For the homeless living on city streets, the only option for medical care is usually a hospital emergency room. But ERs aren't equipped to manage chronic health problems, or deal with mental illnesses conditions that especially affect the homeless.
That's where the family clinic at St. Vincent de Paul Village comes in. Located in downtown San Diego, the health center provides a wide array of medical services to the homeless...for free. KPBS Health Reporter Kenny Goldberg has the story.
The St. Vincent de Paul family clinic sits in a non-descript building just off Imperial Avenue in East Village.
Outside the clinic, some homeless people stand around and shoot the breeze. Inside, a number of folks sit patiently in the waiting room.
Dr. Margaret McCahill is the clinic's medical director.
Dr. Margaret McCahill: "As people come into to visit with us in the clinic, there are three check in windows here. At check in window number one, people who have dental appointments, check in window number three, people who have medical appointments, and in the middle, number two, is for people who aren't really sure what they need.
Beyond a set of double doors lies a series of examination rooms.
McCahill: "Now we're going first into the dental clinic. And you can see the picture here, what we call the wall of smiles. And literally we have hundreds of before and after pictures of patients who have had total dental restoration done.
Just down the hall, there's a fully equipped eye clinic. Here, patients can get their vision checked, and get a new set of glasses.
McCahill: "Glasses and teeth are among the very first things to go when you're homeless. So those are very important things to restore right off the bat."
The clinic also offers a wide range of other services, from pre-natal care to dermatology.
Nearly all of the care is provided by volunteers. More than 200 physicians, dentists, and nurses donate their time to treat the homeless.
Rosetta Tucker worked for years as a hospital nurse. Retirement just wasn't stimulating enough. So Tucker volunteers at St. Vincent's twice a week.
Rosetta Tucker: "Actually, I'm almost enjoying this more than when I was in acute care. I have never worked in outpatient. And this is great, because the patients here really need you."
That's putting it mildly. Most of the patients at St. Vincent de Paul have lost everything. They've hit rock bottom, and are just trying to survive another day.
Father Joe Carroll is founder of St. Vincent de Paul Village. He says the clinic had a very humble beginning back in 1987.
Father Joe Carroll: "We found people were sick, had nowhere to go anywhere, so we got a couple of volunteer doctors. Our first clinic actually was after dinner we'd wash off the tables, put a clean sheet on it, and that was our opening clinic."
Today the clinic is a five-day-a-week operation, with an annual budget of $3 million. It's funded by private donations. The clinic doesn't bill the government or insurance companies for anything. And all of the care is provided free-of-charge. Father Joe says that's crucial to the homeless.
Carroll: "A lot of clinics charge sliding scale, which is great. But even if it's five dollars to come in for a visit, if you don't have the $5, okay, now what do you do?"
Not anyone can just walk in off the street and get medical care here. The clinic gives first priority to the homeless, and serves others who have no access to health insurance on a space available basis.
Caring for this population isn't everyone's cup of tea. But it's the ideal situation for Dr. Vanessa Greenwood, a 4th year medical resident at UCSD. Greenwood is vying to become a specialist in both family practice and psychiatry.
Dr. Vanessa Greenwood and Patient: "And I'm wondering how your mood is, how the depression and anxiety are faring? Well, it's improving a lot, I'm doing a lot better. Excellent, no panic attacks, anxiety .
Dr. Greenwood says after med school in New York, she could have gone anywhere for her residency. But she says she's always had a burning desire to help those in need. Greenwood finds working with the homeless to be extremely fulfilling.
Greenwood: "What I get is really treating the whole patient, and not just medically and psychiatrically, cause we're doing both of those aspects, but I'm also treating their families, and I'm treating sort of the social situations that they're in. And dealing with the legal issues and just the physical barriers to dealing with their care."
The St. Vincent de Paul clinic treats about 4,500 patients each year. And it's getting ready to expand. Father Joe Carroll says St. Vincent will soon launch a mobile health clinic.
Father Joe: "Well we realize that not just downtown are there people without any medical care. So our goal is to go out to various religious institutions, generally cause they have big parking lots, and so this enables us to go throughout the county, and provide the same care we're providing downtown to our neighbors who are falling through the net."
The mobile health clinic is expected to starting hitting the road sometime next month. Kenny Goldberg, KPBS News.
