ROBYN BECK/AFP/Getty Images
Patients receive free dental care at a clinic sponsored by Remote Area Medical (RAM), a Tennessee-based nonprofit, in Los Angeles on April 28, 2010. RAM is offering free medical, vision and dental services to those without health insurance for about 1,200 people per day in the week-long Los Angeles event.
Recap of Remote Area Medical
A complete look at April 29, 2010, the third day of the Remote Area Medical Clinic at the Los Angeles Memorial Sports Arena. RAM is offering free medical, dental, vision and women's health services.
Full story: scpr.org/news/2010/04/29/remote-area-medical-free-clinic-continues/
The first patient Dr. Roger Fiedman, RAM dental director, saw on the first day of RAM taught the volunteers how to do dental triage. The fellow sat down and after looking at his medical history, Fiedman noticed the man was diabetic and had heart disease. The man asked for a filling but once Fiedman looked in his mouth, he saw a different problem. The man’s gums were inflamed and sore and there were harmful deposits all around his teeth. “With a patient like that who is diabetic with heart disease, that can almost be life threatening to that patient,” he said. “They have chronic inflammation of their gums so the absolute best service we could do for him was to clean his teeth, get it all off and get his gums healthier. It can actually help him control his diabetes and heart disease.” Patients receive one of three dental services during their time in the RAM dental clinic. They can choose from either a teeth cleaning, extractions or fillings. Initially, volunteers had a hard time saying no to patients who asked for more than one service, but in the end it hurt volunteer productivity and left patients without any care at all. “The first day what happened was that we really didn’t educate our volunteers well enough,” Fiedman said. “They have big hearts and the patients would say after they did a couple fillings, well can’t you do this filling or that one and they would do some more. At the end of the day while we had the resources to do one service for each person that came we had hundreds of people left because we were moving too slowly.” Learning from the first day, Fieldman said they were adamant about patients getting one service and everything ran much smoother. “When they come in they go to dental triage,” he said. “We find out what the one service is that is most beneficial for you, We decide on that service, we provide that service and we’ve done the best we can.” Medical advice from Dr. Natalie Nevins Download
The advice that RAM Director Dr. Natalie Nevins gives to all of her volunteers is for them to act human. A lot of the RAM patients are in huge amounts of pain, so she said to think about what it would like to walk a mile in their shoes. “Our biggest goal was to treat these patients with dignity, not as cattle, and to have them feel as they move from one area to the next that they are really getting the best care they can be getting” Nevins said. “It doesn’t matter if it’s free or not, it shouldn’t feel like it’s a secondary kind of care that I think a lot of people expect if it’s free. I want them to know that we care even more because it’s free.” Nevins said the clinic brings out a lot of patients who need care but haven’t been able to get it. The most heartbreaking, she said, are all of the diabetics. They often know they have diabetes but aren’t on medication. “There is one lady I saw yesterday who hasn’t taken her meds for six years,” Nevins said. “I can only imagine, once we get her into the clinic for follow up, how bad her kidneys and heart and everything else is because she’s been off of her medication for both blood pressure and diabetes for six years.” Although some of their lack of knowledge about their health is a little disappointing to Nevins, she said she understands that health education is always readily available for the taking. “Your car comes with an owners manual, your toaster comes with one, but you didn’t come with one,” Nevins said. “We make presumptions that people should know how to take care of themselves and that is a really unfair presumption for patients. It’s really important that we remember, especially for health practitioners, that what we think is common sense. ... well common to who?” Overall, Nevins said RAM is going better this year than last year. While the RAM organization has helped to put the event together, it is the volunteers that really made it possible. “When we come together as a team, look at what we are capable of doing,” she said. “We appreciate RAM coming out but they are not the ones that are here doing the work. They aren’t the practitioners, the general volunteers, it’s the community here in Los Angeles who realized there was a need and decided to come out and give back to their fellow community members. That’s what makes all the difference in the world.” LA County Supervisor sees familiar faces at clinic Everyone who needed it showed up at RAM, said LA County Supervisor Ridley-Thomas, 2nd District. “I’ve seen part-time county employees, retired county employees, neighborhood activists, some of my high school classmates, people from various houses of worship that I relate to in the dispatch of duties,” he said. “Everybody’s here and it’s a wonderful time.” Having been a part of the planning process since November 2009, Ridley-Thomas is pleased with the way RAM is going and the amount of people that have come out for health-related services. “This year we’re doing it better and more efficiently,” he said. “It's just the right thing to do in light of the health care needs of the people of this country. This is the epicenter of the uninsured or the underinsured. Not necessarily the unemployed, a number of people here do have jobs, but their insurance is either minimal or nonexistent.” One of the major problems with RAM is that there are simply not enough health practitioners in California who can volunteer for the event. Ridley-Thomas said a bill from Speaker Emeritus Karen Bass will help to fix that problem. “This bill will make it possible for health care providers, particularly physicians and dentists, to provide voluntary services for a specific amount of time in the state of California,” he said of AB 2699 . “If that were to happen, we would have no shortage of providers at events like RAM LA.” “The fact that we’re here at the Sports Arena is a function of the coliseum commission voting affirmatively and unanimously to bring this here because it is a much more effective venue to carry these services forward. the