A health care clinic pops up
One retired ER doc, with county support, responds to a crisis
As Martin Luther King wrote, “Justice too long delayed is justice denied.”
Substituting the words “health care” for “justice” rings just as true – and speaks to today’s reality.
On a cold January night in Hyannis, one initial, small attempt was made to address this crisis.
Scores of people filled the warm Health Ministry facility on Center Street, greeting one another in Portuguese, lining up, filling out forms, chasing kids down the hall. The big attraction was a fledgling pop-up health clinic, a pilot inspired by a retired physician, supported by nurses from the Barnstable County Department of Health and Environment and volunteers from the Medical Reserve Corps.
“This started as a dinner conversation with my niece, who is involved with the County Department of Health,” remembers Dr. Kevin Bresnahan from Harwich. “We were talking about how we have dramatically under-served populations, and there are providers willing to help supply care, but the supply and demand are not coming together. So why not?”
Bresnahan knows the need first-hand/front-line after 25 years as an emergency room physician at Cape Cod Hospital where he met his wife, a nurse. He practiced in urgent care centers as well, retiring three years ago. He knows people can’t get appointments with primary care physicians for months if at all – one office in Hyannis reportedly is telling patients that the earliest openings are in 2025. Even basics like renewing a prescription become major challenges.
“The initial concept was to piggyback on screening the county already does,” he explains. Offer blood pressure and glucose testing, indicators that can be treated with diet and exercise as well as medication to prevent diabetes or strokes. And then have a physician available:
“We realized early on that the demand for something like this is far greater than what we could supply, so we set a target of 20 doctor visits for an initial pilot … We felt we needed to try at a small scale because the learning curve doesn’t start until it really happens. And there was no model we could work with, no one had seen something like this before.”
The county’s public health nursing division was ready, including volunteers from the Medical Reserve Corps, both of which have accomplished extensive community outreach offering COVID and flu vaccinations (among other efforts). The Health Ministry in Hyannis (founder Michael Mecenas was profiled in last week’s Voice) was all in, willing to host as well as reach out. The Health Ministry has built a reputation as a place where people can come without worrying about legal status, where speaking Portuguese, Spanish, or Haitian Creole is not a barrier.
“There were a lot of logistical hurdles,” says Bresnahan. “It was harder than it sounds, months in the planning stage.” They decided they were ready to test the waters on January 18, 5 to 7 pm.
Within an hour of the Health Ministry letting the community know of the opportunity, more than 100 people had requested an appointment.
As people were screened in one room, the doctor was seeing patients in another.
“It broke down in thirds,” says Bresnahan. “One third were on medication that had run out, they hadn’t been able to refill. A third had a minor acute complaint. And a third needed medical clearance or some form, for example to do school sports. One woman had been waiting months to get a work clearance signature.”
There is no testing or lab backup available, and Bresnahan cannot provide referrals to specialists. “I need to stay in my comfort zone, do what I can working with what I have,” he muses. “For some people, the issues are too complex for this setting.
“But I was very pleased with how it worked out. I think it was very beneficial, and has a lot of potential.”
Everyone is assessing the initial experience; there are concerns that demand is so strong the volunteer-driven effort will get swamped even if Bresnahan recruits other physicians and the county remains a vital participant.
“I have no expectation we can meet the entire need,” he says. “But we’re doing the right thing. So maybe we’ll try another slightly scaled-up version in the near future. That’s my hope, that it can grow.”
In which case, health care will not be delayed — and denied — for quite as many.
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Wow. This is inspiring -- and sobering at the same time. Because in a sensible system people wouldn't have to wait weeks or months to get a prescription renewed or to obtain a signature on a medical release to play sports. Blessings upon Dr. Bresnahan, the Health Ministry, and all the volunteers who are making this happen. And you're 100% right about health care too long delayed -- too often it's fatal.
Good article to raise awareness of this important issue!