Like most young physicians graduating from the National Health Service Corps Scholarship Program, Gary Wiltz, M.D., had no idea what to expect when he took on his first assignment—working in a little community health center in Franklin, La. “It was really a culture shock,” recalls Wiltz, who was raised in the city of New Orleans. “The Franklin newspaper was about six pages long and the phone book was about a quarter inch thick.” Then there was the health center itself. “The first day I arrived at the Teche Action Clinic, it had a single location in a dilapidated house that was riddled with termites. I soon found out that the staff of eight was about to lose their jobs because the center had been without a doctor or even a nurse practitioner for six months and so Teche was going to be shut down.”
While Wiltz was a little overwhelmed by the challenge he faced, he quickly fell for the folks in Franklin. “When I got to know my patients and realized we were really serving people in need, I decided to stay,” he says. That was 29 years ago. Wiltz, a 1996 winner of Robert Wood Johnson Foundation (RWJF) Community Health Leader (CHL) Award, is now chief executive officer of the Teche Action Clinics in Franklin. That original, run-down house has been replaced with ten clinic locations where 125 employees serve nearly 15,000 people from the eight surrounding parishes (each parish is like a county).
“We eventually expanded,” Wiltz says proudly. “The original clinic was started by volunteers to serve the seasonal sugar cane workers. Now we treat everyone, regardless of their ability to pay. We deliver babies, have dentists, primary care physicians, diabetes educators and a laboratory, but we do not do surgery. About 45 percent of our patients are working, but uninsured, so we use federal poverty guidelines and charge on a sliding scale. But no one leaves here without their medication or lab work. We’re a one-stop shop.”
RWJF Community Health All-Stars
Robert Wood Johnson Foundation scholars, fellows and grantees, along with the Community Health Leader award winners, address the health needs of the nation in unique and innovative ways. Whether they are creating healthier environments, bringing needed health resources to underserved communities, diversifying the local health care workforce or generating grassroots programs—they make a difference. This series tells their stories.
Wiltz’s passion to dramatically expand Teche’s services grew, he says, from an understanding, “that this is what medicine is all about.” And the good people of Franklin are grateful for his efforts. “There are truly wonderful people here who often show their appreciation through kind words, hugs, the occasional basket of home-grown okra and tomatoes, or maybe hot biscuits,” Wiltz says.
From the Country to the Front Lines
As committed as he is to health and health care in rural Louisiana, Wiltz is anything but a quiet, country doctor. He is also a member of the executive committee of the National Association of Community Health Centers. In that role, Wiltz is a dedicated advocate who works to help the nation understand the importance of supporting and expanding the 8,000 community health centers across the country that provide care to approximately 21 million people. In a recent C-SPAN interview and other engagements over the past few months, Wiltz has spoken out about the need to protect federal health center funding.
“I am deeply concerned about the impact of federal budget cuts on our work. We’ve made a real dent in serving the uninsured population,” Wiltz says. “As the administration confronts the federal deficit and looks for ways to reduce spending, we are aware that cuts to Medicaid and a reduction in community health center funding are part of the national discussion. While we on the Committee understand the need for fiscal restraint, cutting a major source of health care coverage for millions of working families may in turn create an even greater debt for taxpayers and generations to come,” he says.
“Drastic cuts to Medicaid, and the health centers program, will unwittingly generate higher health care costs as people who lose coverage will avoid going to the doctor until they become seriously ill and end up in emergency rooms and hospitals for more costly treatments,” says Wiltz, who explains that calculating the costs of lost preventive care is simple. “If you can do preventive care and get people to check their cholesterol, for example, and stay on their diabetes medication, that doctor visit might cost $140. In comparison, a day in the average emergency room costs $800 and a two-day hospital stay costs $9,000.”
“We see this every day here in Louisiana, where people desperately need more affordable primary care options,” Wiltz says. “In fact, a recent study from Colorado, published in Health Affairs, “Medicaid Patients Seen at Federally Qualified Health Centers Use Hospital Services Less Than Those Seen By Private Providers,” shows Medicaid patients who visit community health centers are one-third less likely to have emergency room visits, hospitalizations and hospital re-admissions, compared to those patients who use hospital related services. The bottom line is if we want to cut spending, we have to invest in the very programs that accomplish that goal.”
Wiltz also notes that federal support does not cover all of the costs of providing care at the nation’s community health centers, which were created in 1965 and have had bi-partisan support since that time. “About 30 percent of our patients have Medicaid, another 10 percent have Medicare and about 5 percent have private insurance,” he says. “The $600 million in cuts that the centers will experience in 2011 will pose a serious danger to our health care safety net. In addition, I believe the centers represent the true meaning of community health by helping all of those in need. We are a large part of the solution to providing access to high-quality, comprehensive, primary and preventive care at the local level.”
Each year, the Robert Wood Johnson Foundation selects 10 Community Health Leaders to receive an award. The winners are outstanding and otherwise unrecognized individuals who overcome daunting odds to expand access to health care and social services to underserved populations in communities across the United States. The program aims to elevate the work of these unsung heroes through enhanced recognition, technical assistance and leadership development opportunities.