From pro bono services by general practitioners to unreimbursed care by hospitals, charity care has always been a part of the American medical scene. Indeed, organized medicine has always expected a degree of free work from its practitioners.
The idealism and chaos of the radical Sixties revealed a critical need for urban indigent health care. A new kind of clinic – the free clinic – appeared in response. The first free clinic was started in San Francisco. Its success – and the need for its services – are reflected in the fact that it is still in operation.
In Virginia, two free clinics were operating in the Richmond area in the early Seventies. A college student from Roanoke was among the clinics’ volunteers. He was Henry Bell, son of Roanoke physician Huston Bell, and he returned home with a mission.
Henry approached his pastor Dr. George Bowers of St. Mark’s Lutheran Church, with the idea of starting a free clinic in the Roanoke Valley. The church’s congregation did more than approve the idea; it offered the use of a church-owned building on Third Street Southwest and agreed to bear the cost of clinic utilities. The stately structure housed tenants in upstairs rooms; lower levels were used for church youth meetings. Called the Way Inn, the venerable building was perhaps less than ideal for its new mission as a medical clinic. But the Free Clinic of the Roanoke Valley had its first home.
An eight-month campaign was launched to furnish and equip the new clinic. Volunteers fashioned exam gowns from old shirts. Medical supplies and drug samples were collected from local physicians. An old exam table was found in the basement of Lewis-Gale Hospital and given to the clinic. Shower curtains and bed sheets were hung from wires to divide the space into examination “rooms.”
Plastic chairs lined the waiting area. A mud room was transformed into the first dental operatory. A hallway equipped with shelving became the first pharmacy. Dr. Bell’s old student microscope was the first piece of lab equipment.
Local social service agencies, recognizing the need for the clinic’s services, provided financial support in the form of small endowments. Among the donors were TRUST, Planned Parenthood, the Roanoke Council of Community Services and the Children’s Home Society of Virginia.
Dr. Bell served as the clinic’s first board president. Branan Thompson was the first vice president. Harry Swartz became the first treasurer, and other directors were drawn from the community. With sample medications on hand and a donation of $250 for Dr. Henry, the clinic was ready to go.
Richard Surrusco signed on as the first volunteer physician. A recent arrival from New York, where he had volunteered at a free clinic, Dr. Surrusco was acutely aware of the needs of the uninsured, or those who fell into the gap between private insurers and entitlement programs. His wife, Barbara, along with a friend, Barbara Taylor, were the first volunteer nurses. Students from Hollins College (now Hollins University), were among the clinic’s first nonprofessional volunteers.
Another of the original volunteers was Estelle Nichols, a young mother of three, who would later become the free clinic’s first executive director. Little did she know that she would soon assume a critical role in the clinic’s story.
The Free Clinic of the Roanoke Valley opened its doors on Oct. 15, 1974. The need for a means of treating the uninsured respectfully and with care and patience was immediately confirmed. The working poor turned out in large numbers, often crowding the stairways and overflowing into the yard while awaiting their turns. With no central air conditioning, summer clinics were hot and uncomfortable; shorts and T-shirts became the unofficial staff uniform. Board meetings were held in the waiting room. Special procedures and labs were limited; seriously ill patients were quickly transferred to hospital emergency departments.
In addition to providing its services, the clinic had to convince the Roanoke Valley medical community of its intentions and the need for its services. It had to battle the radical (and incorrect) image of free clinics as drug treatment and contraception centers. It had to demonstrate that it was not in competition with private practitioners and that it provided services of true value to a population otherwise unable to obtain regular health care. And it had to prove it was in it for the long run. It quickly became obvious that continuity and clear structure were needed.
They arrived in the person of Mrs. Nichols, who in December became the clinic’s executive director (and first salaried staffer). She was to be paid for “eight hours a week.” Those impossibly short hours were the start of a life-changing commitment for the one-time volunteer, who remains on the job to this day.
Dr. Surrusco helped establish screening criteria, charts and operational procedures. Most of all, week after week, he took care of patients, embodying the clinic’s legacy of caring. He could not solve the problems of all the uninsured, but he could help one individual at a time. He was soon joined by fellow physicians Roger Grady, Houston Bell and John “Lucky” Garvin, and the clinic grew. By February of 1975, a second night clinic had been added.
