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One Clinic's Struggle and Success

Thursday, June 18, 2015

A story from one of our Pre-Medical Student Volunteers:

By David Mueller

While I was not there long, my time living in the Broadway area of Kansas City, Missouri was eyeopening. With its low economic status the Broadway district should have been at the forefront of healthcare efforts by the city and its residents, considering how many of its residents are uninsured and at risk of preventable diseases. Sadly, these efforts have not materialized. Recent assessments by public and private organizations have confirmed the area’s appalling lack of affordable healthcare coverage. In fact during my time there, of all of the efforts I witnessed, only one institution consistently provided the necessary care in an efficient way. That group, the Kansas City Care Clinic, continues to struggle with the overwhelming task of providing free or nearly free healthcare to over 8,000 patients.

The Clinic is a non-profit institution with an operating budget of close to $13 million and an administrative margin of only 10%. Despite this it is able to staff experienced providers, perform lab work, and provide primary care to its patients, of which 80% have no health insurance. The rest are woefully underinsured. With so little resources the question is how does the Clinic perform all of this. Perhaps the Cliniccompels its providers to work at an excessive rate. In fact, at the Clinic most providers see fewer than four patients per hour, sometimes fewer if necessary, allowing for the complete provision of care. Perhaps the Clinic focuses on primary care at the expense of community outreach. Actually, most of the Clinic’s efforts focus on vulnerable populations and the prevention of their diseases. For example, the Clinic operates a needle-exchange program, replacing over 300,000 needles per year. This is a proven method designed to limit the spread of blood-borne infections like hepatitis and HIV. The Clinic also distributes free condoms and operates dedicated STD screening programs to limit the spread of sexually transmitted diseases.

The Clinic’s ability to consistently enact these life-saving efforts comes down to one aspect of its internal organization. By operating within the constraints that it does, the Clinic is forced to either continue to improve its efficiency or compromise patient care. As a result it continuously reevaluates and improves its systems, out of necessity, leading to advances in efficiency not seen with regular healthcare. This incredible efficiency takes many forms. The Clinic utilizes a strong core of volunteers that perform functions ranging from clerical work to the assistance of minor medical activities. This was one job that I performed while I was there. The Clinic also maintains relationships with local private organizations and individuals gracious enough to donate.

These improvements in efficiency come at a cost. The major effect of all this is that the Clinic is reliant on such contributions. Without them, according to their CEO Sheri Wood, it could not function. It is here that we have the greatest opportunity to effect change in healthcare for those who need it most. It falls on each one of us to support this Clinic, a member of our community that has already given so much, in a way that properly reflects the degree of good it does for its patients. Volunteers are in high demand. I recommend that everyone try volunteering there for the simple reasons that it is of little cost to the volunteer and of enormous value to the Clinic. The personal reward of having a positive, tangible effect on the community is another benefit. Finally, with only 42% of its revenue coming from government grants the Clinic requires support from private organizations. Donations are taxdeducible and carry with them the rare opportunity to help maintain the health of a vulnerable area. $50 alone stocks an exam room for a week, while $100 provides free HIV screening. I highly recommend supporting the Clinic in this way, given the impact it has.

Soon I will be returning to Kansas City. I hope to see many of you at the Clinic with me or supporting it however you can. In this way we can enact real change in our city and move forward as a healthcare-conscious and caring society.

David Mueller is a premedical student at Boston University and a volunteer at the Kansas City Care Clinic

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