Government, Health|August 15, 2011 11:25 AM

Clinics work to shed past image and prepare for 1 million patients

Dentist Kevin Varley performs a root canal at the Salud Family Health Center in Commerce City.

It’s a common perception that a community health clinic is the medical equivalent of a dingy Department of Motor Vehicles office – with long lines, interminable waits, spotty service.

That’s a stereotype that the 131-clinic Colorado Community Health Network is working to bust as it prepares to grow from 500,000 to 1 million primary care patients over the next several years.

The clinics expect this rapid expansion because the federal healthcare law is expected to result in nearly 700,000 more people in Colorado obtaining health insurance. Such community health centers provide primary care, as well as dental and mental health care, regardless of patients’ ability to pay, and they will be competing with other networks to attract doctors, nurses and other medical professionals.

“The reality is, patients in community health centers may be low income, but the quality is not,” said Ross Brooks, chief operating officer of the Colorado Community Health Network.

The DMV comparison, Brooks says, is “a perception we’re aware of, and it’s just not embedded in reality.”

The Colorado Community Health Network provides medical services to one in 10 residents in the state. Serving half a million patients every year in nearly every county, the network is one of the largest healthcare providers in Colorado.

In anticipation of the increased demand when new healthcare laws result in more people with insurance or Medicaid, Colorado community administrators hope to add some 5,000 doctors, dentists, nurses and other medical professionals in the next five years – more than doubling the current workforce of 3,300.

The large, state-of-the-art Salud Family Health Center in Commerce City just north of Denver underscores the myth-busting reality of community health clinics of the 21st century.

It provides what the organization’s associate medical director, Don Gutstadt, describes as “one-stop shopping,” integrating health, mental and dental services. Previously located in a strip mall, the new clinic opened in December, 2009. Some 72,000 patients are treated there every year. An entire wing is empty, in anticipation of rapid growth.

Salud (which means health in Spanish) has 10 clinics across the state. An estimated 61 percent of its patients are uninsured, and 29 percent are on Medicaid, government insurance for the very low-income. Another 5 percent are on Medicare, government insurance for the elderly, and 5 percent have private insurance.

This Salud clinic has a specialist who comes to the clinic to provide colonoscopies once a week. But routinely bringing in other specialists – like dermatologists or podiatrists or orthopedic experts – can be a challenge. Or, as Gutstadt says, “sometimes we have to get creative to get services.”

In anticipation of a shortage of primary care doctors and other medical professionals, the clinics are launching efforts to entice professionals to work in community health rather than pursuing potentially more lucrative specialty jobs.

Brooks, of the Colorado Community Health Network, details his long-term strategy. Programs like the National Health Service Corps provide incentives to medical students – including paying medical school debts for doctors to work in high-demand areas. A similar Colorado-specific program is also in place. In addition, foundations have also begun to step up to provide incentives to medical professionals to choose community clinics as their top choice as they enter the workforce.

“We believe there is an attraction to community health centers,” Brooks said. “It’s mission driven; it speaks to why [many doctors] went to medical school in the first place – to serve patients in patient-centric fashion, doing direct patient care and pure medicine.”

However, shadowing this plan for dramatic expansion is the political reality that these paying patients may not materialize after all. Republicans say they will repeal the federal healthcare law if they succeed in winning at the ballot box or in court.

Brooks is aware of that. But he says he can’t wait to make plans for the expected doubling in the number of patients. If additional expected funding doesn’t materialize, he said, “we’ll cross that bridge when we come to it.”

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