Make the Leap

The Net Below the Net: Millions in America Count on Free Medical Clinics

Ross Education

How do free and charitable medical clinics manage to provide essential healthcare services to millions of Americans with little to no federal or state funding? Join us on this episode of Make the Leap as we uncover the invaluable role these clinics play in our healthcare system. With special guest Mary Lewis, CEO of the Gary Bernstein Community Health Clinic in Pontiac, Michigan, we challenge misconceptions and explore the real stories behind those who rely on these crucial services. Mary shares her personal journey from struggling college student to leading a clinic that offers everything from primary care to specialized services. 

You'll gain a deeper understanding of the often-overlooked challenges faced by high-risk populations, even those with Medicaid and Medicare coverage. We delve into the comprehensive care model adopted by Mary’s clinic, designed to minimize the need for patients to take multiple days off work. By fostering community support and relying on volunteers, the clinic sustains its mission to serve the underserved. Moreover, we discuss how Ross students can get involved through internships and volunteer opportunities, contributing to a collective effort to address healthcare disparities. Tune in for an enlightening conversation on healthcare access, advocacy, and the power of community-driven solutions.

We’d love to hear from! Send us a message or topic idea.


Stay up to date on Make the Leap by following us on our website, rosspodcast.com, Facebook and LinkedIn.

Speaker 1:

Welcome to Make the Leap, a podcast focused on the many economic hurdles facing college students, lower income individuals and those striving to move up the social ladder. I'm Brad Constant, here with George Graeb and Kristen Beale.

Speaker 2:

George, what is our topic for today? All right, thank you, brad. Our topic for today is the role that America's free and charitable medical clinics play within our community. I think most Americans know that we have multiple healthcare systems in this country and what system you have access to usually depends on how much money you have or your employment benefits. I don't know if many people would disagree that many of our high-risk population continues to struggle, even after the introduction of the American Affordable Act back almost over 10 years ago. Over 29 million people almost 8% of the US population access cares at different kind of clinics, whether it is a federally funded clinic, state clinic or private clinics that depend almost entirely on contributions and donations from the community that they serve, on contributions and donations from the community that they serve.

Speaker 2:

Millions of Americans continue to fall through the cracks. I view the free medical clinics it's like the net below the net, as many Americans struggle to file healthcare where they need it, when they need it, in the locations that they need it. Even with the perception that now we have Medicaid and Medicare coverage for the majority of the population, charitable clinics receive no federal or minimal federal or state funding. They survive purely on donations. They serve over 2 million people per year and 1,400 clinics across the United States of America.

Speaker 2:

The misconception obviously continues to be that if you need health care, if you need medical care coverage, you can get it. And that's not always the case, and this is part of the conversation today, conversation that relevant to a lot of our students that struggle to find care, find it timely, find it in the services that they need and sometimes in the locations and the communities that they live in. So we will spend time talking through this, talking about opportunities for Ross students to help, for Ross as an institution to help. But before we jump into it, I will toss it back to Kristen to introduce our guest today.

Speaker 3:

We are so lucky today to be joined by Mary Lewis, who's the CEO of the Gary Bernstein Clinic in Pontiac, Michigan. Mary is a Ross grad, graduating with honors from Ross's medical assistant program. Her time as a medical assistant has seen her working in pediatrics, pediatric surgery, cardiology and more. She obtained her bachelor's degree in 2018 and grew her career from medical assistant to clinical team manager to practice manager on her way to her current role as CEO. Mary, thanks so much for joining us today.

Speaker 4:

Thank you so much, kristen, george Brad. It is so exciting to be here. First of all, I love Ross. Ross completely changed my life and even to like talk about it now it still brings tears to my eyes. I have so much emotion behind it. So thank you for the opportunity. More importantly, thank you for engaging in this great conversation around healthcare access and advocacy and equity.

