Island Health Clinic

By Erich Luening

(Listen to an audio version of this story).

The Island Health Clinic on Martha's Vineyard is part of Island Health Inc., which arose more than four years ago out of the work of the Dukes County Health Council. The Island-wide committee was created by a group of Vineyard residents, many with professional health-care backgrounds, who were interested in bringing a community focus to health-care issues on the island. Island Health's mission is to provide high- quality health care for Martha's Vineyard residents and visitors regardless of their ability to pay, according to Island Health Inc. The clinic is just one of many services provided by Island Health. Under the supervision of the medical director, who is a family practice physician, Island Health staff provides a whole assortment of medical services to uninsured and underinsured residents and island visitors.

Paula, who asked her that her last name not be used, is a Brazilian native and restaurant worker on Martha's Vineyard. She's been to the Island Health clinic a handful of times. She likes the clinic better than the emergency room at the Martha's Vineyard Hospital.

Paula (in Portuguese, translated by Jakeline Oliveira) "I feel more comfortable here because here we have women who treat us. And I like here. It is the third time I have come. I like it here very much. And at the end it's faster so it's better coming here."

Lynn DeYoung, a nurse practitioner, exams Paula, who is complaining of pain when she urinates.

Clinic staff say about fifty-percent of the patients who come to the clinic speak Portuguese and need interpreter services The growing immigrant community on the island makes up the majority of the uninsured resident population. But Paula is just one example of the type of patient coming to the Island Health Clinic, the first rural health clinic of its kind in Massachusetts. Uninsured, underinsured, insured islanders and visitors a like use the clinic as an alternative to the busy ER at Martha's Vineyard hospital, or when they can't get in to see their primary care physician. Physician's assistant Carol Anne Lindsey says the clinic aids people of all walks of life on the island.

Carol Anne Lindsey "Island Health Care is very important. We have established wonderful relationships with people in our community. Folks who have been here their whole lifetime and people who visit the island for a couple of days and new immigrants. We have a great cross section in terms of population here they feel comfortable coming to us and we feel comfortable with them."

The federal government declared the Vineyard a health professional shortage area in 2001. The situation has gotten better with the influx of new physicians to the island over the past few years. But there?s an increasingly large group of residents who can't pay for adequate health care. According to Island Health, out of a year-round population of about 15, 000. there are approximately 3,400 uninsured islanders and at least another 1,000 who have insurance but can't get into an existing private medical practice. Registered nurse Kathy Rose is a part-time staff member at the clinic. She says uninsured people tend to put off getting healthcare until the very end. The clinic provides a place where those folks can stay on top of their health care needs.

Kathy Rose "I've been a nurse on the island for almost thirty-five years and have run into people everywhere who have no means to pay for their healthcare and become chronically ill and really get themselves into difficulty because they are unwilling to absorb the expense. So a clinic that can help them get healthcare services and get some kind of subsidy is critically important for the kinds of people who live here."

The clinic is housed in a rented office space adjacent to the Triangle Pharmacy in Edgartown. There is a reception area, a lab for routine tests such as urinalysis, pregnancy, pap smears, and strep, and two exam rooms. The eleven-person staff is a mix of full-time and part-time workers. A physician, Dr. William Morris acts as its medical director. He usually is in the clinic once a week. The clinic is not intended to act like an ER or walk in facility. In fact, patients are asked to call an hour before they come in and set up an appointment. The clinic handles both sick and well visits, with an emphasis on preventative care and works closely with the Martha's Vineyard Hospital. Penny Franklin, the clinic manager, says she would like to provide more services in the future.

Penny Franklin "I think what we'd like to see are more specialty units here. We send a lot of our patients off island and it's very difficult for them to travel off island. We've a specialty network that is set up and in the process of obtaining more physicians off island for our patients who are uninsured those are our free care patients, but if we had more physicians on the island that could help patients who have no insurance that would be fantastic."

Patients like Paula are part of the free care plan to get healthcare at the Clinic. But free care is not assured for everyone who attends the clinic. The clinic uses a sliding scale to determine eligibility for reduced fees. Clinic staff are quick to point out that their patients aren't just the uninsured and those with low-incomes. The clinic tries to meet the healthcare needs of all islanders - regardless of their financial situation.

Broadcast March 30, 2006

Erich Luening reports for the Cape and islands NPR stations.