The long years of medical school and training to become a surgical oncologist were well worth it to Dr. Katherine Morris. Dr. Morris practices at Legacy Good Samaritan Hospital and Medical Center and volunteers for Project Access of Multnomah County. But many times, the health care system is far more tiring than any of the long hours she once spent as an intern and resident.
Like many health care providers, Dr. Morris occasionally provides free health care for those in need. Federally qualified safety net clinics are available in many communities to give care, regardless of ability to pay. In Multnomah County, 13 such clinics fall under the umbrella of the Coalition of Community Health Clinics. But when a patient needs more than the safety net can provide, then both patient and doctor face formidable obstacles. Patients may fail to get the care they need. A recent report says that an average of one Oregonian per day dies due to lack of health insurance.
Even when there is a specialist like Dr. Morris willing to provide care, too often the doctor or safety net clinic has to track down and convince other specialists, labs, diagnostic imaging providers and hospitals to give services for free. Cancer surgery can be very complex, Dr. Morris explains. It can involve radiology, anesthesiology, nursing, hospital inpatient services, pathology and support staff such as respiratory and occupational therapy. It requires a great deal of coordination.
“I can do the charity case, but all the other parts have to be arranged by the hospital,” Dr. Morris said. “If I can’t get that support, I can’t do what I need to do.”
Often, coordinating these services—finding the specialists who will provide care for free—will delay surgery by a couple of weeks. If a clinic or hospital takes on too many charity cases, care coordination can use valuable time and resources that could have been spent on diagnosis and treatment.
By recruiting other specialists to join her as a Project Access volunteer, Dr. Morris is looking forward to fewer frustrations for her and other health care providers as well as better care for those in need in Northwest Oregon and Southwest Washington.
“The biggest frustration for physicians and danger for patients are the times when a patient may not have a life-threatening problem just yet can’t afford to get needed treatment,” Dr. Morris said. She recalled a woman who had a lump in her breast and needed surgery. Without health insurance or access to inexpensive care, she had delayed making an appointment with Dr. Morris for several months. By that time, the disease was in an advanced stage and had spread to the woman’s internal organs. “If she had primary care, if she had access to specialty care, it’s highly likely that this would have been caught and she would have had a chance,” Dr. Morris said. But she didn’t. She was not yet 35 years old.
Without Project Access, all the separate components that make up a complicated procedure such as cancer surgery would have to be coordinated by the hospital or physician. “That’s a huge benefit and lifts a huge burden,” Dr. Morris said. “I think it’s a phenomenal program, I am so impressed.”