Seven-week-old Brooklyn Bell squirms under the cold metal of Dr. Tom Boschen’s stethoscope. She stares beatifically as Boschen gently examines a faint rash on her face and chest.
On this day, the 66-year-old retired pediatrician’s touch is golden. Only moments before he had stuck a probe in the ear of 9-month-old Zenaida Benavides without eliciting so much as a whimper.
On the third visit of her short life to the Doctors Care clinic, Brooklyn is just as satisfied a patient. When Boschen judges her skin condition to be “a mild case of baby acne,” first-time mom Danielle Bell breaks out in a smile.
She and her infant daughter came to Doctors Care the same way an increasing number of patients do. Danielle Bell was laid off from her job when she was seven months pregnant, and with the job went her health insurance.
Bell checked on COBRA, the health insurance coverage folks can buy when they are between jobs, but it cost $300 a month and she was, of course, unemployed.
“I don’t see why they offered it to me when I didn’t have a way to pay for it.”
It is one of the many Catch-22s in America’s system of medical care.
Danielle Bell and Brooklyn fell through the safety net until they landed at Doctors Care.
Guys like Boschen consider it “an obscenity” that the most powerful, wealthiest country on Earth refuses to guarantee health care to its citizens. But as he waits for politicians to change that, Boschen donates his time to keep uninsured kids healthy.
Since 1988, Doctors Care has offered good, affordable medical care to uninsured residents of Arapahoe, Douglas and Elbert counties. Relying on volunteer physicians and donated hospital lab and pharmacy services, Doctors Care stepped up when overflowing caseloads forced Denver Health to stop treating suburban medically indigent patients, says executive director Bebe Kleinman.
“I do think there should be some sort of legislation to to make all doctors take a certain percentage of patients on Medicaid (government-paid health insurance for the poor),” says Nancy Mitchell, a pediatrician who came to Doctors Care after giving up a 15-year private medical practice. “So few doctors take Medicaid now, the ones who do get inundated. You lose money on each Medicaid patient you treat.”
Groups such as Doctors Care depend on grants from many philanthropic programs. The agency has applied for funding from the Post-News Season to Share campaign to fill critical gaps.
Gaps like the one Sandra and Caesar Lara and their daughter Jacquelyne are stuck in. Sandra, 20, cleans offices. Caesar, 24, makes pizzas. They can’t afford health insurance. So here they sit in a Doctors Care exam room, waiting for Boschen to check Sandra’s thyroid. The working couple pays for the visit on a sliding scale.
“We have a deeply held belief that if patients can pay something, they should,” says Deb Chapman, a physician’s assistant who directs the clinic. “The most common payment is $5 (per visit).”
Boschen enters the exam room where the Laras sit. He converses in Spanish, a skill he developed with high school and college language courses, along with time spent in South America.
Down the hall, Doctors Care mental health specialist Linda Pearson has just finished a 90-minute telephonic marathon in English, trying to arrange coverage for a “head med” needed by a youngster.
“No physical problem seems to require a character or judgment review,” Pearson says with obvious exasperation. “Every mental problem does. The country, very tragically, has the philosophy that there is a higher value to having a physical problem. There’s lots of guilt and shame to having a mental health problem.”
Add in a lack of insurance or poverty and the burden can become enough to deprive people of badly needed treatment. This is why Pearson takes time off as a private psychiatric nurse practitioner to head over to the Doctors Care clinic. An author of a child-rearing book “The Discipline Miracle,” she “does a tremendous amount of family therapy and parenting work” with her indigent patients.
What Pearson dreams of is a “no wrong door” entry into the medical system that includes mental health as well as physical health.
Until then, Doctors Care will have to make do with compassion in the form of donations. Donations of time and services from doctors and hospitals. Donations of money from a public that could be one layoff or domestic crisis from the clinic’s patient register.
Jim Spencer’s column appears Monday, Wednesday and Friday. Reach him at 303-954-1771 or jspencer@denverpost.com.