1. Medical Volunteering in the Community G. Paul Doxey, M.D. St. George, Utah

2. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE (Formerly the Doctors Free Clinic)

3. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE I

4. Presentation by: G. Paul Doxey, M.D., Chairman of the Board of Trustees Gary Lambert, M.D., Medical Director Deanne Staheli, R.N., Clinic Director

5. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE non-governmental privately funded Medical Clinic non-governmental privately funded Medical Clinic targets patients without health insurance, which means if patients have Medicaid (welfare), Medicare, or other insurance, we dont see them targets patients without health insurance, which means if patients have Medicaid (welfare), Medicare, or other insurance, we dont see them low operating budget low operating budget mostly staffed by retired volunteer doctors, dentists, and therapists mostly staffed by retired volunteer doctors, dentists, and therapists Short term medical, dental and mental health issues Short term medical, dental and mental health issues supported by many organizations including the United Way, IHC Charities, private donations, etc supported by many organizations including the United Way, IHC Charities, private donations, etc

6. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE History: History: 1. founded by the Washington County Medical 1. founded by the Washington County Medical Association and Medical Alliance in 1999 to address the problem of the uninsured 2. housed at the Dixie Care and Share from 1999-2002 3. moved to the present site at 1036 Riverside Drive in 2002 at Trailhead for city jogging path

7. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE History (cont) History (cont) 4. land (valued at $500,000) for building by a local family 5. building was mostly donated materials and labor by the SUHBA 6. City of St. George bought part of the land from DVC for Trailhead and now shares parking lot

8. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE Current operational status of DVC Current operational status of DVC 1.One fulltime employee, two part time 2. Approximately 34 volunteers: 7 doctors, 5 dentists, 6 nurses, 3 psychologists, 3 nurse practitioners, and 10 secretarial helpers 3. $100,000/ year operational expenses 4. Clinic will supply needed medications, arrange for free or reduced cost medicines, or pay for them ourselves

9. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE How many patients/year and whom do we see? How many patients/year and whom do we see? 1. 2003: 4,058 patient visits 2004: 4,272 patient visits 2005: 6,329 patient visits 2006: 6,867 patient visits, of which 1,511 (22%) were for mental health encounters. This includes emotional disorders plus alcohol and drug detoxification. 2007: At the present rate, we will see approximately 8,800 patients this year.

10. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE 2006: 2006: 98.1% of our patients were from Washington County 98.1% of our patients were from Washington County 95% were United States Citizens 95% were United States Citizens 17% were children 17% were children 65% of adults were employed 65% of adults were employed 15% were Hispanic 15% were Hispanic

11. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE 1. Criteria for eligibility is 150% of the poverty level ($1,226/year for family of 1, or 4,321 for family of 8) 1. Criteria for eligibility is 150% of the poverty level ($1,226/year for family of 1, or 4,321 for family of 8) 2. 60% of our patients are employed 2. 60% of our patients are employed 3. 50% are High School or College graduates 3. 50% are High School or College graduates 4. We averaged 35 patient visits/day last year 4. We averaged 35 patient visits/day last year

12. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE Board of Directors – 11 members from our community Board of Directors – 11 members from our community Finances are monitored by a CPA Finances are monitored by a CPA 501c3 organization 501c3 organization 2002 Award for Rural Clinic of the Year 2002 Award for Rural Clinic of the Year

13. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE How do we interact with you? How do we interact with you? Follow-up from the ED, Instacare and hospitalized patients including behavioral medicine will be able to be seen within one week of discharge for ongoing care and help with the cost of medications. Follow-up from the ED, Instacare and hospitalized patients including behavioral medicine will be able to be seen within one week of discharge for ongoing care and help with the cost of medications. This includes medical and pediatric outpatient care, non- surgical gyn patients, orthopedic to include undisplaced fracture care, minor trauma care, dental care, and mental heath access to counseling and psychiatry. This includes medical and pediatric outpatient care, non- surgical gyn patients, orthopedic to include undisplaced fracture care, minor trauma care, dental care, and mental heath access to counseling and psychiatry. We also are a referral resource for patients who want to detox from alcohol or substance abuse. We also are a referral resource for patients who want to detox from alcohol or substance abuse. Limited access to subspecialty consultation utilizing the physician referral program which allows our patients one free or discounted consult. Limited access to subspecialty consultation utilizing the physician referral program which allows our patients one free or discounted consult. STD testing and womens health. STD testing and womens health.

14. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE We do not: We do not: Offer a continuous supply of sample medications. Offer a continuous supply of sample medications. Have the equipment or time to do elective minor sterile surgical procedures Have the equipment or time to do elective minor sterile surgical procedures Prescribe narcotics for chronic pain problems. Prescribe narcotics for chronic pain problems.

15. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE Relationship to DRMC Relationship to DRMC Routine x-rays, ultrasounds, labs are graciously donated, with no cost to the patient or clinic. Routine x-rays, ultrasounds, labs are graciously donated, with no cost to the patient or clinic. IHC has donated each year to our general fund. IHC has donated each year to our general fund. Physicians, nurses, physical therapists, pharmacists,, IT, allied health professionals, and administrators have volunteered their time to the patients we see. Physicians, nurses, physical therapists, pharmacists,, IT, allied health professionals, and administrators have volunteered their time to the patients we see.

16. DOCTORS FREE CLINIC OF SAINT GEORGE Why do I Volunteer? Why do I Volunteer? Medicine as it should be Medicine as it should be Patients are universally appreciative Patients are universally appreciative Good feeling at the clinic Good feeling at the clinic Treating the patient and not protecting yourself from liability Treating the patient and not protecting yourself from liability Satisfaction at the end of the day Satisfaction at the end of the day

17. Video Presentation

18. DOCTORS VOLUNTEER CLINIC OF SAINT GEORGE Private (non-governmental) effort by a community to address a community problem Private (non-governmental) effort by a community to address a community problem Reduces inappropriate visits to the local ED at Dixie Regional Reduces inappropriate visits to the local ED at Dixie Regional Access to medical, dental and psycho-logical care by the people caught in the middle between welfare and private insurance Access to medical, dental and psycho-logical care by the people caught in the middle between welfare and private insurance Questions? Questions?