Treated With Respect

Mar. 18, 2015

A photograph of Treated With Respect

Medical clinics for low-income workers ensure that payments won’t be painful

David Howell is in a very different place than he was a year ago.

“I’m a recovering drug addict, and I was actually in jail this time last year,” he says.

Howell’s first priority when he was released was staying sober. He moved into a halfway house run by his Alcoholics Anonymous sponsor, and he started looking for work.

“I’m a healthy man today because of them.”

“I got a job pretty much as soon as I got there, but since I’m in construction, it’s hard to get health insurance,” he says.

That became a serious problem — fast.

Howell noticed a painful protrusion in his abdomen. He remembered hearing about the Church Health Center, a faith-based nonprofit providing health care to low-income, working people in Shelby County.

“I knew something was wrong, so I went to their urgent care, and they diagnosed me with a hernia,” he says.

“They took me in as a patient, got me started with orientation, and even expedited my surgery. From the moment I got there, they really took care of me, and I’m a healthy man today because of them.”

Uninsured, not unemployed

For many Tennesseans, Howell’s story is all too familiar.

More than 773,000 Tennesseans have no health insurance, according to a recent University of Tennessee study, with 20 percent reporting in 2013 that they could not afford to see a doctor.

When faced with a serious medical problem, they need help. They find it at clinics across the state, like Church Health Center in Memphis or Friends In Need in Kingsport.

“Our patients are the working uninsured — they’re relatively low income and they have to have help,” says Dr. Nathan Ridgeway of Friends in Need. “But they’re also willing to pay what they can because they appreciate the care they get so much. And that makes them our partners, not just patients.”

While they serve patients at opposite ends of the state, Memphis’ Church Health Center and Kingsport’s Friends in Need have similar requirements.

Patients must:

  • Be uninsured
  • Have a job
  • Have an income that’s less than 200 percent of the federal poverty line

There are some exceptions at each clinic — for students, single parents, etc. — but all patients pay a portion of their care costs based on income.

That’s a big deal for Randy and Rhondia Lightner, owners of a landscaping company who’ve been coming to Friends in Need for more than 10 years.

They have tried to purchase health insurance many times, but premiums have always been too high.

Business owners Randy and Rhondia Lightner have been Friends In Need patients for 10 years.

“I’ve always worked for everything I’ve got,” says Randy, “I don’t believe in handouts. Friends in Need has taken good care of us without making us people who just want something for nothing.”

At the Church Health Center and Friends in Need, people can get primary and dental care, as well as referrals to specialists. Rhondia is thankful for that access to specialized care every day.

It’s even more important for people who don’t have insurance to have a good outcome because they literally cannot afford complications. If something goes wrong, it’s immediately, ‘Am I going to lose my job?’”

A while back, when she began experiencing double vision, Randy knew it was a sign of trouble and made sure she got checked out at Friends in Need.

Dr. Ridgeway diagnosed multiple sclerosis (MS), and referred her to a specialist, who confirmed the often disabling disease of the central nervous system. MS affects every person differently, so a personalized treatment plan is necessary, and Rhondia got that.

“Ten years later, I’m doing fabulous,” she reports. “I get regular rechecks every three to six months; they always make sure I have my medications; and they got me started on the medicine so quickly, even though it’s the relapsing MS, I’ve never actually had a full-blown relapse.”

But the caring attitude of the staff is what Rhondia remembers most.

“They made something that should have been very scary much easier,” she says. “It’s just beyond description.”

Getting personal 

Howell feels the same way about the Church Health Center.

“My doctor told me what I was going to go through, how long it was going to take to heal and exactly what she was going to do,” he says. “I explained up front that I’m a recovering addict, and we dealt with the pain medication issue head on.”

Howell’s surgeon, Dr. Nia Zalamea, is one of only two general surgeons in the U.S. who does charitable work full-time.

“She always has a smile, and she never judges you,” he says. “I’ve had surgery twice. The guy who operated on my hand when I was 14 — I’ll never forget how cold and impersonal he was, like a mechanic working on a car. So the humanity Dr. Zalamea displayed was really reassuring and comforting.”

Dr. Zalamea feels just as strongly about the doctor/patient connection.

She may not have as many surgical resources as she did in private practice, but the support she gets at the clinic — dieticians, physical therapists, nutrition and exercise classes — allows for holistic patient care. And treating the patient as a whole rather than repairing an ailing part of them means they are more likely to take care of their health long-term.

Dr. Nia Zalamea is one of only two general surgeons in the U.S. who does charitable work full-time.

“Here I get to do medicine the right way,” she says. “David is a healthy guy, trying to do things right, and our goal is to get people back to their livelihood. It’s even more important for people who don’t have insurance to have a good outcome because they literally cannot afford complications. If something goes wrong, it’s immediately, ‘Am I going to lose my job?’

“When people can stay on their feet again, they remember how the clinic helped them out, and it’s not uncommon for them to return the favor.

“I had one gentleman say, ‘I know it cost more than $125 for you to give me this surgery,’” she recalls, smiling. “So he came back and gave us more money!”

To learn more about the biggest health problems facing our state, click here.

Photos by Steve Jones (Church Health Center) and Erica Mowell (Friends in Need).