Anatomy of a free clinic

After working more than 20 years as a nurse, Patricia Leavitt’s dream was to start a free clinic for people without health insurance. But along with passionate commitment, it took leadership, determination, networking, dollars, an eye for accounting and the ability to schmooze. It all came together at a setting that she hopes is a model for patient care in the future.

by Betty Lynne Leary

Anna Willis, Patricia Leavitt and Lois Hamel

Anna Willis ’10, who interned at the Leavitt’s Mill clinic over the summer, talks on the phone as nursing professor and clinic founder Patricia Leavitt, left, confers with Lois Hamel, director of the nursing program in the Graduate & Professional Studies division.

Patricia Leavitt vividly remembers the first patient she treated at the Leavitt’s Mill Health Center when it opened five years ago in Buxton, Maine.

“We weren’t even ready to see patients yet, but a woman called and clearly had symptoms of a kidney infection,” explains Leavitt, an assistant professor of nursing at Saint Joseph’s College. “We told her to come in, and we treated her infection before it became severe. I’ve been glad these doors were open from the very first day.”

As a nurse practitioner, Leavitt sees countless patients without insurance, those who wait to seek help, trying to avoid a costly hospital visit, until their problem becomes so serious they are forced into the emergency room. The largest group of the uninsured is adults, ages 20-50, many of whom are just starting off with low-paying jobs.

“I found the patients to be very friendly and kind. They just happen to have jobs that do not provide insurance.”
Ruth Smillie,
nursing student

“The system is so frustrating,” Leavitt says. “Most people aren’t looking for a handout. They want to pay their own way, but they defer care to avoid financial trouble.” It’s these patients Leavitt sought to serve when she created the Leavitt’s Mill Health Center, named after a grist and saw mill that operated in Buxton in the late 1700s.

Leavitt recalls another patient who came to the clinic with a swollen, painful arm. A painter, she hid the pain from her husband because, with no health insurance, she didn’t want to burden her family.

“She had a severe blood clot in her arm,” Leavitt says. “She had to go on blood thinners for a year, and we checked her every few weeks to monitor her progress.” Services offered by the clinic are available to anyone, and patients pay what they are able to afford. Follow-up care is included even if it means a trip to the hospital for further testing, treatments, surgery, even chemotherapy.

“We have a beautiful network of providers,” says Lois Hamel, director of distance nursing education at Saint Joseph’s. Hamel, a close friend of Leavitt for many years, got involved at the clinic last summer.

“We have a dental hygienist doing exams, we have a physical therapist in the building, and a chiropractor down the street, all willing to provide services to our patients,” Hamel explains.

Hamel coordinates internships for her students at the clinic, an experience that benefits both student and patient.

“One student, on her first day with us, was just blown away by the experience,” Hamel relates. “We give very thorough exams, and the student learns a lot, the patient learns a lot, and I learn from both of them.” And it’s not just routine injuries or illnesses. The team has diagnosed several cases of cancer including breast, cervical and bone cancer.

“We also see a lot of people with diabetes,” Leavitt adds. “By getting a patient’s blood sugar under control, we prevent huge problems, since diabetes affects all systems in the body.”

Ruth Smillie of Standish, a graduate student in the college’s distance education program for nurses, spent 150 hours over several months at the clinic developing a diabetes program. She created educational brochures for patients, provided one-on-one counseling to teach about diabetes, and started a walking program at a local sports facility.

When one patient struggled with the task of giving herself insulin injections, Smillie took extra time to teach her.

“She was able to work through her fears and tears and learn how to take better care of herself,” Smillie says.

Patricia Leavitt with a patient

Assistant professor of nursing and clinic founder Patricia Leavitt enjoys a laugh with a patient. Volunteers from both the on-campus nursing program and the distance education nursing program help at the clinic.

“It’s absolutely possible to help people in your own community without having to be a large corporation. What Patsy Leavitt has established in a small building in Buxton should be a model for health care around the nation.”

The clinic is open all day Thursdays, twice a month on Saturday mornings, and twice a month on Wednesday evenings. Leavitt would like to see other students from Saint Joseph’s get involved, such as social work students, marketing students and information systems students who could work on database management.

“It’s good for the school to have an association with something so positive for the community,” she says. And the experiences students gain in this real-world setting are unmatched.

“It’s a toss up as to who benefits more, the student or the patient,” Leavitt notes. “A student can look a person in the eye, someone who was just a statistic before, and truly connect with them. Concepts like social justice and access to health care come alive, and there’s just no substitute for that experience.”

www.leavittsmill.org

BACKSTORY:
HOW IT ALL BEGAN

Patricia Leavitt had worked in hospital emergency rooms long enough to see that they were in constant use for primary care needs by people who lacked health insurance. When her husband asked her to leave her nursing position for a year to help him with his farm equipment business, she made a deal. She agreed to help him, if he helped her start a health clinic that would serve the uninsured.

Not only did her husband’s business allow her time to start the clinic, her husband also helped to raise money for it by hitting up his business associates.

While selling tractors and trying to start the clinic seem like divergent activities, she says the business experience helped her become savvy at financial statements and customer service.

Leavitt has spent the last five years raising more money and running the clinic as a volunteer, though part-time staff members now handle some day-to-day operations. Her biggest challenge has been recruiting and maintaining a stable team of volunteers to ensure continuity of care.

Of the skills needed to start and equip the clinic, it turns out the quality she needed the most was the ability to schmooze. As her husband told her when she was vice president of nursing at Brighton Medical Center, “You may think you’re a nurse, but you’re a salesman.”

Though she doesn’t like to talk about herself and names team-building as her biggest leadership skill, she is a force to be reckoned with. Her clinic mantra: “Work myself out of a job.” In the meantime, she has developed a model of how holistic care can be delivered, how preventive medicine can be practiced and how nurses can make a difference.

AND ON THE OTHER SIDE OF THE WORLD…

Carrie Patch

After watching the movie Sicko, the 2007 documentary that examined the crisis of the uninsured in America, Carrie Patch ’08 got angry. She channeled her anger into an in-depth investigation of the question “Is Health Care a Right?” for her senior thesis.

While researching the paper, Patch discovered Cross Cultural Solutions, an organization that sends volunteers around the globe. She volunteered to go to South Africa where she saw firsthand what can happen in a nation without preventive medicine.

“I worked in an AIDS hospital and it really put things into perspective,” Patch says. “We take things for granted here, especially health care. Our system isn’t perfect, but it’s better than most.”

This wasn’t Patch’s first experience with African children. When she was a sophomore at Saint Joseph’s, Patch sponsored a child for over a year before the little girl, named Mapenzi, died from AIDS. “It’s hard to do more than send money and letters when you sponsor a child,” Patch explains. “But when I went to South Africa, I got to hold kids and do hands-on things to help them.” While she describes the experience as absolutely incredible, watching children die, often with no parents, was the hardest.

“I came to work one day and they told me that a little girl was going to die and that I needed to hold her,” Patch recalls. “That’s very hard to do. It’s long, painful and nothing like you see on TV. It’s hard to watch someone die, just watching and waiting for hours, especially a kid.”