by Candi Helseth
In a mountainous region of Virginia where people are poor, roads are inadequate and public transportation is non-existent, a clinic that offers “one-stop shopping” is improving the health of area residents. Opened three years ago, Giles Clinic offers free medical, dental and mental health care as well as on-site prescription medications for uninsured, low-income individuals.
Glenda Ball—who works as a part-time Family Nurse Practitioner at the clinic alongside volunteers and another, recently hired part-time Nurse Practitioner—says many patients had gone 15 years or more without seeing a primary care doctor when the clinic opened. When they got desperate, area residents sought care at the Emergency Room at Carilion Giles Community Hospital, a critical access hospital.
Daniel, 40, was one of them. He had suffered from bad headaches and dizziness for years. The night he went to the ER his blood pressure was a dangerously high 217/132. Following treatment, ER staff set Daniel up with an appointment at Giles Clinic to get his hypertension under control. Ball monitored Daniel’s blood pressure medication and helped him make appropriate lifestyle changes. Within six weeks, his blood pressure was down to 135/86 and the headaches and dizziness were gone.
“We have multiple patients with untreated diabetes, mental health issues and chronic health problems that they’ve self treated or ignored for years,” Ball said. “We’ve reduced a lot of unnecessary ER visits with our services. Our patients will tell you if they didn’t come here, they’ll go to the ER. We work them in.”
Ball is a jack-of-all-trades, providing urgent and primary care assessments and treatment. She provides primary medical care for patients as well as checking their mouths for decay and disease, giving them an eye exam, and diagnosing and prescribing medications for depression or other mental health needs.
“We’re the gatekeeper here,” Ball said. “I take care of what I can and refer them if they need more specialized care or we don’t have the equipment here.”
Giles Clinic is a satellite of the Free Clinic of the New River Valley, which has been operating for nearly 30 years about 35 miles away in Christiansburg, Va. The free clinics serve the primarily rural Montgomery, Floyd, Pulaski, and Giles counties as well as the city of Radford.
Giles County has about 18,000 residents, the great majority of them low-income and underserved, said Michelle Brauns, executive director of the New River Valley Free Clinic and the Giles Clinic. The county’s poverty rate is higher than the statewide average and the county is designated as having acute shortages in primary care, mental health and dentistry. More than 900 individuals have received care since the clinic opened in October 2007; that figure doesn’t include repeat visits. Patients aren’t billed but are asked to provide a donation. Brauns said the average donation is $5.00
“Opening Giles Clinic with all of these services under one roof has increased access and compliance for patients,” Brauns said. “We have a low no-show rate for appointments now. The total lack of public transportation and the fact that many people living in that area had no vehicle made it really difficult for patients to get to Christiansburg for appointments.”
Since the downturn in the economy, Ball said she’s seen the number of patients with depression increase. Giles Clinic uses a mental health assessment tool that contains a test patients take on a handheld computer. The test screens patients for nine common psychiatric disorders and generates a lab report indicating potential mental health concerns. Ball follows up with a personal assessment, and when necessary, refers the patient to the Mental Health Association of New River Valley Pro Bono Counseling Program, which provides mental health professionals who volunteer their time and travel to the Giles Clinic to see patients.
Patients who need dental care beyond an exam and preventive treatment are referred to the Christiansburg clinic where a hygienist is on staff and Virginia Tech dental students and area dentists volunteer their time to do fillings and more advanced oral work. They are among more than 450 physicians, nurse practitioners, nurses, specialists and residents that volunteer time at the free clinics.
Free prescriptions are available through RxP, a partnership organization of Virginia affiliates. Brauns said patients can get prescriptions filled for $4.00 at the local drug store or pick up their prescription meds at Giles Clinic. A courier service delivers the prescriptions to the clinic from Christiansburg.
A HRSA Rural Health Care Services Outreach Grant in 2007 supplied funding to open the Giles Clinic. Brauns said the grant monies ended this year and she is seeking additional grant opportunities for ongoing expenses. However, she added, volunteers and strong fundraising efforts by local organizations positively impact the clinics’ viability and ensure their ongoing service.
Daniel says he appreciates having a clinic in town now. He continues to see Ball regularly. He’s lowered his caffeine intake, eliminated the numerous over the counter medications he used to control his headaches and continues to watch his blood pressure drop. At his last appointment, he told Ball he had never seen his blood pressure so low and he feels the best he ever has. Those are the rewards that make Ball’s work worthwhile.
For more information, contact:
Michelle Brauns, MS
Free Clinic of the New River Valley
215 Roanoke Street Christiansburg, Va. 24073
Phone: 540-381-0820, ext. 106.
Back to: Fall 2010 Issue