By Marge Fenelon
What started with tranquil contemplation of a pine tree in the woods surrounding Lake Tahoe may be a creative solution to the growing number of people who lack basic health care in the United States.
Dr. Robert Forester was on vacation with his family in Lake Tahoe, Calif., in the summer of 2000. While relaxing on the cabin's porch and enjoying the beauty of the nature around him, a particular pine tree caught his attention and suddenly an idea popped into his head, an idea that would allow him to intertwine the practice of medicine and his Catholic faith and at the same time provide free health care to uninsured patients. Today, that idea is called St. Luke's Family Practice, and it's located in Modesto, Calif.
St. Luke's Family Practice is a self-sustaining nonprofit medical clinic designed to provide free outpatient health care, consistent with the Catholic tradition, to uninsured people who are ineligible for government programs.
At the time of his vacation, Forester was happy being a typical doctor in a typical medical practice. Step- by-step, he told Our Sunday Visitor, God called him from his Protestant upbringing into the Catholic faith, away from performing sterilizations and on to a Catholic bioethics convention.
"I was sitting there and suddenly I wondered what was this family doctor from Modesto doing here," he said. "I had no idea why I was there."
He knows now, but it took a while to come to the realization that he was to found St. Luke's Family Practice. "I sat around for two-and-a-half years after that," he said. "I thought I was supposed to be the adviser on this. I thought I'd find young, energetic doctors who would do the work and I'd advise them."
He found one other energetic doctor, Dr. Richard J. Heck. Heck had children attending the same Catholic grade school as Forester's family. One night, Heck and his wife invited Forester and his wife out to dinner. That began a lasting partnership in the founding of an innovation in health care.
"We talked all night, but I hadn't brought up my idea," Forester told OSV. "Then, as we were walking home, I told [Heck] that there was one more thing I wanted to talk to him about." Much to his surprise, Heck had been thinking along the same lines. From there the ball rolled forward at an increasing pace.
The clinic opened its doors Jan. 1, 2004. Since then, the two have conducted more than 10,000 office visits with uninsured patients.
The clinic operates on a unique principle of cash-only, low-overhead, technology enabled and retainer-modeled practice. The clinic has a limited staff -- two doctors and one medical assistant -- and is housed in a modest 950 square feet of office space.
Income is generated through the membership of benefactors, who pay $1,300 annually. In return, benefactors receive quality health care and same-day appointments from a personal physician who is familiar with their case and available to them by phone or e-mail 24 hours a day and seven days a week. Lesser amounts are charged for additional members of the same family and those younger than 35 years old, and slightly greater amounts for those older than 60.
Benefactors need to carry basic health insurance for hospitalization, lab work and consultants. In many cases, minimizing coverage and raising deductibles coupled with the benefactor fees actually saves them money on health care.
Benefactor fees also cover health care for recipients, or those patients who are uninsured and are not eligible for state or federal programs. Recipients visit the clinic on a walk-in basis and are given basic health care that includes simple testing and diagnoses and acute and preventative care. Recipients are given prescriptions and referrals to specialty clinics as needed. Recipients who are eligible for other state and federally funded programs are assisted in making those contacts. Those who are too sick to be cared for in the clinic are referred to an emergency room. To assure quality care for everyone, physicians limit their patient load to 300 benefactors each and as many recipients as their schedules will include.
"Dr. Heck and I both went from making almost one-quarter million dollars per year to making roughly $77,000 our first year [at St. Luke's Family Practice]. We were high rollers before we came into this," Forester said. Gradually, their salaries increased, and they're now earning average salaries for family doctors.
According to Heck and Forester, that was a small price to pay for being able to live their faith in their work and provide excellent health care to the uninsured.
Nurse practitioner Hilda Sielicki gave up a profitable job to become the clinic's medical assistant. "I've been so blessed in my life. I wanted to do something that would make a difference," she said.
The difference lies in the clinic's independent status. It doesn't accept government money and does not bill to insurance companies, which allows doctors and employees to uphold their Catholic beliefs without government intervention and will exempt the clinic from the provisions in the controversial H.R. 3200 -- America's Affordable Health Choices Act of 2009 -- should it pass the House and Senate and become law.
The idea is gaining momentum. In 2003, Dr. Michael Kloess read a medical journal article about St. Luke's Family Practice. It impressed him and motivated him to partner with Dr. Anne Volk Johnson in founding Our Lady of Hope Clinic in Madison, Wis., which is modeled after St. Luke's Family Practice.
Currently, Kloess and Volk Johnson work part time at paid family-practice positions in order to support their families. As the organization grows, they hope to move to full time working exclusively for Our Lady of Hope Clinic. "Our ability to treat the uninsured gives benefactors and recipients the opportunity to care for one another. This is truly Catholic, pro-life health care, not only because we don't do abortions but because we're performing the corporal acts of mercy. Both Dr. Volk Johnson and I see that as vital to our mission," Kloess told OSV.
One patient that especially impacted Kloess was a woman who had been diagnosed with a benign brain tumor. She'd lost her health insurance and was unable to pay the cost of periodic evaluations to monitor its growth. She needed a referral from a primary care physician, and Kloess was able to provide that for her.
"All that time she didn't know how it was growing. She was just living with it," he said.
Volk Johnson added that chronically ill patients also benefit from the clinic. "We've been able to see people and write them prescriptions for diabetes and blood pressure medications while they were without insurance that I think they would have stopped taking otherwise," she said.
If giving is receiving, then clinic benefactors stand to gain the most. Mary Tejeda is delighted to be an Our Lady of Hope Clinic benefactor, and feels she's received far more than she's given.
"It's almost too good to be true. For not a large amount of money, I can have health care for myself and help to provide health care for others who wouldn't otherwise have it," she told OSV.
St. Luke's Family Practice: www.stlukesfp.org
Our Lady of Hope Clinic: www.ourladyofhopeclinic.com
Father of goodness and love, hear our prayers for the uninsured members of our community and for all who are in need.
For those who seek care but find that it is out of reach, may they find consolation in your healing presence.
For all who are blessed with health and security, may they work to fulfill the needs of those who are sick and insecure.
For leaders who make decisions that affect the health and well-being of others, may they strive to ensure the fundamental right to health care.
We ask this through Christ our Lord who healed those who believed. Amen.
Almighty God, help us this day to direct our attention and concern to the poor, needy and sick in our local communities. Let us hear their hopes and their struggles. Help us to respond in an effort to restore their faith and their belief in their human dignity. May we find within ourselves the conviction to always put the powerless foremost in our minds and hearts. Let us so live that all who know us may know that you are a God who cares, when they experience our care and concern. Let us draw strength from each other as we share our talents for the good of the people we serve in all of our facilities -- We ask this through Christ our Lord, Amen.
Marge Fenelon writes from Wisconsin.