Clinic offers frontline care to uninsured
BY KAREN BERKOWITZ kberkowitz@Pioneerlocal.com August 6, 2013 8:24PM
Nurse practitioner Marjorie Kozlowski gives a kindergarten physical to Maya Knopfhart, 5, of Grayslake, at the Fenix Family Health Center in Highwood. | Karen Berkowitz-Sun Times Media
Updated: September 8, 2013 6:18AM
Leading a tour of her storefront health clinic in Highwood, Dr. Louise Berner points out some donations and bargains that enabled her to open on a shoestring budget.
“We’re showing that you don’t need a lot of money to start a clinic,” said Berner, founder of the non-profit Fenix Family Health Center.
The waiting room furniture and cabinets came from IKEA. The examining-room tables were either donated or purchased on eBay.
“This examining table was $100 off eBay,” said Berner. “A new one would cost between $1,500 to $15,000.”
She was able to have them reupholstered at no charge by a woman who believes in the clinic’s mission: To provide low-cost, accessible primary care in the Spanish-speaking community.
The 3-year-old clinic also keeps overhead down by sharing its space at 130 Washington St. with a chiropractic clinic.
The physician hopes to demonstrate the cost-effectiveness of such frontline clinics in addressing the lack of health care options for the poor, uninsured and underinsured. She believes the system can work if patients have a primary care clinic to call.
While fulfilling her residency at Cook County Hospital, Berner regularly handled cases in which a patient ran out of a $3 drug or stopped taking his or her insulin, leading to serious complications and a hospital admission that could run into the tens of thousands of dollars.
“That happened over and over and over again,” she said. “That is just dumb.”
Berner also saw patients turn to the emergency room for primary care issues as routine as urinary tract infections or diaper rash.
“They would call somewhere and be told, ‘Go to the ER,” said Berner, who holds a medical degree from Rush University Medical School in Chicago. “Then it’s on someone else’s nickel.
“We tell them, ‘Come here,’” Berner continued, noting that many routine issues also can be talked through over the phone. “As a citizen, I don’t want them going to the ER for diaper rash. I’m paying for that; we are all paying for that.”
Before opening Fenix, Berner researched the reasons patients don’t access what health care is available. At many clinics, the “no show” rate can run as high as 60 to 90 percent after patients have scheduled an appointment. She said that results in a waste of professionals’ time and health care resources.
That inefficiency can be reduced dramatically when patients are given a same-day appointment, Berner added. Patients also are more likely to keep a future appointment if they are able to see the same clinician, Berner noted.
The Fenix staff also is bilingual and culturally sensitive to patients’ predispositions and understanding of issues.
Berner provided an example of new mothers who go into a panic at the first sign of infant vomiting and diarrhea because bacteria-based diseases are a leading cause of infant mortality in many third-world countries.
“It is our responsibility to train them,” said Berner, who has five clinicians on staff.
The concept of refilling a prescription also can be foreign.
“When you give them medicine for high blood pressure or diabetes, we have to explain the difference between a cure and treatment,” she said, noting a patient will wonder why they still have high blood pressure after taking the 30-day supply of pills from the last doctor.
Berner believes primary care physicians also are well-positioned to recognize mental health issues, so psychiatric care is integrated into the Highwood practice.
“Most patients don’t come in and say, ‘I have depression,’” she said. “They say, ‘I have a stomach ache or I have a tight feeling in my throat and I feel as if I can’t breathe.’”
About 50 percent of patients at Fenix Family Health Center come from the immediate area of Highwood and Highland Park. Another 40 percent come from other areas of Lake County areas including Waukegan, North Chicago, Gurnee and Round Lake Beach.
Highwood resident Denia Arreola, the clinical manager at Fenix, said the clinic fulfills a dream she’s had for a long time and is meeting a need in the community.
“Patients don’t have insurance,” she said. “They have low income. When they get sick they don’t have a place to go. Here they feel welcome.”
One-half of Fenix patients are children, which means they automatically have Medicaid coverage through the All Kids program. Nearly 40 percent have no insurance and 9 percent have private insurance, but with high deductibles.
The clinic’s fee structure is $50 for an initial visit and $35 for subsequent visits.