Iowa City Free Clinic celebrates 50 years of continuing service

IOWA CITY — This spring marks the 50th year of operation for the Iowa City Free Medical Clinic, not only marking a major milestone for the local nonprofit but also making it the second-longest running free health care clinic in the United States.

Despite the bumps it had endured along the way — including steep challenges presented by the ongoing pandemic — the facility is now a thriving organization, clinic officials say.

“Thanks to our community, we’ve made a difference in the lives of thousands of people over the last 50 years,” said Barbara Vinograde, executive director of the Iowa City Free Medical and Dental Clinic. “It’s just something I’m really, really proud of.”

The Iowa City Free Medical Clinic officially opened March 19, 1971. The longest running free clinic in the country is Haight Ashbury Free Clinics in San Francisco, which opened in 1967. Some other free clinics in the United States were founded before Iowa City’s, but had to close for a number of years due to funding constraints and other challenges.

Free medical clinics are nonprofit organizations, funded by government dollars or private donations, that provide primary health care as well as other health services, such as dental or maternal care, aimed at medically underserved communities.

Dozens of these organizations opened during a “movement” in the mid-1960s and 1970s, spurred for the most part by the social and cultural reform happening in the country at that time, researchers say.

Decades later, experts say more than 1,200 free and charitable clinics operate nationwide, providing care for millions of Americans who are uninsured or underinsured. Even with the advent of the Affordable Care Act, certain populations still remain underserved in access to health care services.

‘Health care is a necessity’

Vinograde attributed the success of the Iowa City Free Medical Clinic to community support, both from monetary donations and from the hundreds of medical professionals who volunteer to provide care for patients. The clinic also got a boost in its early days when it was able to operate in its space rent-free for first five years, thanks to a longtime member of the clinic’s board of directors, Dave Schuldt.

“I think that many people in our community are very well aware that access to health care is a necessity,” Vinograde said. “ … People have listened to us and people believe us when we say ‘this isn’t right — going to the emergency room should not be the place people go to for care.’ So I think a huge piece of it is that this community has had our backs.”

The majority of the free clinic’s patients are refugees or immigrants who recently made their way to the states, and have nowhere else to turn for health care. At some point, home remedies and over-the-counter solutions no longer work, and they often find themselves at the Iowa City Free Medical Clinic.

“It’s rewarding knowing you’re helping them when they can’t get it elsewhere,” said Bill Riker, a physician assistant and longtime staff member who also serves as an interpreter.

Over the years, the volunteer medical staff at the free clinic have seen a shift in patient needs, said Dr. George Bergus, a volunteer family medicine physician. He also works at the University of Iowa Hospitals and Clinics.

In the early days, patients were seeking care for acute problems, or short-term issues such as an injury or a brief illness. Nowadays, the clinic spends most of its time helping patients with long-term, chronic conditions such as diabetes, high blood pressure and high cholesterol, among other issues that are harder to control.

“It’s part of the evolution of medicine,” Bergus said.

Given the nature of the operation, there’s are limits to what a free clinic can do in some cases, Riker said. Providers can’t order CT scans or other tests if the patient can’t afford those services.

“It is very, very difficult,” Riker said. “You just take a deep breath and do what you can for patients.”

Here to stay

The 50-year milestone didn’t come without challenges. In its first year alone, the free clinic moved three times before finding a permanent home in the basement of the Wesley Foundation, the United Methodist campus ministry center at the University of Iowa. The basement space was the clinic’s home until 2006, when officials moved the operation to its current location at 2440 Towncrest Drive.

The past year has presented its own challenge. The Iowa City Free Medical Clinic never stopped seeing patients throughout the COVID-19 pandemic, but Vinograde said officials did scale back operations to reduce the risk of spreading the virus among staff, volunteers and patients.

Like many health care providers and health systems, the past year has also posed a major financial challenge. Vinograde said free clinic officials will be launching a capital campaign in the near future to help fund the operation and to help fund a renovation of its existing building to make room for officials to expand services.

Vinograde also wonders how the pandemic may shift thinking on the need for health care services, making some realize the importance of “what they may have taken for granted,” she said. Vinograde said she would like to see more policies that make health care more accessible to all.

But as long as the Iowa City Free Medical Clinic is needed, it will stay here, officials say.

“At some point, I’d like to be able to say that the free clinic will be able to close because it won’t be necessary any more, but I don’t think that’s going to happen for a while,” Vinograde said. “I do think that over the next 50 years, a lot is going to change.”