Xenos Free Clinic

Last night I volunteered at Xenos Free Clinic, which is a free clinic that is funded by a local church in Columbus. The clinic is run entirely by volunteers and last night the clinic served about twenty patients with a nurse practitioner, a physician, and two nurses.

My goal any time I have one of these experiences is to learn something from it - whether that is something I hope to do, or something I hope I don't do. Last night was some of both, but mostly I learned what not to do from the physician I was shadowing.

The patient population of this clinic is very poor and the patients don't have any insurance. Most of them are uneducated and have never been taught how to live a healthy life style. They don't have money to get prescription meds or to see a specialist.

XFC helps with these patients by seeing them entirely free of charge. If a prescription is needed, they always try to prescribe from the free or $4 lists from grocery stores. If one is prescribed from the $4 list, they often also give the patient a $4 gift card for that store so that it is free for the patient. If a specialist is needed, there is another free clinic in town (Physicians' Free Clinic) that has different specialists available for referral.

The physician that I shadowed seemed like a good doctor and he was nice enough to volunteer his time at the clinic. However, I was intrigued by how he treated the patients. Often he would talk to them in medical terminology they clearly did not understand. The patients would stare at him blankly but he would continue using complex medical terms. He also would talk to me about the patient as though they weren't there while the patient was still sitting there. The physician was a decent teacher by explaining to me what was going on, but he was neglecting his patients. Even after prescribing something, he did little to talk to the patient about what it was for or how they needed to take it.

I recognize that the patients were extremely poor (maybe even homeless) and were at a free clinic, but I didn't think that warranted this physician talking over them. They were still patients who needed help and they deserved the same amount of humanity that would be shown to any other patient. I hope that I can always treat my patients with respect and talk to them on their level of understanding.

I enjoyed the time at XFC because it gave me a little bit more perspective on a population with which I have not had much contact. While the patients should not be treated with any less humanity, there are issues that warrant special considerations. If you refer them to another free clinic, will they have transportation to get there? Would educating them more about diet be a better solution than prescribing blood pressure meds? (He prescribed high blood pressure meds to a patient who admitted to eating fast food twice every day - but he didn't say anything about that.) Do they understand English enough to understand what is going on? (We had a patient that moved from Mexico only a year ago.)

All patients, regardless of background or financial situation, typically have complex issues going on that need to be considered in the delivery of health care. In a free clinic setting, these issues are even more evident and have to be considered. I hope to be aware of such issues and complex situations that some of my patients may be experiencing and help them do more than just get medication. My role may not be to solve their other issues, but my role is to help them connect with the resources that can help them.