University student volunteers have been dedicating time volunteering for the Charlottesville Free Clinic — a non-profit organization that aims to improve access to health care by providing affordable medical services to its patients.
The Charlottesville Free Clinic strives to be an open door to health care, providing free medical care to those ages 18 to 64 whose annual income ranges from $17,236 to $49,960. The clinic also provides free dental care to individuals ages 18 to 64 with an annual income up to $31,225.
Barriers to healthcare access — such as inadequate health insurance — limit the distribution of necessary medical services and create health disparities in the U.S. Data from before the COVID-19 pandemic shows that people of color in particular had worse health outcomes than their white counterparts across an array of medical issues — including pregnancy-related deaths.
Associate Director of Development WIlla Barnhardt explained that the clinic’s mission is to act as a primary care provider that can see patients quickly and refer them to another community provider if necessary. To avoid crowded waiting rooms during the pandemic, the clinic provided a curb-side service where patients would be given dental exams at their vehicles.
“The whole point of the free clinic is to establish this primary care network, so people don't have to go to the emergency room if they have a cough,” Barnhardt said.
Medical debt is prevalent for people who are insured or uninsured, as well as for minorities. In 2017, 30.8 percent of households not fully insured had medical debt compared to 16.2 percent of those fully insured — households with health insurance coverage for all members all year — according to the 2018 Survey of Income and Program Participation. The survey also found that 27.9 percent of households with a Black householder carried medical debt, while 17.2 percent of households with a white, non-hispanic householder had debt.
The Charlottesville and upper Piedmont areas had an uninsured rate of 10.4 percent among nonelderly adults — those aged 19 to 64 — per data from the 2009 to 2018 American Community Survey and the 2017 to 2018 Behavioral Risk Factor Surveillance System. The rest of Virginia had an uninsured rate of 12.4 percent.
Barnhardt said the clinic serves a variety of patients in the Charlottesville community. The clinic’s 2020 annual report showed that the clinic’s patient demographic was 43 percent white, 24 percent Black, 24 percent Hispanic and 6 percent Asian.
Patients at the clinic can receive free care and treatment for chronic illnesses, such as diabetes and high blood pressure, as well as minor illnesses like bronchitis and influenza. The clinic also provides free mental health support, integrated care, tooth extractions, fillings, dental cleanings and X-ray exams.
Barnhardt said the medical clinic accepts patients between 138 to 400 percent of the poverty line, while the dental clinic accepts patients between 0 to 250 percent of the poverty line. This means that for 2021, the Charlottesville Free Clinic covers medical care costs for individuals with annual incomes ranging from $17,774 to $51,520 and dental care costs for individuals with an annual income up to $32,300, per HealthCare.gov.
“Removing the aspect of paying at the end of your doctor's appointment is so unique, and these people that come to the free clinic are so grateful for that,” Barnhardt said.
Evidence shows that prioritizing primary care can lower the costs of care, improve patients’ health through accessible services and reduce health inequities. In 2016, health care spending cost $10,000 for one individual on average. In 2023, the cost for one individual is expected to rise to $14,944.
Third-year College student Mahdin Hossain has been volunteering at the clinic since May and primarily works at the front desk.
“I really think working in this clinic has been super helpful because I've been put into a clinical setting, and I actually get to face patients now,” Hossain said.
For prospective medical students, volunteer positions provide them with direct patient interaction and can help develop interpersonal and clinical confidence.
Third-year College student Christina Pantzer has used her qualification as a certified nurse aide to volunteer at the clinic since July.
“[The clinic] is slower-paced, so you do have the time to go in and analyze the condition more,” Pantzer said.
A clinical research study from the American Journal of Medicine found that 14.73 percent of a physician’s shift is spent in patient rooms, while nurses spent 32.97 percent of their shift in patient rooms. The study concludes that both health professionals spend a small portion of their time in direct contact with patients in intensive care unit settings — including observations from outpatient and inpatient settings — highlighting the need for increased time with patients.
The study also concluded that physicians are generally happier when they are able to interact more with their patients, finding that adequate time spent with patients is associated with higher physician job satisfaction.
The free clinic makes an effort to specialize patient and health professional interactions through its Clinica Latina — which occurs two nights per month and devotes a whole evening shift to patients who speak Spanish. The shifts are filled with only health professionals and volunteers who can speak Spanish fluently, so that patients who only speak Spanish can have the opportunity to receive care without a language barrier.
“I feel like there's a shortage of healthcare providers that speak Spanish, and [the Clinica Latina is] really nice because I feel like [the patients] really appreciate the service for one, and it's nice to have that connection,” Pantzer said.
One of Hossains’s favorite patient interactions involved him being able to communicate over the phone with a patient in Spanish, who then recognized him a few weeks later.
“It was just really nice that someone [appreciated] the fact that I was trying my best to help them out,” Hossain said.
In addition to having increased one-on-one patient interaction, student volunteers are able to work as part of a team of professionals dedicated to enhancing patient care.
“I think that the free clinic is one of the best teams that I've worked on just because I feel like everybody really cares and is there to make a difference and cares about the community,” Pantzer said.
Effective teamwork can positively affect patient safety and outcome by constructing a more patient-centered health care delivery system.
“I think everyone just wants to help out and … make sure that everything is going smoothly for the patient from when they arrive all the way until they're ready to go,” Hossain said.
Additionally, premed student volunteers can make connections with the clinic’s staff to find out more about their desired speciality.
“I've met some nurse practitioners that have talked to me about their experiences and why they like doing what they did,” Pantzer said. “I've gotten some advice about the application process which is really awesome.”
By providing medical services to adults who cannot afford them, the Charlottesville Free Clinic aims to meet the needs of the Charlottesville community all the while helping student volunteers gain experience in the health care field.
This article previously misstated the income eligibility for medical and dental care at the Charlottesville Free Clinic. The medical clinic’s annual income eligibility is 138 to 400 percent of the federal poverty line, which is $17,774 to $51,520, and the dental clinic’s eligibility is 0 to 250 percent of the federal poverty line, which is $0 to $32,300. This article has been updated to reflect these figures.