Speaker 2:

So, mary, before we get into the nitty gritty, talk about your journey. Right now, ross has about 3,700 students. Many of them probably have walked in your shoes or are walking in your shoes right now. I think your message is not going to only be uplifting, but it's going to be meaningful in terms of direction and in terms of what's possible. But maybe start with your own personal journey, both on the career side and on the personal side.

Speaker 4:

I come from a long line of health care providers. My mother was a nurse, my grandmother was a caregiver. My great-grandmother, mary, who I'm named after, was an indigenous healer, so healthcare is in my blood. My mother, like I, knew that healthcare was the only career for me. Right? My brother, my sister and I, we knew that there was no other option for us other than health care. My mother wanted us all to be medical doctors, right, and so we all went to college.

Speaker 4:

I get to college my first year and I hate it. If I can be 100 percent honest with you, I hated every bit of college. It was not a good fit for me. And so I remember going home after my freshman year, having that conversation with my mother that, yeah, college isn't for me. And growing up, especially in an African-American home, education was it right, you go to school, you get an education and you do great things. And I told my mom it wasn't a good fit for me. And she says, well, you have two choices you can go back to college or you can work. Those are your only options. And it's like, okay, college isn't the option, because I don't want to go back. And I'm 19, right? Who's going to hire a 19-year-old fresh out of college, kind of, you know, failing.

Speaker 4:

And a girlfriend of mine said, hey, I'm enrolling in this medical assistant program at Ross. And she says I want you to do this class with me, I want you to go through this program with me. Okay, and I'm telling you, like the pressure to go into healthcare and this idea that I had failed college, I had failed my mother, I had failed this lineage of great women before me, I don't want to say I was hopeless, but it kind of felt hopeless. Right, I go to Ross and I'm telling you it changed my life. And I remember being inspired and excited about healthcare, probably for the first time, like I was happy about healthcare, I was excited to be pursuing this career and I'm telling you it has been one heck of a ride ever since. And so, george, when I reached out to you and I was like I just want to say thanks, because I am who I am today, I am where I am today, truly because of the education that I received from Ross.

Speaker 2:

So, on this, on this podcast we take, we talk so much about getting the opportunity right, not not only getting a chance, but also having the resources and and the support to take advantage of of that opportunity. And many of our students, I think, who are going to listen to this, are going to ask well, how did you get to where you are right now? So Ross maybe gave you that first opening, so to speak, open the door. Maybe talk a little bit about what did you do with this opportunity after you left, ross?

Speaker 4:

I am a lifelong learner and I will say I think it's two things. It's one finding a great mentor and seizing opportunity Right. So I have been really fortunate to have great people in my life who saw things in me, even when I didn't see them in myself, to say you're better than that, you can do this. Have you thought about right? So I've been very fortunate in that regard. But seizing every opportunity opens up so much to you. I can't tell you the number of times I was presented with oh, the nurse doesn't want to do this, was presented with oh, the nurse doesn't want to do this. So are you interested? Absolutely, I think. The best example I can give I was working at Advanced Cardiac Healthcare and they were looking for someone to run their telecumidant clinic and they had one nurse who had already kind of she had been doing it, had been doing it and no one else wanted to step up and I was like I'll try it. So I attended this online class and became an anticoagulation practitioner and I telemanaged a 215 patient Coumadin clinic the first in May to do that. And the more I found, the more that I was willing to seize those opportunities and understand that presenting as a continual learner. It opens the doors for you and I have to be completely honest.

Speaker 4:

When I obtained my bachelor's degree in 2018, that was 30 years after I had graduated from high school. But during that time, I managed a 215 patient Coumadin Clinic. I was the clinical team manager for a residency program. I became practice director of a $15 million building. I became the director of employee training at the same organization all without having a degree. But I was hungry. I was relentless in learning and growing and seizing opportunities. Every student listening to my voice medical assisting, farm tech, dental assisting that's a stepping stone right. I am proof that the possibilities are endless if you pursue them, and I encourage you to pursue them. There's a lot of untapped potential inside of each of us and sometimes it just takes someone unlocking it. So consider yourselves unlocked today to pursue greatness.

