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Audio Transcript
Samaritan House
SAN MATEO, CALIFORNIA
Host Intro: There are only 300 or so free medical clinics in the United States. They serve some of the roughly 40 million people in this country who don't have health insurance. One of these clinics is in San Mateo, California, a small city just south of San Francisco. There, retired doctors and nurses have responded to the needs of the uninsured by providing health care at no cost. They handle more than 500 appointments each month. As part of a series on the changing face of retirement, Elana Hadler reports:
Narrator: Just over a decade ago, when he was still in private practice, Dr. Bill Schwartz responded to an ad in the San Mateo County medical society bulletin. Samaritan House, a nonprofit organization, was looking for a doctor to start a free clinic to complement their other programs, which feed, clothe, shelter and otherwise support the county's neediest residents. Schwartz, who's 70, says the clinic started small – a one room facility where a handful of physicians saw patients after-hours a few nights a month. But as news of the clinic spread, the steady stream of patients turned into a deluge. The clinic needed more doctors, more nurses, and a lot more space. The space issue was relatively easy to resolve. The bigger challenge was finding practicing physicians who could volunteer during work hours. Then Schwartz retired, and he realized that there had to be people out there like himself – retirees who wanted to practice medicine and help others – but in their own way, on their own time...
Bill Schwartz: I was walking down the street one day and an old patient came up and took me by the shoulder and said, "say you used to be Dr. Schwartz, didn't you?" In other words, because you change when you're retired you're thought of as a different person and in a sense that's not true but I think we like to maintain out identity as long as we can. Dentists, doctors, nurses and others, who spend their lives professionally this way, develop an identity of who they are, their work and their profession is a part of their being, of who they are, of what they are.
Elliott Shubin: I find this to be kind of an island in the chaos, if you will, a little oasis.
Narrator: Dr. Elliott Shubin
Elliott Shubin: Where you can let down your guard and let down your defenses and not have to worry about somebody not pre-approving something that you want to do. The paperwork is almost negligible, except for the chart and the satisfaction that you get in being able to just focus on the patient and take care of the patient is tremendously satisfying.
Narrator: Shubin, who's 59, sees patients twice a month at the Samaritan House Free Clinic of San Mateo. He's one of 35 volunteer doctors. There are only a handful of paid staff members, including a medical director and a clinic administrator. Everyone else ... nurses, dentists, social workers, dietitians and interpreters - nearly 100 of them - are volunteering their time. And the majority are retirees, like 70-year-old John Sarconi ....
John Sarconi: I had no problem with the practice of medicine prior to HMOs. But this is nice because we're unimpaired by all the trappings that go on in modern medicine. I've said again and again, these are the same patients that I learned my medicine from. These are the same people who sat on the benches at the medical schools where I was a student and an intern and a resident, so what goes around comes around. It's come full circle.
AMBIENT SOUND OF SARCONI WITH PATIENT
Narrator: Sarconi's patient, Manuel, fits the profile of many who come through these doors. They are the working poor. People with no insurance ... housekeepers, nannies, busboys, janitors... most get paid minimum wage and many work two to three jobs to try and make ends meet. The majority are immigrants from Latin America, and many are here illegally. Manuel works the night shift, from 2am to 8am, at a local hotel.
MORE AMBIENT SOUND OF EXAM
Narrator: In an adjacent examining room 49-year-old Mary Twieg teaches a patient how to give herself a breast exam.
AMBIENT SOUND OF MEDICAL EXAM
Narrator: Twieg retired five years ago at 44. Six months later she was diagnosed with breast cancer – She's found her calling at the breast care clinic, where she educates woman about preventive care...
Twieg: I knew that I didn't want to work full-time when I had children at home and my husband is a cardiologist who works all the time and it was nice for me to have the opportunity not to have to work full-time. But I wanted to do something and I wanted to be involved with the community and the breast care clinic was an ideal place for me to be of help because I saw the benefit myself of early detection. I caught mine so early I didn't even have to have chemotherapy, I just had surgery and I'm supposed to have a long and healthy life now.
