Today was long. I have some sort of bacterial infection in my ear that is causing me severe pain on the right side of my head and neck. We were understaffed at the clinic, and I was translating for a gynecologist who kept making comments about how poor people should stop reproducing and how liberals are ruining this country. I feel tired.
I can't help thinking about borders, though. Many of my patients are second-class citizens in this country because of a 1,833-mile line in the sand that was drawn in 1848. They, just like my grandparents, decided to come to the U.S. for a variety of reasons, which can likely be boiled down to one word: opportunity. Yet our immigration system is broken, and only those coming from the "right" countries, with the "right" skill set and the "right" amount of money in the bank are welcomed with open arms. Everyone else: well, sorry. I could go on about this for hours, but my main point is that a random line that was decided on over 150 years ago now dictates the citizenship status of many people within the United States.
In a way, this system mirrors what I have been learning about the free clinic system in Savannah. Most of the other clinics in the area can only see residents of Chatham County because they receive indigent care funds to do so. I have no idea when the county lines were drawn in Georgia, but I've looked at maps and to me, the boundaries seem pretty random. Within Chatham County, we don't necessarily have tons of resources, but Savannah alone has a decently-sized network of providers who can see people who, for one reason or another, don't have health care. But what do most of these clinics say to those who live just 5 minutes outside of this county? Well, sorry.
Good Samaritan Clinic is the only clinic in this area that will see patients without health insurance, without discriminating based on citizenship status or county of residence. Our philosophy is that if you want to drive the 100 miles each way for a visit with a gynecologist, be our guest. And many of our patients do just that. Because to be honest, at least from my limited understanding of this state, once you leave the Savannah area, you don't hit another city for a few hours. And we all know how wonderful rural health resources tend to be in our country...
So what's happening? Good Sam is somehow getting patients dumped on us by area hospitals and clinics who don't see the need to treat individuals without health insurance, notably those whose residence is outside of Chatham County. The problem with this is that we only have doctors at the clinic 6-7 times per month. We don't necessarily mind that we aren't getting as much reimbursement from the county as other clinics, but the people who are most affected by these policies are our patients. Since I've been working there, I've seen a woman with a shattered ankle arrive at our door with a cardboard splint, a man with recently diagnosed lung cancer call to receive care, and two men who have been diagnosed as in extreme need of knee/hip replacements. They come with referrals from other places, and then we are left trying to find specialists who will do reduced-rate services to supplement what our clinic can offer for free. And these things don't happen overnight. So while I am waiting on calls back from people in the area, many of my patients are anxiously awaiting some form of news about treatment possibilities. If only they had decided to live on this side of the county line...
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