Medical Medical Volunteering inVolunteering in

the the CommunityCommunity

G. Paul Doxey, M.D.G. Paul Doxey, M.D.

St. George, UtahSt. George, Utah

DOCTORS’ DOCTORS’ VOLUNTEER CLINICVOLUNTEER CLINIC

OF OF

SAINT GEORGESAINT GEORGE(Formerly the Doctors’ Free Clinic)(Formerly the Doctors’ Free Clinic)

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II

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Presentation by:Presentation by:

G. Paul Doxey, M.D., Chairman of the G. Paul Doxey, M.D., Chairman of the

Board of TrusteesBoard of Trustees

Gary Lambert, M.D., Medical DirectorGary Lambert, M.D., Medical Director

Deanne Staheli, R.N., Clinic DirectorDeanne Staheli, R.N., Clinic Director

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non-governmental privately funded Medical Clinicnon-governmental privately funded Medical Clinic targets patients targets patients without health insurancewithout health insurance, which , which

means if patients have Medicaid (welfare), means if patients have Medicaid (welfare), Medicare, or other insurance, we don’t see themMedicare, or other insurance, we don’t see them

low operating budgetlow operating budget mostly staffed by retired volunteer doctors, mostly staffed by retired volunteer doctors,

dentists, and therapistsdentists, and therapists Short term medical, dental and mental health Short term medical, dental and mental health

issuesissues supported by many organizations including the supported by many organizations including the

United Way, IHC Charities, private donations, etcUnited Way, IHC Charities, private donations, etc

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History:History: 1. founded by the Washington County 1. founded by the Washington County

Medical Medical Association and Medical Alliance in Association and Medical Alliance in

1999 1999 to address the problem of the to address the problem of the uninsureduninsured2. housed at the Dixie Care and Share 2. housed at the Dixie Care and Share from 1999-2002from 1999-20023. moved to the present site at 1036 3. moved to the present site at 1036 Riverside Riverside Drive in 2002 at Trailhead for Drive in 2002 at Trailhead for city jogging city jogging pathpath

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History (cont)History (cont)

4. land (valued at $500,000) for building 4. land (valued at $500,000) for building by a by a local family local family

5. building was mostly donated materials 5. building was mostly donated materials and and labor by the SUHBAlabor by the SUHBA

6. City of St. George bought part of the 6. City of St. George bought part of the land land from DVC for from DVC for Trailhead and now “shares” Trailhead and now “shares” parking lotparking lot

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Current operational status of DVCCurrent operational status of DVC1.1. One fulltime employee, two part timeOne fulltime employee, two part time

2. Approximately 34 volunteers: 7 doctors, 2. Approximately 34 volunteers: 7 doctors, 5 dentists, 6 nurses, 3 psychologists, 3 5 dentists, 6 nurses, 3 psychologists, 3 nurse practitioners, and 10 secretarial nurse practitioners, and 10 secretarial helpershelpers

3. $100,000/ year operational expenses3. $100,000/ year operational expenses

4. Clinic will supply needed medications , 4. Clinic will supply needed medications , arrange for free or reduced cost arrange for free or reduced cost medicines, or pay for them ourselvesmedicines, or pay for them ourselves

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How many patients/year and whom do we see?How many patients/year and whom do we see?1. 1. 2003: 4,058 patient visits2003: 4,058 patient visits

2004: 4,272 patient visits2004: 4,272 patient visits2005: 6,329 patient visits 2005: 6,329 patient visits 2006: 6,867 patient visits, of which 1,511 (22%) 2006: 6,867 patient visits, of which 1,511 (22%)

were for mental health encounters. This were for mental health encounters. This includes emotional disorders plus alcohol includes emotional disorders plus alcohol and and drug detoxification.drug detoxification.

2007: At the present rate, we will see approximately 2007: At the present rate, we will see approximately 8,800 patients this year.8,800 patients this year.

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2006: 2006: 98.1% of our patients were from 98.1% of our patients were from

Washington County Washington County 95% were United States Citizens 95% were United States Citizens 17% were children17% were children 65% of adults were employed65% of adults were employed 15% were Hispanic15% were Hispanic

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1. Criteria for eligibility is 150% of 1. Criteria for eligibility is 150% of the poverty the poverty level ($1,226/year for level ($1,226/year for family of 1, or 4,321 family of 1, or 4,321 for family of 8)for family of 8)

2. 60% of our patients are employed2. 60% of our patients are employed 3. 50% are High School or College 3. 50% are High School or College

graduatesgraduates 4. We averaged 35 patient visits/day 4. We averaged 35 patient visits/day

last yearlast year

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Board of Directors – 11 members Board of Directors – 11 members from our communityfrom our community

Finances are monitored by a CPAFinances are monitored by a CPA 501c3 organization501c3 organization 2002 Award for Rural Clinic of the 2002 Award for Rural Clinic of the

YearYear

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How do we interact with you?How do we interact with you? Follow-up from the ED, Instacare and hospitalized Follow-up from the ED, Instacare and hospitalized

patients including behavioral medicine will be able to patients including behavioral medicine will be able to be seen within one week of discharge for ongoing care be seen within one week of discharge for ongoing care and help with the cost of medications.and help with the cost of medications.

This includes medical and pediatric outpatient care, This includes medical and pediatric outpatient care, non-surgical gyn patients, orthopedic to include non-surgical gyn patients, orthopedic to include undisplaced fracture care, minor trauma care, dental undisplaced fracture care, minor trauma care, dental care, and mental heath access to counseling and care, and mental heath access to counseling and psychiatry.psychiatry.

We also are a referral resource for patients who want We also are a referral resource for patients who want to detox from alcohol or substance abuse.to detox from alcohol or substance abuse.

Limited access to subspecialty consultation utilizing Limited access to subspecialty consultation utilizing the physician referral program which allows our the physician referral program which allows our patients one free or discounted consult.patients one free or discounted consult.

STD testing and women’s health.STD testing and women’s health.

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We do not:We do not: Offer a continuous supply of sample Offer a continuous supply of sample

medications.medications. Have the equipment or time to do Have the equipment or time to do

elective minor sterile surgical elective minor sterile surgical proceduresprocedures

Prescribe narcotics for chronic pain Prescribe narcotics for chronic pain problems.problems.

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Relationship to DRMCRelationship to DRMC Routine x-rays, ultrasounds, labs are Routine x-rays, ultrasounds, labs are

graciously donated, with no cost to the graciously donated, with no cost to the patient or clinic.patient or clinic.

IHC has donated each year to our general IHC has donated each year to our general fund.fund.

Physicians, nurses, physical therapists, Physicians, nurses, physical therapists, pharmacists, , IT, allied health pharmacists, , IT, allied health professionals, and administrators have professionals, and administrators have volunteered their time to the patients we volunteered their time to the patients we see.see.

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Why do I Volunteer?Why do I Volunteer? Medicine as it should beMedicine as it should be Patients are universally appreciative Patients are universally appreciative Good feeling at the clinic Good feeling at the clinic Treating the patient and not protecting Treating the patient and not protecting

yourself from liabilityyourself from liability Satisfaction at the end of the daySatisfaction at the end of the day

Video Presentation

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Private (non-governmental) effort by a Private (non-governmental) effort by a community to address a community community to address a community problemproblem

Reduces inappropriate visits to the local Reduces inappropriate visits to the local ED at Dixie RegionalED at Dixie Regional

Access to medical, dental and psycho-Access to medical, dental and psycho-logical care by the people caught “in the logical care by the people caught “in the middle” between welfare and private middle” between welfare and private insuranceinsurance

Questions?Questions?