Well, as is the case over much of the country, free or inexpensive clinics are overrun with patients. Many of the users of the systems are poor Americans, not just undocumented immigrants. This is the case with the clinic in our hospital. Since our clinic is “nicer” than the others in the area (and I mean it is cleaner with nicer staff), we get people coming from relatively far away to utilise our services. As a result, the place is a zoo. People wait months for their first appointment and sometimes longer to see a specialist. This is made worse by the fact the state government has cut the funding to it starting in 2009. Who absorbs all the run off? The ER. It has gotten so busy that our clinic is not accepting new patients PERIOD – unless you are referred by the ER or are admitted to the hospital. As a result, people are going there to sign up for routine medical care or to have chronic complaints evaluated and are told to go to the ER for a referral. What a night mare! Yesterday I had three patients who came in simply for that – and I don’t blame them now that I know what is happening. I am being forced to waste my time and resources on providing referrals for ROUTINE care – not fore even remotely emergent conditions! Stuff like ” I need a physical” or “High blood pressure runs in my family – I want to be checked for it”. Of course these are all charity cases too. I don’t mind helping but this is a bad policy. Fortunately, I heard the other day that a truly free clinic is opening a town over being funded entirely by volunteers and donations – and they want referrals. I am going to start sending them.