Speaker 2:

So, but maybe maybe back to the unlocking and the mentor part. You know many of our students. Their first thing sometimes is to get a job that pays them money, so they can pay their bills, they can get their head above water. You talked about mentoring and I've always believed in my own career that the reason I am here is because I was very lucky to work for some people who've invested a lot of time, a lot of effort in me, and I think you're telling a little bit of a similar story that somebody believed in you along the way, somebody invested time and effort into your career. Can you maybe give some idea for our students why it's important that you find somewhere that believes in you, versus just sometimes chasing the money or chasing the position and identifying that ultimately, working for the right people is just as important as a salary that you make.

Speaker 4:

Oh, absolutely.

Speaker 4:

I have a saying I prefer peace over a paycheck any day right, we spend more time at our jobs than we do with our families, and so to be somewhere where you are celebrated and not tolerated is so key.

Speaker 4:

More importantly, I really believe that everyone has a place right, their sweet spot, and it's so important to find that place right, where you can grow, you can develop, you can ask questions and you are encouraged to be more today than tomorrow than you were today. Learned in my career and even starting out early in my career if I can't say yes to the mission and the vision of the organization, I don't take the job because that's not my place. I need to be able to say yes, I need to be able to get up in the morning and I know that kind of sounds new agey and it's not Because when you are in your place, that's your place of success, and that didn't happen overnight, and so I'm not saying for the students that this is going to happen overnight, but you have to be diligent and you have to be intentional.

Speaker 3:

Mary, I'm so glad and proud to be connected with you through Ross and what you do at the Gary Bernstein Clinic. Can you the GBC? We're a free clinic.

Speaker 4:

That means we don't accept insurance of any kind. We are not a third party insurance provider, we're not a Medicaid provider. Every single service that our patients receive, 100% free. I like to say no strings attached because, most you know right, we've heard that, oh, that's too good to be true, we really are. And there are no strings attached because, most you know right, we've heard that, oh, that's too good to be true, we really are. And there are no strings attached. You have to be uninsured or underinsured, you must be a Michigan resident and you must live at or below 250 percent of the federal poverty level. If you meet those eligibility requirements, we are your place, and so we provide pharmacy services, medical services. That includes primary care, but we also have 12 specialty clinics as well ophthalmology and optometry, as well as a full service pharmacy. And again, it's at no cost to Michigan residents and we serve. Although our clinic is in Pontiac, michigan, we actually service all 83 counties of Michigan.

Speaker 2:

How do you do that? How does the word get out? How do people know where to find you?

Speaker 4:

Word of mouth. I'm telling you, I feel we're the best kept secret. That kind of everyone knows about Really word of mouth. Kind of everyone knows about Really word of mouth.

Speaker 4:

Oftentimes, when we think free clinic, this is a full circle moment for me actually leading the Bernstein Clinic, because I utilized a community health clinic growing up. But there's this negative idea of what a free clinic looks like right, it's a hole in the wall, it smells bad, the people are rude. That's not the case at all. We actually have a 7,700 square foot building that is magnificent. It looks like a traditional medical office and our patients are treated with respect and dignity and they receive exceptional care here. And I think that's the difference that we service a population that's used to receiving standard of care is really the bottom level of health care from my perspective. Right, and people deserve exceptional care. Dr Bernstein I'm the founder of the clinic. He believed that everyone has has the right to great health care, regardless of their ability to pay for it, and I wholeheartedly, like in my gut, believe that and that resonates with me. So, yeah, that's the clinic. It's an amazing place.

