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While feeling Keshauna Butler's hot forehead, Nurse Practitioner Cathy Kay (right) talks with Rickey Graham II about Family Nurse Practitioner Cathy Kay (right) talks with Lili Ramirez, who tells of a pain in her left elbow. Speaking Spanish with Ramirez, who did not speak English, Kay found the problem in a few minutes. |
Sherrie Swift is unemployed and uninsured. Asked where she would go for medical care if the Mobile Health Clinic had not stopped recently in Colonial Beach, Swift replied, "I wouldn't."
Swift and her neighbor, Michelle Boyer, were among the patients who visited the mobile unit when it made one of its regular visits to Westmoreland County.
The two women are typical of the type of patient that the program is now trying to reach: uninsured, unemployed and unable to get basic medical care.
"I can't afford to see a regular doctor," Boyer said.
The specially outfitted RVs have been a part of the Fredericksburg medical community since 1995. But MediCorp Health System, the owner of the units, suspended the service earlier this year and then relaunched it in September to serve the needs of the working poor.
In effect, the two 34-foot Gulf Stream coaches have become rolling free clinics and an alternative for some patients to the emergency room.
"We wanted to make the program fit the need," said Pamela Thorpe, manager of the service.
The staff now provides primary-care treatment and follow-up care for children and adults. In the past, it did only episodic care, referring patients to their doctors for continuing treatment.
The problem, Thorpe said, was that most patients didn't have a doctor or couldn't afford to see one. Now, they can return to the van on its next stop in their community. For example, one of the units will make a scheduled visit to Bowling Green Primary in Caroline County tomorrow.
Patients pay for the service on a sliding-scale based on their income.
"The majority of our patients are going away with no bill at all," Thorpe said.
Michelle Boyer, 35, recently met the van outside Colonial Beach Elementary School. She and her husband, David, an electrician, and their three children moved to the town last year from Florida.
Boyer said she learned about the van when her children brought home a flier from school.
"I'm very impressed with it," she said.
She was treated for chest pain, and paid nothing for the care.
Without the van, "I'd end up going to the emergency room if it got really bad," she said.
Boyer also convinced her neighbor, Swift, to join her. Swift wanted the staff to check out a persistent cough diagnosed as smoker's bronchitis. The cost of her visit: $7.10.
Each of the vans is staffed by a nurse practitioner and a nurse. Denise Middleton and Charles Jones are aboard the van that visits Caroline and Spotsylvania counties and Fredericksburg. Catherine Kay and Shelia West travel to King George, Westmoreland and Stafford counties.
The vans stop at 31 locations within the six localities. These sites include schools, churches, offices, stores and housing complexes.
The mobile units started as a school program, funded in part by the Virginia Department of Education. MediCorp, with funding from its Mary Washington Hospital Auxiliary, took over the operation in 1999.
The vans still stop at many of the area schools, and the staff still does sports and school-entry physicals, childhood immunizations and screenings.
Seventy patients were treated aboard the two units in September, including several who will return for follow-up visits.
"Now we're able to manage their care on an ongoing basis," Thorpe said.
