How To Expand Access With Mobile Healthcare: Bethesda Community Clinic

For Melissa Belfield, Executive Director at Bethesda Community Clinic, going mobile was a practical response to a growing transportation problem: “We used to have a bricks-and-mortar clinic in Holly Springs, and the area had changed demographically. We realized after a certain number of years that our patients were having trouble getting to our clinic. We had a lot of no-shows and a lot of people who just couldn’t get a ride or get there on time.” Bethesda initially operated its mobile clinic alongside its permanent location. Melissa explains, “We opened our mobile clinic while having our bricks-and-mortar clinic at the same time, and quickly realized that we were able to see so many more patients if we simply eliminated that transportation barrier.” Dr. Lee Jacobs has served as Medical Director at Bethesda Community Clinic for 16 years: “We have mobile medical units doing primary care throughout Northwest Atlanta. We cover many areas that have people who are homeless, but we’re also covering people who have bad insurance or no insurance, which is a big part of it.” Many of the patients Bethesda serves have gone without routine care. Dr. Jacobs says, “The majority of people we care for have bad diabetes or bad blood pressure. The numbers you see are numbers you would never see in a general medical office. They’re so high because people have not had care.” By taking care directly into the community, the clinic can reach people who may otherwise remain untreated. “We really come out here. We go to where they need us,” Dr. Jacobs explains. “Since we transitioned to a mobile clinic, we see so many different kinds of people, so many great and amazing people. It has really helped ease the difficulties with transportation.”

For Dr. Lee Jacobs, providing comprehensive healthcare means reaching people where they already are: “The only way to really provide comprehensive health to the people who need it, people without transportation, is to go where they are. That’s why the mobile units are so critical to providing healthcare in those vulnerable populations.” Melissa Belfield describes access as meeting people within their own communities: “Access means meeting people where they are. Finding creative solutions to make sure that everybody who has a need gets those needs met.” Bethesda brings its mobile services to places people already visit. Melissa explains, “Going directly to where the people live, work, play, and worship allows that person accessibility to the clinic in a new way. Most of our sites are located either at a community center, a church, a food pantry, places that patients are already going to receive other amenities such as food or social services.” This creates a more convenient, connected experience for patients. “It allows them to come to us like a one-stop shop,” Melissa says. “Not having to chase after medications elsewhere or have to come back and forth between food and their medical care.” One patient describes the value of that accessibility: “It’s very important, and it’s very good to the community. It helps because a lot of people can’t afford insurance, or a lot of people are homeless. I’m fortunate not to be homeless, but there are a lot of people, and it helps a lot of people.” The patient adds, “The fact that it’s mobile and people can easily access it, it’s a lot easier than just going to a doctor’s office.”

For Bethesda Community Clinic, leaving the bricks-and-mortar model created new opportunities to serve patients without financial barriers. Melissa Belfield explains, “By dropping the bricks and mortar, we also became a fully free clinic, which opens up opportunity for more people to come and receive care without a barrier.” Going mobile also reduced the clinic’s operating expenses. “Another big change of going mobile was cutting the overhead,” Melissa says. “The overhead expenses are less, so direct patient care actually gets increased with your funding. Your funding outputs, your dollar outputs, become more valuable and multiply faster when you can be utilizing partnerships.” The mobile model also makes Bethesda more visible throughout the community. Melissa explains, “You become visible in the community, where you’re not tucked away in a building somewhere, but you’re traveling from site to site.” The mobile unit itself helps introduce the organization to new people. “You have a massive billboard that you’re driving down the road, and people begin to see and wonder, ‘Who are you, and what are you doing?’” More importantly, the clinic can meet patients directly where they are. Melissa says, “There’s no better feeling than pulling up and knowing that you’re helping people who you would’ve never reached had you been in a bricks-and-mortar building. Having a mobile health program is a benefit for the patients and for the clinics.”

A Bethesda volunteer explains that the mobile clinic provides the space and equipment needed to perform important medical services: “It’s been a huge game changer for us. Just the other day, I did an EKG in there and brought our equipment in there.” The van was able to accommodate both the equipment and the patient comfortably. “It fit in there perfectly, had plenty of space, and that’s also very accommodating for patients, too, to feel like they have space in a closed environment.” The volunteer also highlights the importance of confidentiality inside the mobile unit: “It creates that sense of privacy as well, which patients really need and really want, especially when talking about sensitive topics and information.” For one patient, Bethesda discovered health problems that had previously gone undiagnosed: “Bethesda Health has found a lot of things wrong with me that I was unaware of. I originally came here for high blood pressure. I got diagnosed with congestive heart failure.” The patient explains how serious the condition could have become without treatment: “If they hadn’t found it, then it could’ve progressed to be a lot worse. If Bethesda didn’t exist, I’d be going to the emergency room a lot more, and last year, I was hospitalized eight times.” A patient’s family member describes the hope the clinic provides for people without insurance: “My dad’s come here because he doesn’t have insurance. I think that it’s too expensive. This service gives us hope. Bethesda covers a lot of programs for everything.”

Melissa Belfield connects Bethesda’s mobile care model to the clinic’s larger mission: “At Bethesda Community Clinic, we envision a world where everyone has access to high-quality healthcare. Our goal is to continue to expand and meet the many needs that our community has.” That expansion could include additional mobile units and a wider service area. Melissa explains, “That can be from maybe having a bunch more units, statewide coverage, but our next venture is going to be pediatric in-school care.” Bethesda plans to bring care directly to students. “We are so excited to be able to bring Sprinter vans to the schools to serve children on-site.” As a safety-net clinic, Bethesda continues to look for unmet needs and new ways to respond. Melissa says, “We are a safety-net clinic, and therefore, we are trying to see what needs need to be met and what creative ways that we can meet those needs.” For Melissa, mobile healthcare is both a present solution and part of the future of care delivery: “We know that mobile health is not only the present best delivery model, but we also know that our future is moving towards mobile health nationally. We get to be leaders in the sector, and we’re excited to see where this may take us in the future.”