Kristen Frankel spends 14 hours a day learning about health care administration.
The newly hired assistant director at Lake Norman Free Clinic started as a volunteer doing new patient screenings - a duty she insists on performing still to connect with patients.
The Huntersville clinic recently expanded its services for the uninsured, thanks to a state grant from the N.C. Office of Rural Health & Community Care. $175,000 will be awarded annually for three years and divided among other area nonprofits, including the Ada Jenkins Center, Matthews Free Clinic and Charlotte Community Health Center.
The clinic's portion of the grant will help provide salaries to Frankel, a nurse practitioner, a certified medical assistant and a lab technician. The clinic also is funded, in part, by private donations and four area churches that give a percentage of their offerings to the clinic each year.
"You can just see how needed this service is," said Frankel. "We're seeing huge, huge growth...all tied to the grant. And it's a first for us in so many ways. We have open appointments and we just really want to get the word out."
In August, Frankel will celebrate her one-year anniversary with the clinic. Born in Atlanta and raised in Mooresville, the Lake Norman High School and N.C. State graduate is two years away from earning her master's in health care administration from UNC-Charlotte. She lives in Davidson and works 30 hours a week at the clinic while taking night classes in Charlotte.
For her, interacting with the patients is what keeps her so engaged.
There's the recent transplant who moved from New York with his family of six - all of them without insurance until they visited the clinic. He now mows the facilities lawn each week to show his appreciation.
Patients have donated their time and skills to stain the front porch and help with overall facility upkeep. Another helped Frankel re-wire her computer.
"Each one of these patients has a unique story like that, so it's important to me to get to know them," she said. "They come in, they're tense, they're scared and they don't know what to expect from a free clinic. It's heartbreaking but it's also encouraging because nothing feels better than seeing someone's face - their worry and their pain disappear - after we tell them, 'This is what we can do. This is what we can give you. This is how your life is going to change.' I've had people cry just sitting in my office."
Adrian Cobb, 39, of Huntersville is a great example of the kind of patient Frankel hopes to reach.
Cobb hadn't seen a doctor in at least 12 years before he visited the clinic last week for back pain and trouble breathing. His step-mother told him about the free clinic. He was told he could have anything from sciatica to the beginning stages of emphysema. He will have follow-up visits with a cardiologist and a sleep specialist within the month, he said.
"It's pretty serious stuff," he said. "I had no doubt that if I didn't go, I'd be dead within the next six months. When she told me, 'Let's get you back to see a doctor,' I was like, 'Oh, I made it.' I was amazed at the very least. Now, I don't have to suffer. I'm really grateful they're here."
The former electrician's helper has been unemployed for two years and his reason for not seeing a doctor for so long was simple.
"Prices," he said. "You can't afford doctors nowadays."
A brief history
Dr. David Cook of Lakeside Family Physicians founded the clinic in 1999 in order to serve a growing need within Hispanic community. He began seeing four to five uninsured patients per week but that number rose quickly.
"Word spread like crazy and before he knew it, there were 40-50 people lined up to see him on Wednesday evenings," said Frankel.
Based out of First Baptist Church of Huntersville until about three years ago, the new facility has six exam rooms, a waiting room for about 50 people, a triage room, a conference room for patient education classes and three private offices. It is located off U.S. 21 on Hunters Road in Huntersville.
One of the greatest benefits of the grant is it has elevated the clinic's ability to provide more customized, one-on-one attention to patients.
The clinic has served at least 3,000 patients since 2001. During its first three years, the clinic was open one day a week for about three hours, offering about 2,000 patients appointments annually on a $9,500 budget.
Today, it is open 30 hours a week, offering about 5,750 appointments a year on a $135,000 budget (not including the grant). With staff salaries its about $265,000. The clinic also will have its $400,000 mortgage paid off in December.
The clinic gets about 25 new patients weekly and has added 340 new patients since January, Frankel said. About half of the clinic's 100 volunteers are medical professionals and many patients also volunteer regularly.
A family of four making less than $55,125 year ($4,593 a month), or an individual making less than $27,075 a year ($2,256 a month) may qualify for free medical care.
"I have very few people who don't qualify," she said.
When it comes to combating such chronic care issues as diabetes and hypertension, Frankel believes patient education and continuous, preventive care are among the best solutions, especially for those without insurance.
"I think the systems in place are very inefficient and cost a lot of money," said Frankel. "I believe we need to be combating preventatively. We need to get these patients in and educate them. They may hear they have diabetes, but they don't necessarily know what that means. We are designing a new way for health care to be provided to people. We're restructuring it to personalize the evaluation and care for them, but it has to be inexpensive and efficient. We don't want to provide them with just a Band-Aid, we want to put them on a system that will improve their health."
Chronic care issues are the clinic's focus; they're being discovered more frequently during the new patient screening process.
If it weren't for the clinic, Frankel said the community could easily feel the effects of other people's chronic medical conditions going untreated.
"What happens is they don't see a doctor cause they can't afford it," she said. "So, they get continuously worse and worse and worse until it gets to the point where they're going to the emergency room and racking up major, major medical bills that all of us are paying for.
"Our goal here is to give them the preventative care, show them how to change their health patterns, how to combat the disease that have, so they don't end up in the emergency room."
One recently screened patient had five chronic care issues, including acid reflux, diabetes, coronary artery and high blood pressure. After an hour-long appointment with a nurse practitioner to evaluate care needs, she went on to receive weekly appointments with a nutritionist.
"The nutritionist really shows her how to test (for diabetes), how to use the medications she gets - really works with her diet, works with her exercise and goes slowly through all the different stages to really put her on a path to combat the disease."
Frankel would like to see the facility evolve into a full-service "medical home" for those without insurance within the next five years, as well as continue to develop area partnerships with other nonprofits or community organizations to maximize community care.
"The sky's the limit," she said. "When I leave, I'd really like to leave this place knowing we reached our maximum capacity for all the things we can do. It's just so great to see a full waiting room during the day. I continue to meet so many amazing patients."