Magazine article Clinical Psychiatry News

Nashville Clinic Focuses on Immigrant Groups

Magazine article Clinical Psychiatry News

Nashville Clinic Focuses on Immigrant Groups

Article excerpt

WASHINGTON -- When Dr. David Gregory worked to open a health clinic for the uninsured in 1991, he thought that he would be treating residents of the nearby housing projects. Most of the residents were African Americans.

Since then, however, Siloam Clinic has become the treatment center of choice for a large population of refugees and immigrants from some 100 countries, ranging from Afghanistan to Vietnam.

"Things changed--TennCare [Tennessee's Medicaid program] expanded to include more uninsured patients, and the patients didn't need us so much," said Dr. Gregory, who is with the division of infectious disease at Vanderbilt University in Nashville, Tenn.

"But one morning, in walked a Vietnamese man. He had spent 9 years as a prisoner of war, and survived torture and forced labor," he said. "I started looking after him and his wife. It turns out that there were about 4,000 Vietnamese refugees in the area."

Before Dr. Gregory knew it, word spread among that refugee community that care was available at Siloam at a nominal charge--and the clinic had many new Vietnamese patients.

Now, 80% or so of Siloam's patients are from Nashville's expanding refugee and immigrant population, he said. The clinic's scope of practice includes health screenings, immunizations, primary care, patient education, and specialty care. The clinic receives funding from Medicaid, federal grants, donations, foundations, private insurance, and patient fees.

"Establishing trust [with these individuals and their communities] is dependent on integrity and honesty," Dr. Gregory said.

A faith-based endeavor that takes its name from biblical references to the Pool of Siloam, the clinic has grown from its humble beginnings in a renovated apartment to a new, debt-free, 12,000-square-foot building that includes 12 examination rooms and a chapel.

The need for this type of community service has grown dramatically since 1991 as the population of uninsured and un-derinsured grows, Dr. Gregory said. He offered some advice for physicians who, seeing a need in their own communities, want to help.

"What's a doctor to do in the face of these daunting challenges?" he asked. "You can do something, but it takes planning. There are many land mines."

The first thing Dr. Gregory suggested for those physicians who believe they may want to open a similar clinic is to examine motivation.

"Why are you doing it? Is it altruism? Faith-based? An intellectual challenge? Be honest about why you want to be involved," he said. …

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