Syndicate content

Medical Professionals Hold Free Clinic for the “Hardest-Working Feet in Madison”

On a snowy Saturday morning just before Thanksgiving, almost 40 of Madison’s homeless and disadvantaged were welcomed to a free bimonthly foot-care clinic hosted by the First United Methodist Church and organized by the Madison Street Medicine Initiative, which is operated under the Madison Area Care for the Homeless OneHealth (MACH OneHealth) organization (http://machonehealth.org/). This clinic has been underway for almost two years and has become increasingly successful, popular, and efficient with each successive session. At the November 18 event, running from 9 am to 12 noon, the number of participating health professionals (MDs, nurses, wound specialists, and volunteer helpers was approximately the same as the number of homeless (38) seeking help with their feet. As Meg Collins, an RN and certified wound care nurse from Madison and Dane County Public Health said, this clinic is a great opportunity to care for the “Hardest-Working Feet in Madison.” One of the medical professionals who is key to this wonderful effort is Ann Catlett (at right in photo), MD, who is a trained internist specializing in palliative care at UW Health. Dr. Catlett is also Medical Director of the Madison Street Medicine Initiative. This recently founded Initiative is funded by a two-year $100,000 UW Baldwin Grant intended to leverage University expertise to do good. Dr. Catlett said that before the foot clinic was started, MACH OneHealth had heard from those experiencing homelessness, as well as from outreach workers, that foot care was a major health need for the homeless. After the clinic had been launched, the Madison Street Medicine Initiative undertook a survey that confirmed this need. Dr. Catlett said the survey results also highlighted that homeless people have trouble accessing health care because of transportation challenges, as well as also having issues of mistrust of providers and fear of judgment in the clinic setting. Dr. Catlett added that the Project Coordinator for the Madison Street Medicine Initiative is Bootsie Harden.

As noted, the Madison Street Medicine Initiative is operated under the MACH OneHealth organization, which has been in operation for just over two years. MACH OneHealth has secured grants from UW Health ($2,000) and the City of Madison ($7,000) to fund supplies needed by the foot clinic. Dr. Catlett said that the principle of MACH OneHealth is that everything is connected and needs to be considered and integrated in health care. Among these connected interactions are mental, environmental, social, and animals.

Dr. Catlett, who was pitching in and helping patients just like all the other volunteers, noted that the foot clinic has undergone a “most amazing process of continuous quality improvement loop.” After every foot clinic, the volunteers get together to discuss what worked well and what might not have worked as well, and to make suggestions for improvements that can be implemented in the next clinic session.

This session ran very smoothly as patients checked in with volunteer Maureen Quinlan who scheduled the patients to enter the clinic program which began with a triage stage where the particular needs of the individual were initially assessed. Maureen also monitored the movement of patients through the program.

Among the ministrations of the medical volunteers were toe-clipping, washing of feet, diagnosis and initial treatment of athlete’s foot, the trimming down of calluses (often a result of ill-fitting shoes), treatment of occasionally seen diabetic foot ulcers, and, if necessary referrals for further treatment. Sometimes, the treatment of “macerated” feet is necessary, particularly during rainy times when shoes, often ill-fitting, get wet and expose the feet to water for extended periods of time.

Street Pulse editor Jeremy Evenson was one of the many beneficiaries of this month’s foot clinic as nurse Jill Monfre identified and treated an ingrown toenail that Jeremy had and that, if left alone, might have led to the need for surgery. “I am very grateful,” Jeremy said.

The clinic offered a large contingent of generous medical professionals who volunteered their time to examine and, if necessary and appropriate, to treat the feet of the homeless visitors to the clinic. In addition to Dr. Catlett, KJ Williams, MD, a specialist in palliative care was on hand to help wherever she could. Also pitching in were Ruthanne Chun, DVM; James Ircink, MD, a resident in family practice; and Sarah Schaaf, a fourth-year medical student.

Nurses included Meg Collins and Jill Monfre, both certified wound care nurses; Carolyn Virginia, a hospice care specialist; Anica Bausch, an oncology nurse; Lorrie Hylkema, a nurse specializing in mental health; Lizzie Kelly, a community health nurse who works at Meritor’s home health unit called Unity Point at Home; Lizzie is also a triage nurse and is instrumental In quality assurance, improvement, and organization that sustains ongoing clinics; Nan Wild, a nurse practitioner; and Ginny Spernoga an Access community health nurse who supervised the socks station at this clinic. Usually Ginny is in triage and she is an instrumental part of the clinic, both as triage RN and because she sources most of the items needed for purchase for each clinic. Podiatrist Elizabeth Plovanich, who is usually at these clinics could not participate in this one due to a conflict. Nan Wild’s daughter Beth Wild was this clinic’s manager and volunteer coordinator.

Oncology nurse Anica Bausch was called out for special note by wound care nurse Meg Collins. “Anica is a founder of the foot-care clinic — without her, we never would’ve started! In my humble opinion it was her enthusiasm and recruitment that really built the first year of clinic volunteer participation and gave a warm spirit to the whole thing. She is like the heart and life force of the project for me!!!” Together with Anica, Meg is a co-founder of the foot-care clinic

Dr. Ircink is a Madison native who is doing his residency in family medicine at a hospital in St Paul. He was home for the weekend and thought there would be nothing better than helping out with the foot clinic. Dr. Ircink had gone to medical school at UW-Madison and while there he had participated in the Friends of State Street Family, individuals who take needed materials out to the streets to help the homeless. In fact, Dr. Ircink said that his medical dream is to do street medicine.

Another of the impressive medical volunteers was Sarah Schaaf, a fourth-year medical student at UW-Madison. Sarah said that her ultimate goal is to work in family practice, but she noted that volunteering at the foot clinic gives her the rare opportunity to take what she has learned already and to give back help to real patients. She said that during much of her time in medical school, she is in the role of learner and beneficiary of the knowledge that others are dispensing. In the foot clinic, she is able to give back practical help to real patients and she finds this immensely rewarding.

Ruthanne Chun, DVM, Associate Dean of Clinical Affairs at the Veterinary Clinic of UW-Madison and Hospital Director of UW Veterinary Care, had learned of the foot clinic opportunity through her work with MACH OneHealth, of which she is a co-founder. She also works with WisCARES (https://wiscares.wisc.edu/), a group that seeks to help the housing insecure with needs that their pets might have. Dr. Chun was only too happy to pitch in wherever she might be needed at the foot clinic.

The clinic also offered a large assortment of free shoes and new socks freely available to those in need. The large shoe section was staffed by volunteers Delaney Carins (at left in photo) and Mary McCuthcheon. Delaney, who is a recent UW-Madison grad who now works at the school as a student advisor, learned of the foot clinic opportunity through a posting on the volunteer match web site. Mary learned of the opportunity through a neighbor who had volunteered in the past, but was out of town this weekend. As noted earlier, the large new socks station was run on this day by community health nurse Ginny Spernoga.

Toward the end of Saturday’s session, many were thrilled to note the arrival of visitor Garrett Lee, who, along with Dr. Catlett and Dr. Ruthanne Chun, was one of the original founders of MACH OneHealth, and who is the current Board President of MACH OneHealth. Garrett said he was extremely impressed with how smoothly the clinic was running and how far it has come from its beginnings just about a year-and-a-half ago.

While awaiting their turn for care, patients were offered delicious breakfast food provided by Catholic Workers in the church’s dining room. The entire event was hosted by the First United Methodist Church under the guidance of the extraordinary Karen Andro.

See you, and your feet, in another two months!

by Michael D. O’Neill
logophile2000@yahoo.com