News
Parker Health Center Helps The Uninsured
By Ryan Fennell
RED BANK - While the debate rages in Washington over how best to make health care in the United States both accessible and affordable, a small organization on the borough's west side is providing a lifeline to the uninsured.
The Parker clinic was named in honor of Dr. James W. Parker, Jr., an African-American physician who, like his father before him, treated many generations of Red Bank residents of all races in his office on Shrewsbury Avenue.
Dr. Parker was known for opening his office at 5 a.m. in order to accommodate working people who could not afford to take time off from their job to go to the doctor. He was also known as a compassionate physician who often waived or reduced his fees to make sure that his patients had the health care that they needed regardless of their economic situation.
Dr. Parker died in 2004, but the clinic established in his name continues in his memory.
In July 2000 the Parker Family Health Center saw its first three patients in a donated trailer in an empty parking lot on Shrewsbury Avenue in Red Bank.
Three years later, the clinic moved into a brand new, permanent facility with a waiting area, five exam rooms, offices, and space for patient education.
Since then, the Parker Center has treated over 60,000 patients, averaging approximately 10,000 patients per year.
"That's actually individual patients," said Anne Torre, grant writer for the clinic. "A lot of patients have chronic conditions. We have a lot of patients that really depend on us for ongoing care." All of those patients were treated at no charge.
"We are volunteer based, with 100 medical professionals of all types," Torre said. "They volunteer their time either here at the clinic or see our patients in their own offices."
According to Torre, volunteers donate approximately 10,000 hours per year to the clinic with a dollar value conservatively estimated at $600,000 per year.
"That's a tremendous contribution our volunteers make," Torre said.
In the years since it opened, the Parker Center has evolved from a walk-in clinic to an appointment-based operation.
It is currently open six days per week, including two evenings and Saturday mornings.
Patients at the Parker Center come from 40 towns throughout Monmouth County, with 38 percent residing in Red Bank. In 2008, 50 percent of patients were Latino, 16 percent were African-American, 24 percent Caucasian, seven percent Asian and South Asian, and three percent from other ethnic groups.
The most common chronic illness the Parker Center treats is diabetes. Diabetes is a growing problem in the United States especially among Latino and African-American communities due to a genetic predisposition to the disease, said nurse practitioner Carmen Phaneuf, who has been volunteering at the clinic since 2001.
"In the U.S. there's a growing number of diabetics of epidemic proportions," Phaneuf said. "With that there comes a huge cost to our country and costs to our patients in terms of their health and financially."
According to Phaneuf the average person with diabetes spends two to three times more in health-care costs.
"It's expensive just to maintain without any complications," added volunteer registered nurse and certified diabetes educator Joyce DeJohn. "Our population is considered an at-risk population on a good day. They obviously lack health insurance but also have financial challenges."
Phaneuf said that many patients that come to the center have not been taking their diabetes medications, instead coming in after six months to a year without any health-care and sometimes rationing the medications they possess because they can't afford their prescriptions.
"They are making decisions to cut out certain meds even though they don't really know what they are cutting out," Phaneuf said.
The rationing and lack of medication use stems from the high cost of medication without insurance Phaneuf said.
One bottle of inexpensive insulin costs $40, while test strips for monitoring blood sugar range from $60 to $100.
"So people are coming in not checking their blood sugar and just at a complete loss," said Phaneuf.
According to Phaneuf when patients arrive at the center their blood sugars range between 200 and 300 and out-of-control for a long time. A normal level is below 140.
"I think it's overwhelming to a lot of primary-care providers and they don't know how to manage it very well, and there's a lack of education on insulin, and a lack of education on the patients' part," Phaneuf said.
"I worked at the hospital for the last 15 years," said DeJohn who began volunteering at the Parker Center in 2007. "I was dealing with people that had insurance and who had access to medications. Even in that population, it's a challenging disease to manage. What I find so remarkable is what (Phaneuf) has been able to do with this particular population."
