Dr. Murray L. Katcher has a front-row seat to an endless array of health-care horror stories involving low-income and homeless people in Madison. He doesn't like what he sees.
"The health of homeless people is awful," says Katcher, a pediatrician and chief medical officer for the state. "Most of their health problems are the result of lack of access to good health care."
Katcher is the co-founder with Dr. Ted Goodfriend, a retired Veterans Administration physician, of MEDiC (Medical Information Center), which runs six Madison clinics staffed by health-care professionals and students.
The care provided at these clinics is free. They help educate medical, nursing, pharmacy, physical therapy and physician assistant students at the UW School of Medicine and Public Health and the UW-Madison pharmacy and nursing schools.
Since 1991, students and medical professionals have treated more than 15,000 patients at the six clinics, which include a homeless shelter for men and a women's halfway house. The second-oldest clinic, which runs out of the Salvation Army's shelter at 630 E. Washington Ave., serves single women and homeless families.
The South Side Clinic, 2202 S. Park St., is the only one that serves all low-income residents. It's open on Saturdays, from 9 a.m. to noon. (For more information on the location, times of operation and qualifying information for the six clinics, see medic.uwmedstudents.com/clinics.)
Most patients treated at the MEDiC clinic have Medicaid, or are uninsured, as are 47 million Americans.
"That number is growing every day," Katcher says. "When people lose their jobs, they lose insurance. Many Americans can't get health care and are going into debt to cover medical expenses."
Rebecca McSorley, a second-year medical student who serves as a coordinator at the Salvation Army clinic, says some clients do have some kind of health insurance. "If they don't, the Salvation Army's social workers try to get their clients on programs such as Badger Care," the state program for low-income working families with children.
Nearly 30 Madison physicians volunteer annually to guide the students' work at the free clinics. More are needed.
"We have an incredible but small group of dedicated volunteer doctors," McSorley says. "We are always looking to get more faculty physicians involved."
The Salvation Army clinic lacks some of the advanced, primary care equipment that other centers offer, but Katcher says it nonetheless provides high-quality care.
"Many patients say it's the first time anyone ever paid attention to them," he says. "Students take the time to take a really good medical history and do a thorough physical exam that is followed up by a physician."
Some Madison physicians and hospitals provide charity care to clinic patients whose symptoms point to serious medical problems. "We see a lot of untreated diabetes that may require kidney transplants or leg amputations if the diabetes isn't controlled," says Katcher. "The students reach out to the hospitals and clinics to get the services and volunteers needed."
The cost to operate the clinics is minimal. "There are no administration or salary costs," notes Katcher. "The biggest expense is the free drugs for people who can't afford them."
The Cremer Foundation has helped by providing nearly $100,000 in grants in the years MEDiC has operated.
"The foundation has a focus of working with at-risk populations," says Holly Cremer Berkenstadt, a board member. "[MEDiC] helps medical students realize that there are all kinds of people out there without medical insurance. Even if they have just a cold, it's important that they have access to medical care."
About 250 of the more than 600 medical students at the UW School of Medicine and Public Health annually sign up for volunteer MEDiC rotations, Katcher says. "About two-thirds come back for a second year."
Kjersti Knox, 28, a second-year medical student from Pocatello, Idaho, served as coordinator for the Salvation Army's MEDiC clinic last year.
"Volunteering allows you to hear the voice of people who don't always have a voice in our society," says Knox, her eyes welling with tears. "Our patients face so many more hurdles than most people."
When Roberta Matlock, a 30-something mother of two children, lived at the Salvation Army's warming house for several months, she came to appreciate the students who worked at the clinic - and not just for the care they give.
"They always have smiles on their faces," says Matlock, a cashier. "I've been to plenty of clinics where physicians weren't friendly."
Matlock and her husband, Tim, have been treated through MEDiC for debilitating problems with asthma and bronchitis.
"The students took the time to sit down and explain the treatment plans and how long it would take us to get better," she says. "At that time, we couldn't afford medical care."
Another clinic patient is Renalda Thompson, who moved to Madison with her husband and their two teenage children in 2007, after Thompson was laid off from her job as a youth outreach specialist in Chicago. She's also impressed with the students she's encountered: "If they wouldn't have told me they were students, I would have thought they were professionals."
Thompson says the clinics provide better care than hospital emergency rooms, and she and her family have never been turned away. Her only caveat: "I wish they were open more than once a week."
Dr. Dipesh Navsaria, a pediatrician and clinical instructor at the UW Medical School, serves as the medical director of MEDiC's Reach Out and Read, a chapter of a national nonprofit group founded by pediatricians and educators in Boston to promote early literacy among low-income populations. The program, which provides free books to young children, operates at two Madison clinics and Access Community Health Center, a federally funded clinic for uninsured patients who pay on a sliding fee scale.
"Research shows that children who are comfortable with books do well in school, have higher vocabularies and increased IQs," says Navsaria, whose involvement with free clinics dates to when he was a physician's assistant in Danville, Ill.
He notes that uninsured patients "are charged much higher rates than insured patients because of the uncertainty of whether they can pay." He says medical professionals who volunteer at the clinics may be more inclined to donate their services to treat people in need.
Volunteering, he suggests, has other rewards. "My wife will tell you [of] nights I will come home with a big smile because I'm so impressed with such committed, dedicated volunteers who restore my faith in medicine as a healing enterprise."