Clackamas Volunteers in Medicine provides free care to low income populations
This article was updated from its original version
Over the course of nearly five decades practicing medicine, Dr. Ken Martin often found himself frustrated by limitations of health care in the United States.
Patients had trouble paying for insurance if they weren't covered by their employers. And on the other side, rather than focusing solely on the well-being of the patient, doctors like Martin had to factor in other concerns: What kind of insurance — if any — did the patient have? Did the insurance cover the specific treatment the person needed? Who would pay for the CT scan or MRI that Martin deemed necessary?
That wasn't how Martin, a 42-year Lake Oswego resident who specializes in internal medicine, wanted to practice. So when he retired from Legacy Health two years ago, Martin searched for a way to help those who fell through the cracks.
And that was when he found the Clackamas Volunteers in Medicine (CVIM) clinic in Oregon City.
"I was looking at various clinics around here, and which ones have been around a long time and were set up well and doing a good job — (a place where) I didn't have to reinvent the wheel, basically, and could just do my thing," he said.
CVIM, which was opened in 2012, is a free clinic that's part of the national Volunteers in Medicine America organization founded by Dr. Jack McConnell in the early 1990s. Along with physicians like Martin, the clinic relies on volunteers for nursing, translating (73% of the patient population does not identify as white), administrative tasks, scribe work, IT support and more.
"CVIM serves adults who are low-income, uninsured (or underinsured) and living in Clackamas County," CVIM Executive Director Martha Spiers said in an email. "Typically our patients are working, heads of households (supporting families), one missed shift away from unemployment and one paycheck away from homelessness. They make too much to qualify for OHP (the Oregon Health Plan), and too little to afford health insurance premiums or co-pays."
The clinic, which is open Tuesday through Thursday (with eye care available on Mondays and Wednesdays), relies on volunteers like Martin to serve its patients. It offers everything from primary care to prediabetic education and eye care. Specific to those with diabetes, the clinic works on preventative measures to help keep patients healthy and their costs down.
The center also connects patients with specialists by helping them enroll in Project Access Now program, which connects uninsured patients to specialty health care.
Wilsonville resident Vladimir Anokhin started out as a scribe at the clinic. In that role, he jotted down comments from patients so the physician could focus on providing care. Now, he is the clinic manager.
Anokhin describes a certain buzz in the air when the clinic opens and a collaborative spirit between the volunteers.
"I liked the idea of a volunteer setting. If everyone that's involved, the doctors, the nurses, the translators, the scribes, if all of them are volunteering, obviously not getting paid, it seems like there is a conviction to that. Everyone's invested in a different way," he said.
As the manager, Anokhin acts as a bridge between the scribes and the clinicians and oversees all functions of the clinic including patient check-ups, sending in lab work, organizing lab results and administering volunteer training.
"And just general clinic function and flow and making sure patients are receiving the most comprehensive care that we can offer in a free clinic," Anokhin said.
He said some patients who begin to receive health insurance and have to transition to a different provider are sad to say goodbye to CVIM. However, Anokhin said many of the patients are still with the program since it was established in 2012.
Because of the prevalence of non-English speaking patients seeking service, Anokhin said the center is always looking for more interpreters to help out. He also said that nurses are needed and that volunteers sometimes have to take on other jobs to keep the place running.
"If you've ever considered volunteering, experience or not, give CVIM a shot. You can shadow and figure out where your interests lie. It's a family environment," Anokhin said.
Born in Ukraine, Anokhin takes pride in helping immigrants who are struggling to adjust to new surroundings and, as a Russian and Ukrainian speaker, he said it's rewarding to be able to help providers communicate with immigrants from those countries.
"It's rewarding to see the relief they experience when they are struggling to use their broken English and express themselves. If I switch into their native language it's this weight lifted off of them in discussing something as simple as, 'Do I qualify for a dental referral?'" he said.
Spiers noted that physicians can derive mental health benefits from working at the clinic.
"I met with the new executive director of the national VIMA ... and he was emphasizing the mental health benefits for physicians," Spiers said, noting that across the country physicians have one of the highest rates of suicide among professions. "He described the VIM clinic alliances as not only providing care for people living on the edge of poverty and unable to afford health care, but also as a life-sustaining opportunity for retired and working physicians to reconnect with their original life's purpose."
Further, the clinics provide opportunities for physicians to mentor younger premed students, who often take care of transcribing and other data entry. Anokhin, for one, is hop-
ing to attend medical school soon.
"That's what I got tired of in practice, too, is doing all the typing and data entry," Martin said. "Four to six hours a day you're spending dictating notes, answering emails, answering phone calls and (doing) drug refills. ... So the scribes do all of the data entry for us, plus they're premed students (or) pre-physician's assistant students, so it gives me a chance to do some teaching."
In the end, of course, it's the patients who are at the center of CVIM's efforts. Spiers noted that aside from diabetes and hypertension, conditions like anxiety and depression also are common among patients at the clinic.
"A critical tenant of the VIM clinics is that we serve our patients within the 'VIM Culture of Caring' that seeks not only to provide quality medical care but to address the hurt often caused by stigma," Spiers
The clinic runs off of grants and donations and Anokhin's staff is hoping to get the word out about the organization to attract more patients and funding.
"It comes as a surprise to a lot of people that a place like this even exists," he said. "It's almost a situation where people will call an organization the best-kept secret. In our case, we don't want to be a secret. We want people to know about us and support us in any way they can."
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