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Free Clinic Hopes to Make A Difference, July 4,2004, BY SARA LINDAU: Staff Writer, The Pilot (www.pilot.com)

July 4, 2004 - Southern Pines, NC - About 11 percent of Moore County’s population lives below the poverty line, which is less than $9,130 a year.

A third of the population in this region has hypertension. Another third has high cholesterol levels. Nearly two-thirds are overweight or obese, putting them at risk of diabetes and other diseases.

Medicaid and Medicare and private insurance don’t cover the working poor — about 2,000 adults between 18 and 64 years of age in Moore County. An additional 2,500 adults who lack basic medical care weren’t listed in the most recent U.S. Census. Most were Hispanics.

These are the people who are increasingly using emergency rooms as their primary medical care, driving up medical costs.

These statistics come from the 2003 Community Health Survey by FirstHealth of the Carolinas.

The Moore Free Clinic in Carthage hopes to change those statistics by providing an option for the working poor and those who lack insurance. The goal is to provide basic medical care and prevent many of them from developing more serious illnesses that will require even more expensive treatment later, said clinic founders Dr. David Bruton and the Rev. Mark Wethington, pastor of Southern Pines United Methodist Church.

In six weeks of operation, the Free Clinic had seen more than 100 people. Of those, 60 percent were white adults, 26 percent African-American adults and 14 percent Hispanic adults.

The clinic, staffed by medical volunteers, sees patients by appointment on Tuesday and Thursday evenings. The clinic operates out of the Moore County Health Department on Pinehurst Avenue in Carthage.

“There’s a joy in helping people who can’t get help any other place,” said Dr. James Tart, a cardiologist and volunteer at the Free Clinic. He is also a founding member on the Board of Directors.

Dr. Robert Bahner, assistant director of the Emergency Department at FirstHealth Moore Regional Hospital, said many people have been going to the emergency room without a real emergency, because they can’t afford the doctor’s office, even though that is probably less expensive. They know they will be seen at the emergency room without insurance or upfront payment, he said.

A prime example is 37-year-old Bobbie Lee Turney, a graduate of Union Pines High School, who is currently unemployed and lives with his parents. He has worked as an electrician’s and plumber’s assistant and done a variety of other jobs.

He has dental problems and suffers from back pain from a tractor accident that requires him to “move all the time.”

“No one sees you without any insurance,” he said. “The only time they see you is at the emergency room. I went to the emergency room when I broke my collarbone eight years ago. They took six X-rays, gave me a brace for my neck, and sent me a $4,000 bill. They didn’t fix my collarbone.

“I can’t afford no dentist, either.”

He later learned that the Free Clinic couldn’t help with the necessary tooth extractions. He would have to find a dentist on his own.

Preventive Medicine

“The uninsured are less likely to receive care before they get very sick,” Bruton said.

In a recent presentation to the Kiwanis Club of the Sandhills on the Free Clinic, Bruton said, “employer-sponsored health insurance is more costly or not available to these people. The difficulty companies have making a living requires most of them to have employees help pay for this benefit. And often the employees simply don’t make enough money to do this.”

Many people lost their jobs and their insurance in the recession. Many of the higher-paying manufacturing jobs in North Carolina and Moore County are gone, leaving displaced workers without health insurance.

“If you have options (such as the Free Clinic), people will take it,” Bahner said.

The Moore Regional Emergency Department saw 55,628 people in 2003, he said. It’s too early to know whether the Free Clinic will reduce that number, he said.

“About half of the people we see are working people, not making enough money to be above the federal poverty level,” Tart said. “Our goal is not only to provide immediate care but screen for some of the problems that can lead to more serious illness. People can have very high blood pressure and be at risk for a stroke but have no symptoms.

“We try to maintain the same quality of care that we would do in our offices. FirstHealth has been great, doing a lot of lab work for us without charge. The volunteer lab technician visits the clinic to draw blood. The hospital has been very generous providing us with a large number of free X-rays. Radiologists have agreed to read the X-rays without charge, and the hospital is willing to do a limited number of MRI and CAT scans for us.

“As a cardiologist tonight, at the Free Clinic, I saw a man with foot pain, wrist pain and headaches.”

Fortunately, he said, cardiologists are trained as internists before they become specialists.

Other medical specialists, such as an eye, ear, nose and throat specialists, practice there. An eye clinic has expressed interest in sending volunteers to the Free Clinic.

The Free Clinic’s annual operating budget is $300,000. An anonymous gift of $100,000 allowed it to open in April. That grew with a $25,000 grant from Blue Cross & Blue Shield of North Carolina Foundation, and the North Carolina Association of Free Clinics, plus a $25,000 matching challenge grant from local support and donations.

FirstHealth of the Carolinas and Pinehurst Surgical Clinic doctors made the initial commitment to provide volunteers and other support.

The clinic opened April 29, using rotating volunteer physicians, nurses, lab assistants and others with the assistance of the grants for supplies and medicine. The board will probably evaluate the clinic after six months’ operation, said board member Claudia Watson.

Prescription Drugs

One of the main functions of the Free Clinic has been to help people get prescriptions, either through a free prescription assistance program by the pharmaceutical companies that requires a patient to requalify every three months or free samples while they last.

Sometimes, simply writing a prescription for the patient is all that’s necessary.

“Invariably, I’m encountering people who can’t afford medication,” said Dr. David Hipp, an internist whose wife is on the board. He volunteered at a recent Free Clinic. “I’ve seen little acute care, a fair amount of people who had been seeing a doctor and can no longer get their prescriptions.”

Hipp said his experiences have been largely the same as those he sees in his office, but are “unbelievably frustrating.” These conditions are treatable but can become worse without a long-term system for these patients to obtain their prescriptions, he said.

At an office visit, doctors will sometimes give free samples to their patients, but after using them up, the patients are left “in the same boat,” Hipp said.

“These people need to be in a system where they can get the same amount of care as the Prescription Assistance Program provides and a consistent place to go for care,” he said. “The biggest service this clinic has is a staff that gets these people into long-term care. The staff, the director, do an excellent job.

“Physician care is not always the most important thing. They need longer-term care, not a short-term patch, and somebody who can translate (Spanish), is very important,” he said.

As expected, the Free Clinic encounters mostly high cholesterol and hypertension conditions that need ongoing medication. Patients are usually given return appointments, just as a regular doctor’s office operates.

In its first few weeks, Free Clinic volunteers found a handful of previously undiagnosed hypertension cases and at least one diabetic, said Laura (“T.J.”) Tremper-Jones, a registered nurse and the clinic director. She is fluent in Spanish and doubles as the clinic translator.

Thomasina Baldwin, 55, was laid off from her job of almost 27 years when Stanley Furniture Company closed two years ago. Her 58-year-old husband is disabled, and lost his own job at Stanley at the same time. She came to the clinic in June.

Her limited income as a displaced worker doesn’t leave enough money for medication, and she had been cutting down on the recommended dosage for hypertension.

She was helped through the Prescription Assistance Program and given a return appointment, as are most of the patients.

About the Moore Free Care Clinic

The Moore Free Care Clinic provides high-quality primary, preventive and specialty care to limited income people living in Moore County who are uninsured and can't afford access to health care. Health care services at the MFCC are provided by volunteers including: nurses, lab technicians, physician assistants, clerical workers and physicians. The clinic is located at 705 Pinehurst Avenue, Carthage, NC 28327. For more information about the clinic, its volunteer opportunities or to provide a donation, please contact the clinic office at 910-947-6550 or visit the clinic's website, www.MooreFreeCare.org.