These Days Even Affluent Communities Need A Free Clinic

By John Voket

It is about 4 on a recent Wednesday afternoon and Dr Z. Michael Taweh is busily transferring drug samples from a large plastic bag to a secure medicine locker in the cozy but serviceable lab room at Newtown’s Kevin’s Community Center (KCC). When asked why a community nestled in the corner of what is commonly referred to as the richest county on the planet needs a free clinic, the handsome, olive skinned physician does not have to ponder the question.

“Despite what you might think, even here in Newtown we’re finding more and more people are not insured adequately,” he explained. “The economy is suffering. And as two-income families become single-income families because of layoffs and downsizing, and a lot of heads of household are forced to transition from salaried jobs to consulting, self-employment, or even temporary service industry jobs, many of these residents are finding they can’t afford to pay for insurance at all.”

That is why Dr. Taweh decided to dedicate part of his medical practice to the people of Newtown.

A little more than 18 months ago, this free community medical clinic opened with Dr Taweh heading up a staff that included a licensed practical nurse (LPN) who served as the operation’s director and a revolving team of about two dozen volunteers including LPNs and registered nurses (RNs). Opened for visiting patients just a few hours each week, the clinic was initially established to bridge temporary gaps in medical service for residents in this affluent northern Fairfield County community who either lacked medical insurance, or who were underserved with the level of care they could afford.

In those early days, the KCC staff expected to see a few patients each week, primarily from the small population of residents who already received a measure of other social services, state or federal support.

It did not take more than a few weeks, however, for Dr Taweh to discover that the “typical” clinic patient profiles reflected an unprecedented level of individuals who, until recently, were likely covered by benefit-rich employer-supported health plans.

And as he spoke with friends and associates in private practices throughout the region, Dr Taweh began to discover the trend in Newtown was similar to those developing in many smaller communities across Connecticut and the Northeastern United States.

“Today there are 60 million Americans between the ages of 16 and 65 without health insurance,” Dr Taweh said. “About 50 million of those won’t get medical care because they can’t afford insurance and don’t qualify for Medicare or Medicaid. Those statistics have to be reflected in the residents living here.”

As evidence that the trend extends to communities as seemingly well off as Newtown, Kevin’s Community Center reports an unexpectedly high level of traffic in the year and a half it has been open.

“We’ve seen 465 new patients since we opened in August of 2003, and in that time we estimate that we’ve provided direct or referral services valued at more than half-a-million dollars,” Dr Taweh said.

The clinic is currently providing care for upwards of a dozen patients each week, more than double what was expected when the operation opened. While at its peak, KCC was seeing one new visitor for every established patient, a trend that has not diminished significantly.

“We are still finding about three or four patients a week, a little more than one-third, are visiting for the first time,” he said. “Unfortunately, very few of these are acute sick visits — those would be patients seeking a one-time treatment for the flu, or a minor injury.”

In recent months, KCC staff and volunteers have seen a variety of diverse and serious conditions including an HIV case that has escalated to full-blown AIDS, numerous cases of diabetes and the complications that come when the illness goes untreated, congestive heart failure, kidney disease, even an early-stage case of breast cancer.

Despite the quantity of patients and diversity of their conditions keeping KCC staff and volunteers busy each Wednesday afternoon, Dr Taweh and his newly appointed clinic director Linda Pinckney are on call virtually 24/7 to respond to patient emergencies. Besides the time logged during operating hours, Dr Taweh along with other affiliated physicians and Ms Pinckney spend additional time during the week interviewing and training volunteers, visiting with pharmaceutical reps, refining operations protocols, and working to keep patient charts and records up to date.

The clinic also leans heavily on an amazing network of off-site partners, from medical specialists to labs, all providing similar no-cost or low-cost support to KCC patients.

“We’ve just expanded our partner network to include the Danbury Office of Physicians’ Services,” Dr Taweh said. “Today, we’re up to 99 partner physicians practicing subspecialties of medicine including neurology, pulmonary, allergy, immunology, cardiothoracic, and surgical. We partner with the Women’s Health Center of Danbury for OB/GYN services, pap smears, mammograms, and other needs.”

The only area currently lacking for partnership is dental, according to the doctor.

“We’re still looking to expand our network by two or three dentists,” he said.

To promote the good work being done at KCC, and to further its mission to provide a prototype for other communities, Dr Taweh and his staff and board members are working at developing outreach opportunities, whether it is performing speaking engagements, or accepting recognition from community groups or fellow professionals. Dr Taweh recently spoke before a large audience at Bridgeport’s Jewish Community Center, and on April 28, he will be among those honored by the Family Counseling Center during their annual Family Recognition Dinner.

The Gail Smith Award was presented to KCC from Newtown Youth Services in 2004 and Dr. Taweh was chosen among 2,000 Fairfield County physicians to receive the 25th Annual Melville Magida Award presented by the Fairfield County Medical Association and the Richard and Hinda Rosenthal Foundation recognizing a physician who has shown notable capacity for patient treatment and care.

In the near future, Dr Taweh believes he will have to personally involve himself in politics as well, not running for elected office but testifying before Connecticut legislators in the hope of repealing a current statute that prevents doctors without their own liability insurance from volunteering at public clinics.

“I would like to see more physicians have the opportunity to volunteer here, as well as at other free or community medical clinics across the state,” he said. “But currently, even though we have our own clinic liability policy, state law requires doctors to maintain their own liability insurance as well. I’m sure Kevin’s Community Center will be discussed and used as a model as to why we need this law changed.”

Dr Taweh said that today, 21 states allow physicians to volunteer for nonprofits without carrying their own liability coverage.

“Connecticut is one of the few states in the region that makes it very hard for doctors to help those who need the help most,” he said.

Looking to the future, the many dedicated volunteers and board members are working toward both integrating the mission of KCC throughout the community and the eventual goal of expanding further into their own freestanding medical facility.

Development Director Phyllis Cortese outlined some of the initiatives that are set to roll out in the near future.

“More than 5,500 students will receive a bilingual informational flyer this month through Newtown Public Schools, expanding awareness and our reach of patient prospects,” Ms Cortese said. “Kevin’s Community Center will be an active participant in the 2005 ‘Relay for Life’ for The American Cancer Society as well. We are currently coordinating corporate sponsorship opportunities and developing plans for a promotional video. In addition, The Newtown Car Wash is planning a fun fundraiser for this summer.”