Health Care For The Uninsured

By Dr. Jerry Allison
Interviewed by Melissa Moniz
Wednesday - August 13, 2008
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Dr. Jerry Allison

Dr. Jerry Allison
Family Medicine, Medical Director of Aloha Medical Mission Clinic

What are your duties as medical director of Aloha Medical Mission Clinic?

My duties include implementing the policies and procedures of the board of directors and providing guidance and vision for the clinic manager, a full-time position, and the dental director and other part-time staff. An important function is to identify sources of funding. We do receive donations, but a major source is from grants, local foundations and some government sources. We rely on donations and grants to help fund the clinic as we don’t bill for service. Based on funding and expenses, I periodically review the budget and make revisions as needed. In addition to funding, I am always looking for new volunteers, particularly dentists and physicians, and recruiting patients. I also see patients. If a physician is unable make his or her scheduled appointments, or if we have a vacant evening, I’ll be scheduled to see patients.

Where are most of the funds and grants from?

We receive a significant amount of funding from Hawaii Dental Services (HDS). HMSA is also a major supporter of our clinic. This year we also received money from the State Grant in Aid (GIA) program, Weinberg Foundation, Friends of Hawaii, Kaiser Foundation, Title X and the Hawaii Immigrant Health Initiative. Most of our funding sources are short-term, so we are continually looking for income to keep the services going.

To keep within the budget, is there a limited amount of patients that the clinic can accept?

No, we don’t turn people away. Our main limitation is really the number of volunteers. More volunteers means we would be able to be open more and see more patients. The more patients we see, the more funds we are able to receive. Fortunately, the majority of the staff here are volunteers, so we have a very low overhead. What our funding covers are the administrative costs and a few staff to operate the clinic.

What’s the criteria to be a patient here and receive the free medical and dental services?

No health insurance is the primary criteria. This is the mission that was established by our board of directors. We have questionnaires that we ask people to complete because some of our funding sources require this. So all they need to declare is that they have no insurance. Though it is not based on income, most of our patients are unemployed or have low income.

Dr. Jerry Allison does a quick check-up on Nina Post
Dr. Jerry Allison does a quick check-up on Nina Post

How many volunteer physicians help at the clinic?

We have about 40 rotating physicians. Most work one night a month. We have family medicine, internal medicine, pediatrics, OB/GYN, surgeons, dermatology, etc. We schedule patients based on who is working. We also have physician specialists who may see patients in their offices if we have the need to refer a patient to them.

How many volunteer dentists help at the clinic?

We have about 15 volunteer dentists. They work the same as the physicians.

Occasionally, we have physicians and dentists who are able to see patients during the daytime, too.

On an average day, about how many patients come to the clinic?

About 12 patients a day. We have days when we have seen as many as 20-30.

Does the clinic accept both children and adults?

Yes, we see children as well as adults. One would think we would not see too many children because of the state Children’s Health Insurance Program and the Keiki Program. But many of our patients are newly arrived and their coverage has not yet been established. We help the children with school physicals and the parents with pre-employment physicals. Generally, after two or three months, we shouldn’t be seeing the child who has been here in the state and qualifies for health insurance. We also help refer the adults and children to programs they may qualify for. I am surprised by the number of children who qualify who do not have insurance established. We also encounter a lot of people who immigrate here and don’t qualify for insurance.

How many of the patients are here for dental reasons and how many are here for medical reasons?

It’s about 50/50, but it does fluctuate from month to month.

What are some of the most common problems/illnesses treated at the clinic?

If I look at the medications we’re prescribing, I assume we’re seeing a lot of toothaches and pains. As far as on the dental side, we treat a large number of patients with dental caries (deterioration of the tooth and gum). From the medical side, we often see both acute and chronic problems such as coughs, colds, cuts, pain, sprains and infections. We assist temporarily with chronic problems such as diabetes, hypertension, elevated cholesterol, etc. These patients need ongoing care by a primary care provider, so we help get them into the system. We have many patients who are found to be pregnant. We help them with their initial prenatal labs and then refer them to the appropriate providers. We also help patients with family-planning services.

How does the clinic deal with prescription medication?

We have a dispensary here. There are about 30 of the most common medications in stock. If it’s something unusual or expensive, we try to find assistance for patients.

Aside from Aloha Medican Mission, what else are you involved in?

I recently was appointed as assistant professor at the University of Hawaii, John A. Burns School of Medicine, Department of Family Medicine. I will be working part time with family medicine residents and medical students. I have been working in Hawaii for the past three years primarily providing emergency medicine at various hospital emergency departments throughout the state. I am involved with the board of governors of the Hawaii County Medical Society, board of directors of the Hawaii Academy of Family Physicians, and the board of directors of the Hawaii Public Health Association. One of my longtime interests, having been a paramedic for over 15 years, is working with the emergency medical services. I have the privilege of teaching EMTs and paramedics at Kapiolani Community College.

What issues within the health-care industry do you feel need to be addressed?

I think a big concern is the health of the uninsured because the health of the uninsured affects the health of the entire community - their health impacts the health of the others.

And if you keep people healthy, they can go to school and get jobs and become productive members in society. I’m sure everyone in the community wants to work, wants their children to go to school and to be healthy. So providing health care is important.

Another concern is the funding for health care. A significant amount of health-care dollars go to hospital medicine, and if more money was spent in prevention and community health, then perhaps there would be less need for and cost of hospital medicine.

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