By Tim Kruth, DNP, FNP-C, Tanasbourne Medical Clinic

I was talking to Jenny, a newly unemployed individual who now has Medicaid. “I didn’t know where to go. Every place is closed, and I can’t access a primary care provider. I don’t want to go to the ED because that’s where all the really sick people are. Thank you for making it possible to establish with you.” I hung up the phone from my telemedicine phone visit and was glad to have helped her with her medical needs as her new primary care provider.

Her words caught me by surprise. She had insurance and was desperate to find primary care. She told me about calling place after place being told they were closed or not accepting patients at this time. Worse yet, no one knew how things were going to progress. She guessed that she called 10-12 places and this was the health center that was accepting new patients.

I work at a community health center, Neighborhood Health Center (NHC), where we keep the doors open even through an epidemic and we get to provide care to those who have the most need. It’s hard work, but it’s being able to help people like Jenny that keeps me going. When providing health care services to patients in such difficult situations one question sticks in my mind, “How can we minimize the barriers to providing care to this person?”

Once the calls started coming in about testing for COVID-19, it became obvious. There were people concerned, afraid, and experiencing symptoms of COVID-19 but there weren’t enough tests to go around. Soon organizations started providing testing to symptomatic individuals who were already established with their organization but not people like Jenny. Great for their patients, but bad for those who are not established with a primary care provider, or harder yet for those who do not have the benefit of health insurance. The majority of those who are uninsured are persons of color and at the highest of risk. They live in close quarters, frequently work jobs that do not provide protective equipment, and are provided the least amount of health education to know how to effectively identify if they have an infection. They are also the most vulnerable to unemployment because of the lack of resources, and as a result, not working may cost them their job or food for their family. Knowing whether or not they have COVID-19 allows them to better know if they can go back to work and how to protect their families and friends by if they indeed have the infection.

Neighborhood Health Center staff at the Influenza Like Illness or ILI clinic.

At NHC, we decided to answer that need within the communities we serve by developing a COVID-19 testing clinic. We identified locations that would keep sick individuals away from our healthy patients and allow them to have a physical exam by a medical provider even when experiencing symptoms of COVID-19. All this is to do our part and prevent individuals from overburdening the emergency departments and urgent cares.

For me as a primary care provider, easy COVID-19 screening that is accessible to all is essential. We need to provide the simplest and timely access to screening. To that end, our primary care services have made it easy to establish care over the phone with a provider and allow those patients that need to be screened for COVID-19 to do so in a safe environment. NHC recently began providing COVID-19 testing five days a week for individuals who need to be tested.

Staff at the ILI clinic.

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