By 10 on an overcast Monday morning, 15 people are sitting in the second-floor waiting room of the Venice Family Clinic. Some talk softly; others gaze at the art adorning the freshly painted mauve walls.
"It's a little quiet today," says Elizabeth Benson Forer, who took over in February. She replaced Fern Seizer, who retired after 11 years as executive director.
Often, 35 or more patients crowd the waiting area of the nation's largest free clinic, which dispenses health care and hope to the poor, homeless and others without insurance. There are 2,400 non-medical volunteers.
Since opening in 1970, the clinic--which has an annual operating budget of $5 million--has grown from two rooms into its current 17,000 square-foot facility, which includes a pharmacy, laboratory, and 20 exam and treatment rooms. Last year, health care was provided to 11,500 patients and drew famous visitors, including Vice President Al Gore.
In a recent interview, Forer, 37, talked about the clinic's operation and its future.
Question: What's your health care philosophy?
Answer: Every person should be able to have health care, especially preventive and primary health care. If we start with those, then more expensive health problems often can be prevented or avoided. Measles is a classic example. Now there are pediatricians who have never seen a case of measles, although it is coming back.
Q: Describe an average day here.
A: In a typical day, we see 175 patients with a variety of issues and problems. We're staffed by many volunteers; otherwise we couldn't see as many patients. Common problems in adults are diabetes, hypertension, asthma. In children, we try our best to emphasize well baby (care) and prevention. We emphasize lead screening and immunizations. We try to get them to understand the importance of ongoing care.
Q: So, not too much in the way of colds?
A: We have that, too--colds, flu, standard problems. It could be someone coming in with a hangnail. We have women who have been battered--although that's picked up usually as another type of checkup, usually women's health care.
Q: Is there a typical patient?
A: Most work very hard and still have very little money. As a result, they have no health insurance. Everything else can vary in terms of education level, type of work and living conditions. We have people living packed into two small rooms. We have people living a little better, but still (with) no more resources in terms of food, clothing and money. (There are shower rooms available for homeless patients.)
There's a small, hidden group of professional people who have lost their jobs and lost their insurance and are still trying to look like all their friends. They often say, "Don't tell anyone I'm calling here."
Q: What's the typical waiting time?
A: About two hours start to finish. On a bad day it takes longer, but we provide quality care. We don't just whip people through. It's unfortunate, but the need is always greater than our capacity. Every time we have expanded, by the time it's done, we are at capacity.
Q: Do you get patient complaints?
Q: What's the biggest?
A: Waiting time.
Q: Do you have to turn away patients?
A: On the average, 50 a day. We try our best to find (them) other places to go or to get them an appointment later in the week. If it's acute enough, we tell them to go to the emergency room.
Q: How much other care is sent elsewhere?
A: Cardiology cases tend to get referred out. Heart surgery is often a bartering system. We try to get surgeries done for free. A classic case is an ophthalmologist who does cataract surgery for us. There is a range of other services off-site (that) we provide through the help of volunteer physicians.
Q: How many noes do you get?
A: Not a lot. We push. We only ask when we really need it. And we are careful (that) we don't ask the same people all the time.
We have a wide network. A great example is St. John's Hospital, which provides lab and X-ray to us. And 45 seconds after the (Jan. 17) earthquake, that hospital was gone. They were on the phone to us the next day, saying: "We stand by our support to you. It will take us a little while to get back up. But we've reviewed our charitable donations and you are someone we want to be partners with." (People here) were astounded. Because they had just evacuated a whole hospital and we had two test tubes fall off the shelf.
Q: What's your staff size?
A: There are 100 full-time staff, including eight doctors. There are another 500 volunteer doctors. That includes (physicians from) residency programs from UCLA (with which the clinic is closely affiliated), Kaiser, Daniel Freeman Hospital and Cedars-Sinai Medical Center. . . . Any time we get a new doctor, we can see 10 to 15 more people.
Q: And the average time contribution of your 3,000 volunteers?
A: A lot of doctors give three to five hours once a month. Others, once a week. Some retired physicians give that every day. Some of our non-medical volunteers volunteer once a year on Art Walk day (a major fund-raiser) . . . yet others are in every week, doing a wide assortment of tasks.
Q: Care is free, yet donations are accepted from patients. What's the average amount given?
A: On average, patients give $3. There are many who come and say, "What can we give you?"
Q: What are the common praises you hear?
A: They're happy we're here for them. We get letters all the time. The praise is often: "Our children were sick and not only did you take care of the children, but you took care of us too."
Q: What keeps you in the field?
A: I know that every day someone gets health care who wouldn't if I didn't do this work.
I left briefly. . . . I was tired of keeping up with the bureaucracy. The system is so messed up. . . . At home with my kids (though), I was reading the newspaper every day, reading health care stuff and cutting it out. I became this complete maven.