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Health in Limbo


This morning at a free medical clinic on the East Side of Detroit, I was able to take care of a great man caught in limbo with his health and the health care system. The Robert R. Frank, M.D. Student Run Free Clinic takes care of patients who are living without health insurance. Many of the clinic’s patients have jobs that do not provide health insurance and they generally do not make enough money to purchase health insurance on their own. As a result, there are not many places where they can receive affordable, comprehensive, and compassionate care. Fortunately, a handful of students at Wayne State University School of Medicine formed the Student Run Free Clinic in 2009 to serve patients in situations like these.

The man who came in today is a small business owner; he works on homes and makes a living wage, but is unable to purchase health insurance for himself. He initially presented with back pain one year ago and returned to the clinic today for follow-up. Additionally, he had a complaint of chest pain. His family history is significant for multiple heart attacks and coronary artery bypass grafting, and it was determined that he should undergo stress testing to rule out deficient blood flow to the heart. Unfortunately, without health insurance, this man cannot afford stress testing, and the SRFC has not yet established contacts in Metro Detroit that would provide such testing for free.

What to do? This man obviously wants to take a pro-active role in his health and wellness, but is not able to pay for the services that would help him the most. Unfortunately, his situation is not unique — there are many such patients like this within our clinic and across the country. Is it really more cost effective for us, as a society, to allow people to reach terminal illness and disability before we act to help them? Is an emergency room visit when the disease has progressed too far the best way to treat these types of patients? These are questions that have been answered in part by the Affordable Care Act and its constitutionality determination in the Supreme Court.

As a student, I want this man to continue to have an active role in his health and wellness, but I can understand how discouraging it must be to have cost as a barrier to better health. I really enjoy delving into medical knowledge and using what I know to help others become healthier, but it often times comes with a measure of frustration. I know that more comprehensive health care will become more available with the Affordable Care Act, but what can be done in the mean time? Do we continue as is, and reassure our patients that things will look up soon? Do we make donations to local free clinics? It is a harsh reality that our patients face each day — a choice between better health care financed out-of-pocket or maintaining the lifestyle that they desire (paying for their mortgages/rent/cars/groceries/etc…) and it leaves me wanting to be able to do more.

Paul Thomas Paul Thomas (3 Posts)

Contributing Writer Emeritus

Wayne State University School of Medicine


Critical thinker, photographer, and writer, Paul Thomas has an unquenchable thirst for knowledge and understanding. He studied biology and bioethics at Michigan State and is finishing his medical degree at Wayne State. His clinical skills have been enhanced by serving the uninsured in Detroit and by learning from patients with unique challenges.

Recently, Paul has been trying to cure a severe case of wanderlust — cross country road trips and backpacking adventures have thus far been unsuccessful. He once came in second place in a three-legged race, which both cemented his status as a good team player and reminded him of his own fallibility. He blogs, he tweets, and he holds merit badges in astronomy and motorboating.