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Free Health Clinics in Maine Rely on a Cadre of Volunteer Doctors
08/10/2010 05:26 PM ET   Reported By: Tom Porter

According to some estimates nearly 120,000 people in Maine are without medical insurance. A small but growing number of them are turning to free medical clinics to meet their healthcare needs. There are 7 facilities across the state that offer healthcare services at no cost to an estimated 12,000 low-income Mainers.

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Staffed mostly by volunteers, the clinics rely on the goodwill of more than 300 doctors, dentists and other medical professionals who give an hour or two of their time per week to provide treatment or advice. One of them is the Oasis Heathcare Center in Brunswick.

"I have some chronic health problem, diabetes mostly, and I couldn't afford to see a doctor on my own," said Eric, he declined to give his last name.

He is a 53-year old Brunswick resident with a litany of health problems including diabetes, high blood pressure, hepatitis c and kidney damage.
He says his chronic health problems caused him to lose his job as a truck driver, but he was unable to qualify for mainecare - the state's equivalent of medicaid. Instead he turned to the oasis healthcare center.

"They've given me a lot of help," Eric said. "They set me up with a virology clinic at Maine Medical Center, they set me up with a diabetes educator to help me get my diet on track to keep my blood sugars in order. Medications out the wazoo, stuff I could never afford."

"There's very little opportunity to do something that you know made a difference in someone's life, and this is one of them," said Karen Ludwig.

She is a nurse practioner at Midcoast Hospital in Brunswick who dedicates several hours a month to Oasis. She has a background in psychiatric care which comes in handy for the two psychiatric clinics offered by Oasis every month.

"If they have no insurance, which many do not, they're discharged to us, and we're open 2 evenings a month for psychiatric care, it's not nearly enough but it's something," said Ludwig. "We're the only thing there I have patients who are very very ill and it's terrible to see them struggle."

Doctor Peter McGuire"The volunteerism has been amazing over the years," said Oasis founder Peter McGuire.

He is a retired a family practice doctor from Brunswick who set up the free clinic in 1992.

"It's a heck of a lot more fun that medical practice was in the for-profit world, where you had to worry about insurance companies and deal with insurance companies," said McGuire. "I mean doctors now spend 4 to 5 hours a week just talking to insurance companies. Now that's crazy, what a waste of time."

With the help of local hospitals, which donate services, equipment and office space, Oasis serves about 1,500 people in the Brunswick, Bath, Freeport area. But McGuire estimates there are another 2,000 people who also qualify for help - the income requirement is 150% of the federal poverty level, which in Maine is just above $16,000 a year for a single person.

"These patients have so many problems. It isn't just that they have a cold, no," said McGuire. "They also have diabetes and haven't been taking their medicines for the last 4 weeks. They also smoke, they also have many socio-economic problems, they don't have a place to live."

Not all patients are homeless though. McGuire says many of them are struggling in low-paid jobs.

"A typical person would be a sternman on a lobster boat, a hamburger chef at McDonalds, a greeter at Walmart, a summer employee with a construction company driving a truck," McGuire said. "So these people are people that are really trying."

Another problem faced by many Oasis clients is that they don't understand what the doctor or nurse is telling them, says McGuire. This so-called communications gap is an area the center is trying to address.

"They don't understand what hypertension is, or hyperlipidemia, or even terms like high blood pressure or diabetes is. They know they have diabetes, but they don't know what diabetes is," said Shanti Purushotham.

She is heading into her junior year at nearby Bowdoin college. She's volunteering at Oasis as part of a summer fellowship program. Her role involves tackling this problem of 'medical literacy' by developing a training program for medical providers, to help them better communicate with their patients and make sure they take the drugs that are prescribed to them.

Clinics like Oasis play an important role, says Gordon Smith, vice-president of the Maine Medical Association, but they're not the answer to the the state's healthcare access problems.

"They are a band aid that can help hold things together until hopefully we can hold things together until we can have a system ot healthcare insurance in this country, public and private, that covers everyone," said Smith.

Brenda Harvey is state commissioner at the Department of Health and Human Services, which oversees the Mainecare progam. She says there are many people - particularly childless adults - who qualify for Mainecare but are stuck on a waiting list, because of the limited number of federal dollars available.

"We are serving 12 to 13 thousand people but we're not serving everyone who's eligible and those folks tend to be seen at those free clinics," said Harvey.

Without the help of organizations like Oasis, she says, many of them would be forced to seek basic medical care in hospital emergency rooms.



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