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Photo by James Allen Walker for WORLD

CrossOver appeal

Hope Award | A Christian health clinic becomes a safety net for the uninsured

Issue: "Profiles in effective compassion," Sept. 26, 2009

RICHMOND, Va.-By noon on a Thursday this summer, whites, Hispanics, African-Americans, and a woman with bubblegum pink hair packed the waiting room at the CrossOver health clinic here. Despite the high traffic, the clinic did not feel like a warehouse of sick people-everything was orderly and clean, as in a good private practice.

That sensibility is intentional, because clinic founders wanted patients to sense that they are receiving the best care, not something second rate because it's free. CrossOver is evidence that not everything in U.S. medical care for the poor is dysfunctional. While doctors at CrossOver agree reform is needed, their ministry has succeeded in using parts of the system that work: They serve 4,300 uninsured patients a year on a $2.5 million budget.

The clinic opened in 1983 in an old furniture store turned church in downtown Richmond: One Saturday founder Dr. Cullen Rivers and local pastor Buddy Childress put a sign in a storefront window announcing "Free health care." In the dark emptiness of the store at their first clinic, they had a single light bulb, an old examination table, a stethoscope, a blood pressure cuff, and some chairs they borrowed from a bank. People walked in off the street.

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Rivers, Childress, and other local Christians originally intended to address all sorts of urban needs, including legal services, but they soon saw medical help as the most prominent need. Then others came to help. Dr. Daniel Jannuzzi moved to Richmond 20 years ago after his wife noticed an ad in a medical journal seeking a doctor for the fledgling CrossOver. He inquired about the position-and it turned out that he was the only person who had responded to the ad.

At that point Jannuzzi had to decide whether to take a risk. He thought about sticking with his bustling private practice in Baltimore, Md., but he had recurring dreams about working with the poor and uninsured. "It just started eating away at me," he recalls. "We took a leap of faith."

It's rare for nonprofit clinics to have fulltime physicians, but Jannuzzi has worked full-time for CrossOver ever since and helped it build a reputation for doing whatever it takes to help people. His colleagues told me about a snowy day when the city health department called Jannuzzi and nurse Myrna McLaughlin to help homeless people-one with pneumonia, one with an infection-who were standing around a fire in a barrel. Later, when social workers couldn't get another homeless man out of a tree in a park, McLaughlin coaxed the person down to earth.

Jannuzzi said it's hard for doctors to stay committed to poverty medicine year after year: "A physician can find a job overnight. . . . It's sort of the siren's call." But the work itself is engaging from a clinical perspective, he said, because of the complex health issues common among the uninsured. It's also personally fulfilling and challenging: "To grow in my own faith in terms of living out the gospel for healthcare for the poor has been very rewarding spiritually."

Today, the clinic sits on a highway within view of downtown skyscrapers but across the James River, on a side of town that has discarded shells of factories and delivery trucks suffocated by vines. Across the street at a soul food joint, locals sip sweet tea that is less tea and more sweet-they know CrossOver because they have gone to the dentist there.

The dental area is busy. When I visited, a mother was in one of the two dental chairs in the clinic under the uncomfortable whirr of a drill. Dental assistant Kerri Reed helped the dentist, a volunteer who has his own practice, but kept her eye on the woman's four children playing in an adjacent exam room. "Our makeshift nursery," she said, smiling.

But most of the clients come because of medical problems, with primary care sometimes leading to larger fixes. When CrossOver's Dr. Richard Lower-one of the country's pioneers in heart transplants-noticed that a patient seeking birth control pills had blue lips, signs of a heart defect, he called a heart surgeon at the local hospital who agreed to operate on the woman for free.

CrossOver gives the uninsured regular check-ups to keep them on medications for chronic illnesses, and that protects against more costly medical services down the road. "It costs pennies to save hundreds of dollars," says Steve Lindsey, a former administrator at a local hospital who is now on the CrossOver board. CrossOver makes use of philanthropy from hospitals, backed up by charitable donations and a host of volunteers, to provide first-class care for free.

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