Narrator: More than 50% of doctor/patient interactions at the clinic require an interpreter.
AMBIENT SOUND OF PSYCHIATRIST'S EXAM
Narrator: This young Argentine woman, Maria, has come to the clinic today to talk with a psychiatrist about her depression.
MORE AMBIENT SOUND
Narrator: At the end of the session Maria leaves with a new prescription and an appointment with 68-year-old Gilda Holman, a Spanish-speaking counselor. Holman recently got her masters in psychology so she could volunteer at the clinic...
Gilda Holman: I concentrate on the Hispanic ladies and by doing that and knowing the culture I do not follow the book, the psychology book. I figure that all you need is to be compassionate, be human, logic, and common sense. But most of all be human. Because those people feel very isolated. They don't have anybody to talk to. And when they come to me I don't go by the book. I just say listen I'm here to listen you just say what you feel at the end you know they're, "oh, I love you," and because I'm older they tend to look up to me as being the mother. And that's interesting because, you know, Americans look at old people, ahh, old people, dinosaurs, they don't know, but the other cultures, not all of them, but most cultures tend to look at the older person as somebody who has something to offer.
AMBIENT SOUND OF CARMEN AND DR. GERROLD KAPLAN
Narrator: The retired doctors come to the clinic primarily to see patients, but they also find other benefits there – the chance for social interaction among colleagues and the opportunity to teach medical students and residents who choose Samaritan House as a rotation.
AUDIO OF CARMEN AND DR. GERROLD KAPLAN
Narrator: Dr. Gerrold Kaplan coaches Carmen Partida, a third year medical student at the University of California, San Francisco, who spends two days a week at the clinic seeing patients with retired doctors. Partida says she likes working at the clinic because the doctors have more time and expertise than the ones at the university hospital. One of the most striking things about watching the doctors at work is that they don't rush through their appointments. They take their time and they listen to their patients. They ask questions beyond the obligatory ones. In fact, they're encouraged to take as much time as they need with each patient. And this is important, because most of the patients require a more nuanced approach. Burt Kotin, co-founder of the dental clinic at Samaritan House, says they're also incredibly grateful for the care they receive...
Burt Kotin: A woman from South America required full dentures. The teeth that she has left in her mouth were not salvageable. She couldn't eat, her appearance was greatly diminished, she was very self-conscious, and it was really a health problem. And we made her a full upper and lower set of dentures. One day during a break I was working on her husband and I walked out the front door here, we have a little garden hedge here, and she was on her hands and knees with a little hand scissors and some newspapers, and she was trimming the hedges by hand, picking up old cigarette butts, taking off the dead leaves and making a neat package of all the so-called refuse and garbage. And I said, "you don't have to do this," and she said, "but I want to do this." She says, "this is a little way I can repay you for what you did for us. We have no money, but this is a way of trying to show our gratitude for what you've done for us." And I'll tell you something, that meant so much to me.
Narrator: In order to accommodate increased demand, the clinic is moving into a bigger facility sometime this year. They also expanded their reach by opening a branch in another part of San Mateo County. Even before the new Redwood City clinic officially opened its doors there were retirees, like 71-year-old Walter Bortz, ready to start working. Bortz says to grow old successfully we must participate in life around us...
Walter Bortz: The secret for the mind, for the soul, is engagement. And that's the same idea. If we put our leg or our life in a plastic cast it withers and we don't want our lives withering... our legs or our minds or our spiritualism, these all must be nourished and it takes on increased urgency the older we become. The question that older America is asking is out we a resource or a liability? If we become energy suckers then we drag down the rest of our civilization. On the other hand older people should be an amazing resource. We've lived longer, we've seem more, we've experienced more, our perspectives are very, very valuable and I would like us to stay lashed to the national purpose.
Narrator: In San Mateo, California, I'm Elana Hadler reporting.
