Health Sciences Report Winter 2003

Welcome to the South Main Clinic
Where the Patients Are Grateful and the Staff Is Happy to Serve Them

Photos by Tim Kelly
Text by Cindy Fazzi

At the corner of 33rd South and Main Street in Salt Lake City is a clinic like no other. The young mothers in the waiting room are cheerful despite the crowd. Toddlers wailing like ambulance sirens perk up as soon as they enter the clinic's library. Conversations between medical staff and patients are relaxed and friendly. Nobody appears to be particularly stressed out, or bummed out.

If this Utopian clinic seems as real to you as the non-stop drama of "ER," you can rest assured that the place really exists. It's called South Main Clinic, where patients are grateful, and the staff is happy to serve them.

South Main is a special collaboration by the University of Utah School of Medicine with the Salt Lake Valley Health Department. It offers two types of services: pediatrics and obstetrics-gynecology. The health department provides support staff, children's immunization, and family planning services. The Holy Cross Ministries offers maternal health education. The U Department of Pediatrics and the Department of Obstetrics and Gynecology provide all other medical services.

South Main's mission: to serve a segment of Salt Lake City's population that may not be welcome in other clinics. Most of South Main's patients have little or no insurance coverage. Many are Hispanics who don't speak English.

"Most of the families we serve work very hard, but their jobs don't come with health insurance," said Karen Buchi, M.D., South Main's pediatrics director and associate professor of pediatrics at the U School of Medicine.

To address this issue, South Main has a sliding fee scale. "There is no such thing as free care in this clinic," said Buchi. "Every visit costs something, but patients are allowed to pay according to their own ability."

Buchi turned a small storage room into an improvised pharmacy, where uninsured patients can buy antibiotics and other basic medications at a low cost. The clinic buys the medicines at a wholesale price and sells them at the same cost. Without this arrangement, some patients simply can't afford to buy medicine, said Buchi.

The South Main collaboration began in 1995 as an experiment, with four residents and one faculty member. The pediatrics department had been awarded a grant to train residents to serve a high-risk, underserved population. In the next eight years, the clinic expanded as the population it serves grew. Today, 20 pediatric residents from the U spend their entire three-year outpatient care requirement at South Main. They see up to 40 patients every day and also conduct clinical studies to improve medical care. The clinic's prenatal services, available four half-days a week, serve about 30 women on each of those days. Many more children come for immunization shots daily.

"I enjoy working at South Main, because I can use my Spanish," said Miguel Knochel, a fourth-year medical student at the U, whose mother is from Mexico. Nearly all of South Main's attending physicians are Spanish speakers. All of the clinic's administrative employees are bilingual. "There is also ample opportunity in the clinic to make an impact in preventive medicine," he added.

"Down here, we provide medical care to those who need it most. At the same time, we're fulfilling the University's mission of education," said Buchi.

In fact, education is the reason why South Main has a library instead of a playroom. Under the clinic's "Reach Out and Read" program, young patients get a free book from the library with every well-child visit, starting at age 6 months.

"I believe literacy is the key to good health and success," said Carrie Byington, M.D., associate professor of general pediatrics and infectious diseases and geographic medicine, who started the library in 1998. "If you expose a child to books early, that child can excel in spite of poverty. One child who can read can change the future for an entire family."

Maria Guadalupe Calderon, a 34-year-old mother of four, attested to South Main's importance in her life. She said in her rapid-fire Spanish that she has been visiting the clinic since it first opened. There's no other clinic that she can go to, she added.

Calderon is not alone in recognizing South Main's contributions. The U presented a Diversity Award to the clinic in April. Byington is very proud of the award: "Our clinic is an example of how people with different cultural and economic backgrounds can come together to improve the health and well-being of a community."

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