Summer Series 2023: Good Neighbor Health Clinic

Funding Source: Jaharis Primary Care

This summer, I am volunteering at the Good Neighbor Health Clinic in White River Junction, Vermont. Good Neighbor is a primary care and dental clinic that offers free services to uninsured and underinsured individuals residing in the greater Upper Valley. The clinic is small, but mighty. With the support of generous community donations and talented clinical and nonclinical volunteers, Good Neighbor works tirelessly to care for the local community by serving a panel of over one thousand patients. My arrival at the clinic came shortly after that of our new executive director, volunteer coordinator, and LNA. This summer was the perfect time to join Good Neighbor — there is always fresh energy in the clinic, and a consistent focus on improving our services.

It is easy to hear when someone opens the clinic’s front door and takes the stairs up to the door of our waiting room. Upon hearing these distinct sounds, I look up from my computer or paper and anticipate who will walk in. When the door opens, it could be anyone. It might just be the USPS worker dropping off our daily mail, it could be our first patient of the day, a brand new patient, or even something a bit rarer (e.g., an unexpected visit from one of our patients suffering from schizophrenia or a patient suffering from emergent chest pain). With the uncertainties of each day and each visit, I have seen the importance of the staff’s flexibility and go-with-the-flow attitude.

In turn, my role at Good Neighbor has also been quite flexible so far. This is a product of the flux that is always present at Good Neighbor; some days, we see 6-10 patients and other days we see only 2 or 3 patients, depending on scheduling and rates of no-shows. On the days when we have more patients scheduled, my role is more clinical. I will greet patients as they come in, take blood pressures, pulse, height and weight, and then shadow during the rest of their visit. I have even started presenting patients to the attending physician for briefing, a critical skill to hone throughout medical school and residency. Through this experience I have learned about the importance of more nuanced observations of the patient’s appearance and well-being; an understanding of a patient’s acute concern/injury as well as their current financial situation, living arrangements, employment, and prior history is crucial to shaping the physician-patient relationship and the course of treatment. As an aspiring physician, I have been especially appreciative of the opportunity to consistently engage with patients and push myself out of my comfort zone.

On days that our patient load is lighter, I have been assisting with more administrative duties like mailing out letters for donations, putting together gift baskets, cleaning out inventory, and answering phones. While these projects might appear to be less glamorous, the staff has been very appreciative of my work in these roles in addition to a more clinical position. Any efforts towards making the clinic run smoothly, or widening the clinic’s volunteer/donation base, truly help our patients in the end.

In my clinical role, I have been especially captivated by the many hoops that Good Neighbor and their patients must jump through (or sidestep, better yet) to maximize care. Currently, our clinic is unable to treat individuals with Medicaid — since we are not an enrolled Medicaid provider, we cannot order, refer, or prescribe for patients with Medicaid. However, there is an alarming gap in care for low-income individuals with Medicaid, given that there are nearly no primary care providers in the greater Upper Valley region who are taking new patients. As such, Good Neighbor is receiving an increasing volume of calls from patients with Medicaid that cannot find treatment elsewhere, and we are legally unable to help them. Enrollment with Medicaid could be in the future of Good Neighbor, but this small clinic may be overwhelmed by a huge influx of new patients if that were to happen. However, the staff is adept at finding gray areas in which they can provide care to patients in need; this could mean making calls to financial assistance programs, other physicians/clinics in the area, or utilizing relationships with local pharmacies.

My experience with GNHC has only reaffirmed my desire for a career in medicine. Despite the myriad of barriers and challenges to providing care for our patient base, the providers are always focused on their patient’s well-being, creating a comfortable and inclusive environment at Good Neighbor, and taking whatever steps necessary to ensure that the patients receive the correct medications, follow-ups, and tests. This often means that providers go above and beyond to meet with patients for an hour or more, fully explain any diagnoses and treatment plans, and gain a holistic view of their patient’s unique needs. I have been equally impressed with the resilience and resourcefulness of our patients, who have shown a strong commitment to their own health and wellness. I am grateful to the CCPA and the Jaharis Primary Care Fund for giving me the opportunity to engage with patients in my own community, assist with their care, and learn from talented clinicians. I am excited for the new experiences to come over the course of the summer!