar store.

Most confounding to the Free Clinic staff, and most troublesome to fund-raising efforts, is the public perception that patients at the clinic are freeloading, too lazy to work or simply leaning on the clinic's largesse for maladies that aren't all that serious.

Lorri Rice, director of the Free Clinic, surgically slices through the myths about the tiny medical center. First, since people are generally treated on a first-come, first-served basis, lines can start hours before the practitioners show up. But even that's no guarantee they'll be seen. The clinic might be able to see eight to 15 patients an evening, so often a nurse has to walk through the ranks, picking out the people most seriously in need of care and turning the rest away. "You would have to be almost pathological to put yourself through all that if you didn't need to," she said. Indeed, many patients move on to more conventional care once they're back on their feet.

The clinic runs the Social Security numbers of its patients to be certain they aren't eligible for coverage elsewhere. And quite the contrary to being lazy, many of the patients scramble for whatever work they can get, picking up temporary or part time jobs that offer no benefits.

Here as elsewhere, health-care benefits are being whittled to the bone as companies try to save costs. It's hard to blame the small businessman, for often the ever-rising costs of benefits is the difference between profitability and failure. I've talked to a few such folk who genuinely feel bad they can't offer their workers benefits. For them, maybe a contribution to the clinic would be the more affordable next-best-thing.

Because of the United Way blackout (agencies that receive United Way funds aren't allowed to raise money during the United Way's own fund-raising season) you may not be hearing about the Free Clinic's needs over the next three months. But it's important to keep this cramped center, a center that is so short on space and money but so long on heart, in your thoughts. For giving, its phone number is 301-733-9234.

Already, the volunteer contributions of the doctors and nurses in the community is remarkable. Nearly 40 put in time at the clinic and another 123 help out on a referral basis. All told, the free clinic benefits everyone, by relieving pressure on the Washington County Hospital emergency room and reducing the amount of uninsured write-offs that are eventually paid for by those with insurance.

But the clinic's favorite quote in asking for support comes from John F. Kennedy, who said sometimes we have to get involved and pitch in not because it is in our own self-interest, but because it is the right thing to do.

For our neighbors throughout Washington County, for our own people who are in a tight place (that with a bad break or two many of us could just as easily be in ourselves) helping a good group of people administer the health care that ought never be denied any man woman or child, is clearly the right thing to do.




Tim Rowland is a Herald-Mail columnist

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