Dr. Garvin was to play a pivotal role in the growth of the free clinic. As board president for more than 20 years, he provided not only leadership and direction, but the spark for growth. More than any other supporter, Dr. Garvin had the enthusiasm and courage to aim high and always look to the future.
Thanks in large part to the considerable speaking skills of Drs. Garvin and Surrusco, the Academy of Medicine came to value and support the clinic. Support also arrived in the form of a $15,000 grant from Roanoke’s human services committee.
Drs. Victor Skaff and David Black began providing dental care at the clinic, making it the first free clinic in the country to offer this service. Services soon encompassed restorative work as well as the meeting of urgent dental needs.
United Way of Roanoke Valley accepted the clinic as a partner agency. Though no longer in effect, this mutually beneficial relationship continued for many years. The United Way still points to the free clinic as one of its success stories.
The clinic began to receive national recognition; it became the model for other clinics. It organized the Southeastern United States Conference of Free Clinics. Locally, Dr. Surrusco organized the first “Gaps” meeting, which served as a roundtable for Roanoke-area charities and social services. The meeting has been repeated over the years.
Guidepost magazine’s Church of the Year Award went to St. Mark’s Lutheran Church for its key role in launching the free clinic. The award was presented by Norman Vincent Peale.
In response to a letter to the White House from a grateful patient, the clinic received a commendation from then-President Ronald Reagan.
Having outgrown the Way Inn (90,000 patient visits in the first 15 years) despite using every square foot of available space, the clinic launched a campaign to find and fund a new home. Dr. Garvin led the charge with his typical vision and can-do spirit. Succeeding beyond all projections, the campaign raised $1.9 million to set its dream into motion. Among the gifts was $1 million from area philanthropist Marion Bradley Via.
The new clinic opened on Feb. 12, 1990. Much of the labor was donated, as was artwork for the walls and a good deal of the medical equipment. Dental equipment was discounted in exchange for the right to use the clinic as a demonstration site. The new clinic had nine examination rooms, four dental laboratories; a fully licensed pharmacy and a laboratory with 9,000 square feet of space.
On April 12, then-First Lady Barbara Bush dedicated the building and announced the renaming of the clinic in memory of Harry Lynde Bradley, father of principal donor Marion Bradley Via. The clinic was designated a Presidential Point of Light.
Medical Director, Kevin Kelleher, who had been helping Estelle spread the word about free clinics in small meetings across the country, felt it was time to reach out to a larger audience. On Aug. 14, he published in the Journal of the American Medical Association an article titled “Free Clinics: A Solution That Can Work Now.” When the Virginia General Assembly passed the Liability Protection Act for Virginia Free Clinic Volunteers, the most comprehensive such law in the nation, the Bradley Free Clinic clearly had cemented its position as the national model and the place for other clinics to call for information and guidance. Coverage by National Public Radio and The Washington Post followed, and there were consultations with the U.S. Congress. The goal of a national liability protection bill was firmly established.
In response to the increasing need for guidance for fledgling clinics, the Free Clinic Foundation of America was launched. It published the help manual, A Free Clinic: Starting Out, and the National Directory of Free Clinics. Both remain in publication. After the startup manual was mentioned in Parade magazine, the foundation received more than 1,500 requests for copies.
Senate testimony by Dr. Kelleher, in conjunction with the Catholic Health Association, helped lead to passage of the Volunteer Protection Act of 1997, a federal law that protects free clinic volunteers from malpractice actions. Dr. Kelleher also contributed to the Clinton Task Force on Health Care Reform; he was co-author of a report from the task force’s Ad Hoc Committee on Charitable Care.
Dr. Randall R. Rhea, a general practitioner in the valley, was elected president of the board of directors. He continues to lead with dedication, enthusiasm, encouragement and foresight. In the same year, the surgical clinic opened, offering minor outpatient procedures. Very few free clinics offer such services.
The clinic celebrated its 25th anniversary with a gala that raised $60,000.
The clinic recorded its 200,000th patient visit and reached $20 million in the value of health care delivered since opening.
The Bradley Free Clinic celebrated 30 years of successful free health care for the working uninsured of the Roanoke Valley. The clinic could look back with pride and forward with confidence.
After 18 years in our current location, Lynn Via (Secretary) headed up renovating the interior of the building. Thanks to Lynn, the free clinic space is much more inviting and comfortable for our patients and volunteers!
The clinic reached $50 million in value of health care services in 36 years.