Faison’s been at BHC since last June as part of her commitment to National Health Service Corps to pay off her medical tuition. She works at the Ensley clinic, one of five in Birmingham serving primarily low and no-income residents.
“We’re right off the interstate and around the corner from a catholic school. We do sports physicals as a community service for them,” Faison says.
Birmingham Health Care, a nonprofit, was initially started in 1983 to serve the homeless in the city. The downtown clinic still does. But at the Ensley clinic, Faison sees mostly Medicaid patients and the unemployed in the area’s working class.
“We charge on a sliding scale based on their income,” Faison says. Most patients pay $35 for an office visit that includes most of what they need, barring prescriptions. “If they come in with a cold or they have five different problems and need an EKG, they both still pay $35. It’s a good service.”
Faison’s not called on to work odd or lengthy hours. She works eight to five, Monday through Friday, plus a normal call schedule. “It’s like anywhere else with on-call. We’re on maybe once every six weeks here,” she says.
“Basically what I see is the run of the mill internal medicine stuff — uncontrolled diabetes, blood pressure, a lot of back pain. I’m working on getting more kids coming to the clinic.”
The hardest part of the job right now, she says, is if a patient needs specialty care, like surgery or a cardiologist. “This has especially become an issue with Cooper Green closing,” Faison says. She’s called on UAB Charity Care multiple times. “I have had luck there. I’ve called doctors on the phone, and they’re really receptive, but you try to use that wisely.”
Faison says she doesn’t see any out of the ordinary things with this patient base other than a large problem with non-compliance. “Quite a few were concerned that their medication would cause them harm or have a side effect, because they see all the lawyer claims on TV about medications harming people,” she says. “Or they think they don’t really need it, because doctors only prescribe drugs to get kickbacks from the drug company. That part can be kind of frustrating.”
Interestingly, the patient base she recruited from the mental health center in the neighborhood has produced some of her best patients. “They‘re supervised, so they’re really compliant. And when I see them, they’re respectful, and they’re on time or even early,” Faison says.
Unlike most primary care physicians, Faison often can’t just send patients out the door with a prescription. “Many patients don’t have an extra $20 or $30 for meds,” she says. Though BHC runs a pharmacy downtown where they give very deep discounts, “if you don’t have a job, you may still not have the $10. And if someone is on five meds, it may be a decision of grocery money versus medicine.”
So Faison spends hours looking into drug assistance programs and reaching out to drug reps for samples. “I’ve paid for patients’ meds out of my own pocket before, and I’m sure I’ll do it again,” she says. “I can get frustrated that the resources may not be there when I want to do more.”
But other days, working for a non-profit clinic offers her surprising benefits. “I really fell in love with the patients here, and the passion behind the organization,” Faison says. “There’s a feeling that you’re not just numbers, but that the administration really does care about the patients.”
Last December, the BHC administration let Faison open the Ensley clinic for a Christmas party for the housing project across the street. “The security guard was Santa, and my nurse was an elf. We had raffles for turkeys and gift cards, and we had a speech contest. We gave them trophies,” Faison says. “It was good for us. I wanted to be sure they knew a primary care physician was in the community. And it was also fun.
“I can do as much community service as I want, and the organization is behind me,” Faison says. “There’s limits in the financial things I can do, but there’s a really good opportunity to make a difference and let people know I care about them.”
The day before, her new patient was a 90-year-old woman who talked about using her Hancock Fabric discount card to sew a dress for her senior citizen pageant. “She’d come in second, and the prize was six cases of Ensure,” Faison says. “I’m thinking, how precious is this? Who listens to her tell this stuff anymore? That’s what is so awesome about primary care — it’s something different every day and you get to build these relationships with people.”