Speaker 2:

So we talked a little bit about the misconception, about it's a hole in the wall, but I think maybe sometimes there's a misconception. Who actually goes there, right? So you've got all these overlapping Medicaid, medicare, obamacare, whatever American Affordable Care Act and you've got the federally funded clinics and then you've got these charitable clinics and as I was preparing for the podcast, I realized that millions of the working poor go to free clinics and middle-class Americans go to free clinics, depending on the poverty guideline that you've listed, at least for me, I would not have thought of that. I thought you know, if you have money in the US, you'll tend to go to somewhere a private medical office or if you have a job and your employer provides benefits, you go where your benefits take you, but many do not. Many employers do not provide benefits and they leave their people hanging out there trying to find care, and those people tend to be the most at risk. Those are going to be the most vulnerable in our communities. So do you think there is a misconception? Who actually uses free clinics?

Speaker 4:

There is. I am so glad you're bringing this up. There's absolutely a misconception. Oftentimes people think that the individuals that utilize a free clinic are poor. They are shiftless. If I can just be very honest, they don't want to work. It's their fault 42% of our patient population. They're employed. And I'll take it a step further. They actually have two part-time jobs that don't offer insurance benefits, and so, let's say, someone that makes $60,000 a year, between two jobs, they have a family.

Speaker 4:

Oftentimes our patients are caring for one or two additional people, like aging relatives or something like that. So they make too much to qualify for Medicaid and they can't afford the deductible that ranges from $7,000 to $10,000 for a marketplace insurance. So where do they go? What do they do? Traditionally, they would go to the ED to establish primary care, but we know that that's not the purpose of the ED the emergency department and so at the Bernstein Clinic, we're taking care of those folks, and so here we are to make sure that they have and I love what you said earlier, george access to the care that they need when they need it, in a way that's meaningful to them.

Speaker 2:

The other piece that's surprising is how much services you provide. These clinics really are, in some instances, like a one-stop shop. You're able to provide multiple services. Can you maybe take two minutes and talk through all the different clinics that you have within the Gary Bernstein Clinic?

Speaker 4:

Yeah, and that's intentional. So we have primary care. Of course, we have dental. Within dental, we do everything that you would see in a traditional dental office. So dentures, bridges, restorative care, hygiene services.

Speaker 4:

In our medical clinic, again, in addition to primary, we have gynecology, urology, cardiology, ophthalmology, optometry, podiatry, urology, and I could go on and on.

Speaker 4:

We have an onsite lab and, again, a full service pharmacy, and it's intentional.

Speaker 4:

When I need to take a day off because I need to go to the doctor, I sign a PTO slip and I'm essentially paid for not being at work that day. Right, that is not the case for our patient. When they miss a day of work, it's food on the table, it's something for their kids, it's rent. So I want our patient to be able to come to the clinic to see Dr Weitzman for their diabetes management, see Dr Gold the same day for their diabetic foot check, see Dr Jacques the same day for their diabetic eye exam, get their labs drawn and leave the clinic with a 90-day supply of medication. My goal in the next two years is to completely integrate care in such a way that a patient can miss one day of work and hit every single service that they need within one day, because we have to look at our patient from a holistic perspective. So it's very intentional that we have all of these services under one roof to tear down those barriers and really create access.

Speaker 2:

Is that common across all free clinics?

Speaker 4:

and really create access. Is that common across all free clinics? Yeah, that's the goal for all free clinics but due to funding and other things, it's not always easy to accomplish that. We're just very fortunate to have great donors and great community partners who believe in what we're doing and want to come alongside, and we also have great volunteers, Another thing that makes the free clinic model really unique. Specifically here at the Gary Bernstein Clinic, we have 10 paid employees and over 400 active volunteers. So all of my doctors, my nurses, my dentist, my pharmacist, medical assistants, dental assistants they are all volunteers and they do the work of the clinic.

Speaker 1:

So that leads right into my question. How does the clinic continue to be successful for almost 20 years? What is the clinic's biggest area of need?

Speaker 4:

Volunteers. We want to expand. We are at capacity with the volunteers that we have, but there's more opportunity for growth, and so we're always looking for volunteers that love people, love healthcare and want to change the community. So, doctors, nurses alike, you don't have to have medical experience to be a volunteer here. We need people to make phone calls, we need people to confirm appointments, stuff, envelopes. So if you have a heart of service, this is a great place to volunteer. So, volunteers although we have 400 active volunteers, we need more. And then we need funds.