According to DeJohn, the gold standard of measurement when dealing with diabetes is an A1C test.
"What's so remarkable is that this population does better than national averages, twenty points better," DeJohn said.
According to Phaneuf the A1C tests hemoglobin in the blood and the benchmark is a hemoglobin level less than 7.0. The national average for people with diabetes who are at or below that mark is 30 percent. 58 percent of diabetic patients at the Parker Center are at or below 7.0.
According to Phaneuf, for every point over 7.0 the patient doubles their risk for complications.
However, the patients do not come to the clinic with such impressive numbers.
"People who prior to coming here were at 12.0 or 13.0 or were getting it controlled at the ER with no follow-up because they were desperate," Phaneuf said. "Now they are leaving the ER with follow-up at the Parker Center which is good."
Phaneuf noted that the staff at the front desk is in tune to picking up on new diabetes patients when they first arrive at the clinic.
"When you're diabetic you're not just diabetic," Phaneuf said. "You have risk factors or have high blood pressure, high cholesterol, startings of blindness, starting of kidney failure, foot ulcers, and heart problems."
According to DeJohn part of the success at the Parker Center for treating diabetes is the education that patients receive about the disease, which is a mandatory part of treatment.
"It's clinical and education working together in one place," DeJohn said. "It sounds obvious but it doesn't usually work that way."
"It's very much relationship based," DeJohn continued. "We create a relationship, we have expectations, and we empower them. There is accountability but it's done with support, caring, and positive reinforcement."
"The success of the clinic is that I'm not going to let somebody go three months if it's not controlled," Phaneuf added. "They are coming back next week and come week to week until it's controlled. Here, when I say I'll see you in 10 to 12 weeks that means you're good."
"The other good thing is we not only treat the patient as a diabetic but treat the patient holistically," Phaneuf continued. "We ask questions like, "When was your last mammogram or colonoscopy?'"
The Parker Center stresses treating the whole person and refers their patients to other resources when necessary and available. Phaneuf and DeJohn say that patients that are struggling will be helped to find a social worker, or people with behavioral issues will be referred to mental health professionals The center also provides a variety of ways for patients to obtain medications, including pharmacy assistance programs and working with area pharmacies to provide a lot of generic medications.
Diabetic patients can take six or seven medications per day.
"If they have to pay out of pocket you're talking comfortably $200 to $300 a month in medication," DeJohn said.
DeJohn also attributes much of the success of the center to the atmosphere of volunteerism that patients experience when being treated for illnesses and chronic conditions.
"We're a 90-percent-volunteer organization. You have a lot of nice, happy people here," said DeJohn. "There's an overall tone in this place that make people feel very comfortable."
Due to the high percentage of Spanish-speaking patients at the Parker Center, there is also a need for interpreters.
Edith Williams and Mano Mardones both donate their time to help facilitate communication between the doctors and nurses and the patients.
"People are so grateful when they find somebody that speaks Spanish," Williams said.
Williams said that it is a great benefit to the patient because the patient is able to communicate exactly what is wrong with them or what their symptoms are to the doctors and nurses through the interpreters.
"The doctors and nurses that volunteer here are in a position where they can really be doctors and nurses," Mardones added referring to the volunteer nature of the center. "I was fortunate to be led here."
With the recent economic uncertainty in the country and many people becoming unemployed, a loss of health insurance has also affected many people according to Torre.
"We certainly haven't seen it all yet but we have seen an influx of English-speaking patients," Torre said. "It's starting to affect everybody."
"We're poised, waiting for health-care reform but our patients can't wait," Torre added. "Our patients need care now, and we're here."
The Parker Center operates through volunteers but relies on donations and grants to remain viable. The center was recently the beneficiary of the Hope Concert at the Count Basie Theatre this year and is also awaiting a grant for the diabetes program from Horizon. The Mattone family also recently donated $25,000 to the Parker Health Center in memory of their father, Vincent, who was a supporter and honorary board member of the organization.
