Reference no: EM132219237
Case Study : Free Clinic Woes
As the director of Franklin Creek District Health Department, Jane Potterfield was proud of her self. She had gotten a small grant from a local corporation for a part-time receptionist and had received free use of an old store in one of her counties the county that was most rural. She also had all she needed to start a free clinic.
This primary care clinic would be available for those in the rural county who were working but unable to afford health insurance. In other word, they were too poor to afford an individual health plan but probably too rich to be eligible for Medicaid. Because all services were to be free, the state would furnish special help, such as free malpractice insurance coverage for the doctors.
Furthermore, the state health department had given Jane’s health department approval to hold a childhood vaccine program in the same rural building twice a month. This would make it possible to increase the number of rural children who got immunized according to the state timetables.
Jane was at her desk preparing an agenda for the next board of health meeting, with all this good news on it. She felt that she was really making a difference in her region.
Suddenly, there was a knock at her office door.
Jane looked up to see a member of the board of health, Dr. Karen Matthewsen. Jane felt Karen was the best board member they had. Karen was a country doctor who worked in the rural county where Jane’s concerns were the strongest, and Karen was a champion of the medically indigent throughout the whole region.
“Come in, Karen,” Jane said with enthusiasm. “You can perhaps give me some help drawing up the agenda item about the wonderful new free clinic and vaccine program.”
“Well, that is why I wanted to come see you, Jane I am worried about those new developments.” Karen said these words as she sat down in the guest chair by Jane’s desk. Karen was clearly upset.
“But you are the biggest champion for the dispossessed on our board. I thought you would be tickled pink to see more services opening where the need is so great.” Jane was also getting a little upset. This reaction from her old friend was not expected.
“As you know, Jane, I see more poor patients than any other doctor in the area, and I must say that it is tough enough to make a living in a rural county without having neighboring doctors come in and give free care. I know they are not supposed to take my Medicaid patients, but I operate on a close margin closer than you might expect and the loss of even underpaying private pay patients and maybe some Medicaid ones, too, is problematic. Some patients might even prefer your services to going on Medicaid, while I work to get my uninsured patients covered by Medicaid and never turn a Medicaid patient down.
“Furthermore, lots of residents of our rural county could use the new childhood vaccine program you are offering, and those vaccines represent 20% of my practice net income every summer in the month before school opens.”
Jane countered by noting that the free clinic would be encouraging eligible individuals to sign up for Medicaid and to see local doctors, but Karen noted that the free clinic would not be operating but two half days a week, and with volunteer labor, it would be unlikely to do a lot of follow up and paperwork.
“No,” Karen said, looking Jane straight in the eye. “I must say that, for the first time, I am against a new health department program aimed at the indigent. I believe country doctors like me need to be free of well-meaning government initiatives that are redundant, with private enterprises already struggling financially. I plan to vote against the clinic.”
Questions;
If you were a working but poor person needing care in the rural county, what would you recommend the board do?