Health Center 10, a Philadelphia-run primary care clinic, has few options for uninsured patients


Health Center 10, the only city-operated primary care clinic in northeast Philadelphia, has a wait of up to a year to book an appointment.

Step inside the unpretentious office building on Cotman Avenue and it’s easy to see why. Demand for this low cost clinic is so high that every square foot is optimized for space. The narrow corridors are lined with lockers, and there are private rooms that double as examination rooms. The examination room is not as big as a closet. Nearly 10 staff members answer the ringing phones at the huge reception desk.

Uninsured or poorly insured people have few options Demand for primary care in the Northeast far exceeds the city’s capacity to provide care. Wait times for appointments at Health Center 10 are the longest in the city. The health department recently announced plans to open two new clinics in the neighborhood, but the first will not open until at least 2025.

“This health center is maxed out,” says Elena Galkin, medical director of the city’s ambulatory services. “There’s no corner where we can put additional staff to serve people. We do what we can.”

Regular doctor visits are very important to prevent and treat health conditions that can lead to serious chronic illnesses. But for those who are uninsured or “underinsured” who still struggle to pay for medical care, primary care is often not affordable or accessible. is. Health centers10 and other municipal clinics that accept patients regardless of insurance status or ability to pay aim to fill this gap.



Eliane da Silva from North Philadelphia at City of Philadelphia Department of Public Health Health Center 10..read moreMonica Herndon / Staff Photographer

“It takes forever to see a doctor,” Eliane da Silva, 57, who lives in North Philadelphia and does not have health insurance, said in Portuguese through a health department interpreter.

She said that after seeing her once, the doctor asked her to come back in two weeks for a follow-up. But the earliest booking Da Silva could get was a few months later.

Rising inequality

Poverty rates have risen over the past 30 years Located in northeastern Philadelphia, home to approximately 425,000 people. In the Oxford Circle and Castor areas, where 10 health centers are located, the number of people living in poverty jumped by a staggering 352% between 1990 and 2017. The Northeast is part of the city with the highest rate of uninsured patients, Cheryl Bettygall said. , City Health Commissioner.

It’s also the largest concentration of immigrants to Philadelphia, said Bettygall, who ran Health Center 10 before becoming the city’s chief public health officer. By law, immigrants cannot obtain government-funded Medicaid health insurance for five years after obtaining a green card. Until then, many people cannot afford private insurance and rely on health centers10 for medical care.

“This is an incredibly diverse and vibrant area of ​​the city, but it lacks access to healthcare,” says Bettygor.

Patients at city-run medical centers, who don’t have insurance, pay on a sliding scale, which typically costs between $5 and $20 per visit, Bettygall said. About 40% of the patients in the health center 10 are uninsured.

In addition to primary care, the clinic also offers dental care, pediatric primary care, women’s health care, vaccinations, and testing for sexually transmitted diseases and tuberculosis. There is also an on-site pharmacy. The idea is to provide patients with a one-stop shop for their primary care needs.

New patients are typically offered appointments no longer than nine months, Galkin said. Returning patients are usually scheduled within 6 days. Staff have made some slots available for urgently needed care, but high demand and staffing shortages are making it difficult to provide prompt service. About 30 percent of staff positions are vacant across the city-run system of clinics, said Chanel Conley Bacon, director of operations for Health Center 10.

“It takes forever to be seen”

Patients being treated at Health Center 10 said they appreciate many of the services Health Center 10 provides. But the demand is so high that they are also forced to wait much longer for treatment than those with private insurance. And many patients here have no other choice.

On a recent weekday afternoon, Tajikela Perdus sat in the waiting room of Health Center 10 to help her mother with an appointment. She herself, a former patient there, explained: Although she liked the treatment she received privately at the clinic, she chose to seek doctors elsewhere whenever possible.



Tajikela Perdus speaks with reporters at the City of Public Health Health Center 10 in Philadelphia on Tuesday, May 23. Primary care services, including dentistry, are available at health centers10..read moreMonica Herndon / Staff Photographer

“They don’t do anything on time. That’s the biggest problem,” said Perdus, 23, whose family is from Bangladesh and has lived in Parkwood for 10 years.

Recently, my uninsured brother-in-law moved to the city and tried to get an appointment. He was given a date one year later.

Across the room, there was a line of patients waiting to see the hospital pharmacist. The pediatric waiting room downstairs was packed with parents and children. The clinic sees about 300-400 patients a day, and his regular patients speak 40 languages. Some interpreters work at the center, while other patients are required to use a telephone interpreter service at the time of their appointment.

As da Silva spoke in Portuguese through an interpreter about the attending physician at Health Center 10, she said: You may not always receive adequate and respectful care from other staff at the clinic. She said she couldn’t go anywhere else because she didn’t have insurance.

She remembered feeling disrespected and mistreated by her doctors and leaving in tears after a difficult examination. However, she didn’t know who to talk to about her experience and didn’t believe she had the option of seeking treatment elsewhere. (When asked about the episode, clinic directors declined to comment further, saying they were investigating. Department of Health spokesman Jim Kyle said in a statement that the Department of Health “could take these types of complaints very seriously.” We take this very seriously and strive to maintain a welcoming and safe environment for all patients.”

In the pediatrics ward, a young mother who also speaks Portuguese brings her son to the clinic for the first visit. She had applied for her reservation in October, seven months before her.

The woman was prepared for a long wait, she told health department interpreter Jorhanna Costa. “This is a different country,” said the patient. “Maybe it’s like this here.”

Bettygor said it was important for the city to provide more primary care to its most vulnerable residents. A 12-year veteran of the city’s health center, she said she was treating a middle-aged patient whose life expectancy was “significantly shortened” because her health concerns were not addressed early. I remembered

“If I had met them when I was 30, I might have put them on drugs that cost pennies a month,” she says. “This has devastating effects on communities, but it is entirely preventable.”



The sign reads: “We are short staffed worldwide..read moreMonica Herndon / Staff Photographer



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