good news in that regard is that you have a high level of public and private collaboration and partnership and all of what you see, the thousands of people who are being helped, serviced, given high quality care are being able to experience that as a result of a lot of volunteers, not simply those who are providing the services but those who are carrying waters, boxes, doing the technology and the range of other things that make it possible for this event to happen. Frankly, it’s gone so smoothly, it’s really rather incredible. - Alex Cohen Updated 9:44 p.m. | Permalink Health should be an inalienable right Permalink Dentists happy to provide root canals Permalink Living without health coverage After not having insurance for 20 years, 62-year-old Anthony James has come to RAM for all of his basic health needs. While he has worked his whole life, many of the jobs, such as building manager, did not give health insurance. “I take care of myself because I don’t have insurance,” he said. “When my grandmother was living, she was a school teacher and I was under her under Kaiser, but when she passed you lose. So, what can you do?” James said he heard about RAM on the news Monday, April 26 at 4:30 p.m. He jumped up, got on the bus and came down to get a wristband. Today, he was able to take care of dental and vision. “The last time I went to the doctor was a year and a half ago,” he said. - Marla Schevker & Brian Watt Updated 2:54 p.m. | Permalink USC grad students see faces, not statistics, of uninsured Not only is this a chance for Los Angeles residents to receive free health care, but also a learning opportunity for assistant professor Greg Stephens’ grad students in the USC public health program. “We had talked with the coordinators of RAM early on about trying to get some information about the patients they are seeing,” Stephens said. “We are giving back some of the information that we are getting.” The students are asking patients coming out of the different areas questions about their level of insurance, if any, and what is happening afterward in regards to their health. They learned some interesting things from talking with people leaving the dental clinic – those whose mouths were not filled with gauze from an extraction. “A good number of them actually have insurance coverage,” Stephens said. “The Medicaid program here in California is still up and running, but they have canceled the dental coverage.” Even if an individual has an insurance like Medi-Cal and has been seeing a doctor for years, Stephens said, doctors are finding it too expensive to take their insurance. “Their only option is to show up at an event like this,” he said. “Dental issues are huge – you have to find charity dental providers to help you. That’s what they are showing up here for.” Overall, Stephens said gathering data at RAM is a good experience for his students. “I don’t think they usually get to see face-to-face the families that they hear the statistics about,” he said. “They hear the percentage of uninsured persons who can’t see a dentist, but when you go out here and get to talk to them, it’s a lot more interesting and a lot more valuable.” - Marla Schevker & Brian Watt Updated 2:33 p.m. | Permalink USC Mobile Dental Clinic at RAM Permalink Another thousand get medical care at LA Remote Area Medical clinic More than 1,000 Southern Californians are moving through the L.A. Memorial Sports Arena to get medical and dental care on the third day of RAM. That's Remote Area Medical – the Tennessee-based group that travels the country to put on free clinics. Curtis Johnson came up from Compton for some dental work and new eyeglasses. He says the dentist told him his teeth were perfect. And the glasses? "They can't make the eyeglasses that I really need, so what they did was they gave me a voucher and a place to go. There's three different ophthalmologists that I can go to, and they're around the city. So I'll be going to them and they gave me a voucher to give to them." Johnson says he used to work as a truck driver until the company went out of business. "Yeah, I did have health insurance. As a matter of fact, I had Kaiser. I still have it right now – but I can't afford it. I can't afford the co-payments or the medicine. I get all my medicine from the county." Remote Area Medical runs through Monday at the Sports Arena. - Nick Roman Updated 12:46 p.m. | Permalink
RAM statistics: Thousands of patients in clinic's first 2 days
Over 6,300 wristbands were distributed for the clinic. As of Wednesday, 2,260 total patients had been registered, including 122 age 18 and younger. These included 1,136 dental visits, 169 pap smears, 120 mammograms and 275 podiatry visits. There were 500 vision visits on Wednesday by 2 p.m.
- Mike Roe Updated 11:18 a.m. | Permalink 62-year-old woman seeks dental help at RAM free clinic Lyn Whitten, 62, needs dentures. Her upper jaw is smattered with holes where teeth should be, her cracked teeth and broken crowns making up the rest. She was laid off from Hughes Aircraft, or put in early retirement, as she likes to put it, 15 years ago. Being on Medicaid, she still has some health insurance. But, dental isn’t covered. So Whitten, along with the other 400 people in her wristband group, came to the Remote Area Medical free clinic located at the Los Angeles Memorial Sports Arena to receive, among other things, free dental care. “They won’t do dentures,” she said. “But at least they can extract a few. I’m not covered for dental and to get them pulled would be costly.” Whitten drove from Santa Monica for her dental care. While she has had teeth extracted before, it was in an official dentist office complete with nitrous oxide. She said she was here to pay the “price of vanity and beauty,” but in reality she needs the dentures to be able to eat. “I’m scared [of the extractions],” she said. “But getting dentures will be the cheapest way to go, and here I can get a referral.” In addition to free dental care, the RAM also offers vision, acupuncture, gynecology, pediatrics and more. Nelson Ramos, 25, doesn’t have insurance, but does need glasses. Although he hadn’t heard of RAM until he got his wristband, he said he’s found it to be helpful. “I’ve had problems seeing since I was a kid,” Ramos said. “Money is limited for me but I’m trying to save for Lasik surgery.” Enticed by a free eye exam and glasses, Ramos came from Pico Union so he could put the money he would have had to spend on his vision to better use. “Vision is very important to human beings,” he said. “Without it, it limits a lot of what you can do.” - Marla Schevker