Feb. 12, 2001 (San Mateo, Calif.) -- Floriberto sits on the
edge of an exam table, wearing a zippered gray sweatshirt, jeans, sandals, an
immaculately crisp Raiders cap, and a look of unrelenting pain. His right cheek
A day laborer from Mexico, he has a severely infected tooth.
"I tried to find help," he says through an interpreter. "I went
door to door for a doctor, but no one would help."
Patients often have trouble talking to their doctors. It can be hard to get the words out when the topic is emotionally charged or one you’d never bring up in polite conversation.
And for various reasons, sometimes including their own embarrassment, doctors may find it hard to bring up certain topics -- and that can compromise the care their patients receive.
“Communication is an inexact science,” says Bob Arnold, MD, professor of medicine at the University of Pittsburgh School of Medicine and...
Finally, his sister suggested the right door: Samaritan House
Clinic. He will be examined here, in a low-slung, nondescript building in San
Mateo, because he meets the clinic's three prerequisites. He is indigent, has
no health insurance, and lives within the geographical boundaries of Millbrae
and San Carlos -- prospering suburbs between San Francisco and Silicon
"Most communities have this population of invisible
people," says William Schwartz, MD, a retired internist who co-founded the
clinic in 1992. "You see these elegant Hillsborough addresses on the forms,
but they're not paying the mortgage. They're living in a room over the
About two-thirds of the clinic's patients speak Spanish, though
many other languages and cultures are represented. These are men and women who
work as nannies, gardeners, and dishwashers, living as many as five to a room
to keep up with the Bay Area's steep rents. Some are here legally; others are
not. (Samaritan House makes no distinction.) Most have treatable medical
problems such as diabetes, high blood pressure, or tuberculosis that become
emergencies if not caught early.
Floriberto needs immediate attention. Schwartz will refer him
to an outside dentist, for services not available at Samaritan House. The
patient will return to the clinic a week later for a prescription of
antibiotics and will receive ongoing dental care there for weeks.
Samaritan House Clinic certainly isn't the only place in
America that dispenses free health care, but its structure could make it a
model for other communities. The clinic has a rotating staff of 25 to 30
doctors, plus at least 15 registered nurses, 12 clerks, and 15 interpreters.
Yet only three positions are paid, and one of them is half time. The rest are
volunteers, and most of them are retired.