As Dr. William F. Chapman takes Primitivo Peralta’s blood pressure, he carefully begins to assess his patient’s ailments:
The right side of his face itches. It feels as if there’s something in his eye, but his eye is clear. His toenails and fingernails have been bothering him, among other things.
After learning that diabetes runs in Peralta’s family, Chapman says: “We have to get a fasting blood sugar [blood test] on him, first thing.... Diabetes could account for all of these problems.”
He asks Peralta to return in a few weeks to the Pacoima clinic to have his blood drawn. If diabetes is diagnosed, Peralta will be told how he can get free help for the disease.
“I’m happy about the clinic because I don’t have any insurance,” said Peralta, of Arleta, who works for a box manufacturer. “My friend recommended this place. It feels good that I don’t have to pay any money.”
The place is a familiar fixture in the neighborhood, a two-story building in Pacoima called MEND, which stands for Meet Each Need With Dignity. The nonprofit organization aids the poor with food, clothing, household items and dental care, in addition to English and computer classes. Recently, the organization expanded its services when a corps of health-care workers agreed to volunteer.
Chapman, who retired in 2001 after 45 years in family practice in North Hollywood, said he had been looking for such an opportunity. The program is appealing because it offers medical malpractice insurance that covers him while he helps at the clinic.
“I’m so happy to find this place,” the 76-year-old physician said between patients. “I’ve been wanting to volunteer, but I can’t do it without malpractice insurance.”
About two years ago, several local hospital administrators and officials with the Los Angeles Archdiocese began discussing ways to help those without medical insurance. After researching the subject, they discovered that uninsured adults typically have few health-care choices, unlike children, who are usually covered by government programs.
Officials from Providence Holy Cross Medical Center in Mission Hills, Providence St. Joseph Medical Center in Burbank, the Sherman Way campus of Northridge Hospital Medical Center and the archdiocese turned to MEND because of its facilities and established work with the poor in the northeast San Fernando Valley.
“We wanted to find a way to expand coverage to folks and give our retired physicians a way to continue donating their services even though they are no longer in practice,” said Sister Colleen Settles of the Providence Health System’s Southern California region, which includes Holy Cross and St. Joseph.
Another hurdle that had to be cleared was covering the costs of expensive lab work.
“One of the reasons physicians find it difficult to give charity care is that it takes a lot of diagnostic care,” Settles said.
An agreement was reached that lab work and medicine would be paid for by the Providence Health System and the Northridge medical center.
“It’s a great partnership,” Settles said. “One hospital doesn’t have to bear the brunt of it.”
At the first three-hour clinic sponsored by the Access to Care Collaborative in early June, 10 patients were treated. Two weeks later, the second clinic drew seven patients.
Fliers have been distributed listing the clinic’s hours and, as word continues to spread, organizers believe there will be more patients. They estimate that with two volunteer doctors, 24 patients can be examined when the clinic is in operation on the first and third Fridays of the month.
Those seeking medical attention must make an appointment by calling (818) 973-2709.
Special emphasis is being placed on day-care workers and day laborers who can have a difficult time finding the time to go to a doctor.
Carol Bales, a physician’s assistant, said she finds her volunteer work at the clinic rewarding. To schedule it in, she pulls a split shift at St. Joseph Medical Center, where she works in cytology, reading Pap smears and other cultures.
“It’s always been my experience -- and it sounds like a cliche -- that you get more than you give,” said Bales, who has also volunteered at AIDS clinics.
“People are so appreciative,” she said. “They can tell that you really care.
“You get back that love, it’s priceless. It’s a tossup who gets more.”
During the clinic, doctors see patients with such nonemergency ailments as an infected, ingrown toenail or chronic headaches. If the need is serious, as in the case of the man who came in with chest pains, the patient is referred to the county-run Olive View-UCLA Medical Center in Sylmar.
Settles acknowledges the clinic’s limitations.
“One of our hopes is to find them a medical home,” she said. “We’re not their ongoing provider. Hopefully, we can connect them with someone who will be able to follow [their medical case].”
The service seems especially needed after the closing of 16 Los Angeles County-run clinics -- including ones in North Hills, Burbank, North Hollywood and Tujunga -- since March 2002.
At the same time, the county has reduced the number of total annual visits it funds for the poor -- from 700,000 to 570,000 -- to see a doctor at one of 95 sites.
“There’s less supply, but nothing has changed the demand,” said John Wallace, spokesman for the Los Angeles County Department of Health Services.
The MEND clinic is “a great thing because they are just treating adults,” Wallace said. “It’s the medically indigent adults who don’t have options.”
An estimated 800,000 people in Los Angeles do not have medical insurance, of whom 85% are either employed or the dependent of a working person, said Wallace.
Michael Jordan, a radiology nurse at the Holy Cross medical center, goes to work early so he can help out at the clinic.
“It’s important to give back to the community,” said Jordan, 36, one of 10 volunteers at the clinic on a recent day.