College of

Katie Rose Hackney at the Care Free Clinic

September 2011

Katie Rose Hackney was a second-year medical student in East Lansing when he participated in the College of Human Medicine Service-Learning program in 2011. This is her story:

I chose to spend my required 40 hours of community service at the Care Free Clinic in Mason under the supervision of Dr. Barry Saltman.  

The Care Free Clinic has locations in both Lansing and Mason and offers medical care to many people throughout Ingham county and adjacent regions who have minimal or no health insurance. At the clinic, most of the patients have some form of government-sponsored health insurance, including Medicaid and Ingham Health Plan (IHP) insurance. 

I have to admit that I had a lot of assumptions and biases prior to starting my volunteer experience at the Care Free Clinic. I had assumed that many of my patients were going to be drug seekers or unemployed and not attempting to find a job. I quickly realized that those biases were completely unfounded and absolutely not true.  

While I did see a few drug-seeking patients, most of my patients were incredibly hard working individuals who had fallen on hard times. I also saw many patients who had steady jobs but were not offered health insurance through their employer. Listening to their stories and working together to provide adequate health care was an incredibly influential experience for me. 

I have read about the hardships and inadequacies within the US health care system, but had never experienced them firsthand prior to volunteering at the Care Free Clinic. My time at the clinic helped me to realize the role a physician can have in both diagnosing a patient’s condition and in facilitating access to care. Access to care does not simply mean availability for office visits, but also responsibly prescribing affordable medication and ordering only pertinent and necessary studies that are within the financial limitations of patient’s ability to pay for care.

Many times it was frustrating to know that there were medical options to treat the conditions of my patients, but they were not financially feasible to prescribe these patients. One of the great blessings of working at the Care Free Clinic was being able to learn about all of the resources available in the community and to be able to offer that knowledge to my patients.   

Dr. Saltman has established relationships throughout the community that have allowed him to procure medical diagnostic studies and medicinal treatments at a lower cost. For instance, many laboratories in the area would allow Dr. Saltman’s patients to get free blood tests. At the Care Free Clinic, we also had one employee whose only job was enroll patients in a medicine assistance program to help decrease the costs of the patient’s medications. 

My favorite experience during my time at the Care Free Clinic involved the care of one patient.  This patient was in her mid-20s and had not seen a primary care physician for more than six years. She suffered from severe anxiety, and when she arrived at the clinic was extremely nervous. I was able to do her initial interview where we established a trusting relationship and she was able to confide personal information to me. A week later, she came for a follow-up appointment for her physical exam that I performed. When I walked in to the room, she expressed concern that she hadn’t seen me when she first walked into the office and was worried that I wouldn’t be there to perform her exam as she did not feel comfortable having anyone else do her exam. In that moment, I knew that by simply spending some time talking with her on her first appointment I was able to have a profound impact on her. A week after her physical exam, she came to the office again for a follow-up appointment to review medications we had started for her. That week also happened to be my last week volunteering at the Care Free Clinic, and after her appointment I told her that it was my last week at the clinic. She immediately jumped up and gave me a hug, thanking me for making her feel so comfortable. I will never forget that experience. 

I learned, in that moment, the value of the doctor-patient relationship and the gift and responsibility I have to care for people and establish trusting relationships my patients. During my time at the Care Free Clinic, I also learned the importance of identifying the needs of my patients and financial restrictions and ways to access medical care within those limitations. In a time when the health care system has exorbitant costs to both patients and the system, it will be increasingly important to be responsible in prescribing medications and ordering diagnostic studies. I will never forget my experiences with the patients at the Care Free Clinic and hope to take everything I learned about caring for patients in financial distress and carry it with me throughout my career as a physician.