Speaker 4:

We are a nonprofit and so we really rely on philanthropic giving and grants to make this thing called the Gary Bernstein Clinic work and I will say that's true for many of the free clinics across the country, and so funding is always huge. We are really intentional about the things that we pursue. So, although most federal grants aren't available to free clinics, we want to be able to continue to deliver care our way. The doctor needs to spend 10 minutes with a patient Great. They need to spend an hour with a patient Great. And not have that pressure of reimbursement and revenue and generation and all those things, even though revenue generation is a part of it. But yeah, and then we're always looking for great partners to come alongside of us, right? We can't do this work alone. I believe this model is really the answer to the global health care crises, and we can't do it alone, and we need partners to join in the work with us.

Speaker 3:

I was curious if you could share some of those key partners that you talk about, that walk along with you and help you fulfill your mission. I think that would be inspiring, too, to many of our students.

Speaker 4:

Absolutely. The Michigan Department of Health and Human Services, delta Dental Foundation, the Michigan Dental Association, oakland University, william Beaumont School of Medicine, applebaum School of Pharmacy, blue Cross, blue Shield, university of Michigan, corwell Health, and then we just have a host of private foundations and philanthropists that walk alongside of us.

Speaker 1:

My last question is how can our Ross students connect with the clinic?

Speaker 4:

Internships, we are here. So I knew right away that I wanted to make a connection with Ross and provide students with the same opportunity that I've had in my career, and so becoming an externship or internship site is something that we're currently working on, and so if you are interested in community medicine specifically, or you have students that should be exposed to community medicine, we're here and we want to support those academic desires, things like educational workshops and volunteering and we do a lot of things in the summer, like around health fairs, partnering with us, coming on and saying, hey, I have a free weekend, what do you have coming up?

Speaker 2:

That type of thing, yeah, one of the things we offer in our benefit is volunteer time off, paid time off so our staff can come and volunteer at the clinic and get paid from Ross for being there. So I think there's ample opportunities for us to find ways, both volunteering, student-wise externship, internship, financial support. I think there's multiple avenues we can take, but I think from my end of it, I think the biggest piece where our students benefit is that message of hope that you're able to help people. You're in the lifting up people business. You really are trying to do what you can in Pontiac Michigan to impact that community in a positive way when so much of our lives are centered around ourselves and what we need to do for ourselves. So I am going to give you the last word, but you have my commitment that we will find every way possible to help and to partner with you. Mary, I think you have an amazing story and I'm incredibly thankful for all the work that you do. But I will give you the last word here as we wrap up.

Speaker 4:

Thank you. The Bernstein Clinic is an amazing place. So, as students, if you find yourself without insurance, if you need a place where you can receive quality medical care, this is your place, for students also. I really want. I hope that you're walking away feeling hopeful about who you are, about the decision, and I'm getting choked up, sorry about the decision that you've made to pursue a career in healthcare. I can't really see myself doing anything else, and so be encouraged that you're on the right track. Be encouraged that you are going to have the opportunity to really help so many people Again, whether you're a dental assistant, a medical assistant, a nurse, whatever that looks like for you. Also know that there's more inside of you than what you think, what people have said to you. There's so much more inside of you, and I just encourage each of you to pursue it passionately, pursue it, run it down. Sorry, and so be great.

Speaker 4:

Those are my final words Be great, do great things and make a difference. Thank you so much for this opportunity and I'm sorry.

Speaker 1:

No worries. Thank you so listening to Make the Leap. Be sure to visit our site, rosspodcastcom or the podcast platform of your choice to listen to past episodes as well as subscribe, so you never miss a future episode. We hope you join us two weeks from now for our next episode, no Place to Call Home. A broken foster care system sends more kids to prison than college. See you then.

People on this episode