(Doximity lately printed this text of mine on organising a neighborhood mission clinic. It initially appeared right here, however a few of you aren’t on Doximity so, with Doximity’s permission, I’ve republished it on my web site in your studying pleasure)
Many physicians wish to use their expertise on the mission area, however have a tough time discovering an choice that matches into their busy schedules.
A number of years in the past, I seemed for a medical mission, however I couldn’t discover one that may work for me, so I got here up with the concept of organising a medical mission expertise in my very own city. A neighborhood mission meant I wouldn’t must pay for journey to a different time zone. I might additionally present this service year-round.
First, I wanted a spot the place I might have free workplace house and a built-in referral base of worthy sufferers. Our native homeless shelter, the Gospel Rescue Mission, got here to thoughts. The majority of their residents have been on the mission for six–12 months whereas they obtained again on their toes. I mentioned this with the mission director, who felt that by spending an hour or two, at some point per week, I might see everybody who wanted medical help proper there on web site.
Beforehand, when one in all their residents wanted medical care, the mission needed to discover methods to move them to the hospital. Many of the residents on the mission didn’t have medical insurance coverage or transportation. Many didn’t have cash and even any ID, which was usually misplaced or stolen earlier than they reached the mission. This new medical clinic would remedy an issue the mission had been praying about for a very long time.
The mission director gave me a room to see sufferers, put in a sink, and made preparations for scheduling sufferers. They already had a volunteer nurse who got here weekly, and she or he was excited to have a doctor on board to supply what she couldn’t.
One morning every week the nurse and I arrived at 7 a.m. She would report vitals, test blood sugars if wanted, and begin the affected person’s medical report earlier than they noticed me. I might normally see all of the sufferers and be again to my very own clinic by 9:30 a.m.
That first day we noticed 20 sufferers and accomplished all of the charting in two hours. There was no insurance coverage that wanted approval, no billing, no quotas, and no EMR. We took care of solely the rapid wants of the sufferers. If that they had an an infection on their arm, we gave them samples of an acceptable antibiotic and had them come again the subsequent week for follow-up. That go to took lower than 5 minutes of my time, together with the paperwork. This clinic had a huge effect on the residents on the mission with a really small time expenditure from the nurse and me.
For medical information, we used 4” x 6” index playing cards. Every affected person would have their very own card itemizing their identify, birthdate, allergy symptoms, and drugs. Every go to, the date and a one or two sentence abstract of what we discovered and the way it was handled was added to the cardboard. The above-mentioned affected person’s entry would possibly appear like this: “11-19-19 Affected person scraped left forearm on a stick 4 days in the past and now has a superficial pores and skin an infection with no abscess and a pair of” x 2” erythema. Given Keflex 500mg QID for 7 days. Observe up subsequent week.” The cardboard might maintain a few dozen visits.
After holding this clinic just a few weeks, I discovered that lots of the residents had been within the ED or pressing care lately. I contacted the hospital and defined what I used to be doing. I requested they supply one of many hospital laptop terminals to be positioned in our mission clinic permitting us to entry the hospital EMR and to get current lab and X-ray data in addition to ED go to data. They thought it was a cut price to assist me and offered two computer systems, one for me and one for the nurse.
If labs or X-rays have been wanted, I used to be now in a position to get them organized on the hospital’s laptop system. For the reason that hospital already had a program to take care of non-paying sufferers, they took care of this of their indigent program and have been glad our clinic was eliminating the necessity for the non-paying affected person to go to their ED.
Many residents wanted drugs and sometimes didn’t have the cash to purchase them. My nurse talked with a number of docs’ workplaces on the town asking if they might give us their expired samples, as a result of drugs don’t out of the blue grow to be unhealthy after the expiration date. These free samples have been a giant assist to our clinic.
If I had the suitable treatment, I gave the pattern to the affected person. In any other case, I might select a medicine from Walmart’s $4 drugs checklist. The mission employees would then take the affected person to Walmart to select up their prescription. If neither of these two choices labored, the mission had a program to cowl the price of wanted drugs.
Prescribing narcotics was initially an issue. The mission had a zero-tolerance coverage for narcotic use by their residents. I satisfied the employees that generally we would have liked to make an exception. For instance, if somebody had a damaged bone, they might have important ache for just a few days. The mission board determined that if the resident was being handled within the clinic, and the doctor felt that just a few days of narcotics have been wanted as a result of an damage, they might enable it.
A month after the clinic opened, the native newspaper wrote a narrative about us. This introduced different volunteer physicians to our clinic employees. Group members started donating cash and barely used medical objects, resembling finger splints, ankle braces, and crutches. The money donations have been used to buy OTC drugs like ibuprofen, Tylenol, and antacids to have readily available.
There have been a number of instances a specialist was wanted. One resident fractured his wrist. Our clinic didn’t have the provides wanted for casting, so we despatched him to an ortho clinic. I used to be in a position to safe a number of physicians and clinics on the town who volunteered their time and supplies to look after sufferers once we wanted assist. We’d do what could possibly be executed on the clinic and the specialists have been obtainable to help as wanted. Our little mission clinic grew to contain the remainder of the medical neighborhood.
One affected person I noticed was unable to get work due to an inguinal hernia. As quickly as an employer came upon about his hernia, they wouldn’t rent him. I agreed to repair his hernia free of charge after beforehand discussing this selection with my companions. I requested him to see me in my workplace later that day the place I might get all the things arrange. The hospital agreed to cowl their fees underneath their indigent program.
When the affected person got here into my workplace, he requested me why I might work free of charge. I advised him it was my manner of doing mission work with out having to go away town. I’ve been blessed by this neighborhood through the years and simply needed to offer again. He mentioned via tears that nobody had ever given him something. That was a really rewarding second for me and was a great illustration of why I arrange the free clinic. Extra individuals advised me “thanks” within the two hours I spent on the clinic than I heard from my non-public apply all the remainder of the week. People who find themselves actually in want are very grateful for assist.
Folks usually ask about malpractice protection. I merely requested my insurance coverage service if they might cowl me to do that charity work. They mentioned sure, and regarded it an extension of my common apply with no extra premiums.
I encourage you to discover a place in your city to do medical mission work. All it takes is a bit time and also you too will really feel an ideal reward from serving to these in want who’re much less lucky than your self. In the event you pores and skin your knee, you possibly can simply go to the medication cupboard and get a Band-Support. The homeless don’t also have a drugs cupboard.
