By Katie Kerwin McCrimmon
WOODY CREEK — The residents show up at the Woody Creek Community Center on foot, mountain bikes and in Range Rovers. A wrangler from a nearby ranch likes to ride her horse. In the winter, people come on cross-country skis.
The center is known as WC3. (The three stands for the Cs – creek, community and center.) It’s a homey gathering spot in an old log cabin –part coffee shop, part tiny bookstore, part Indian curry joint – and once a month, improvised health clinic.
The screen door evokes the comfort of your grandmother’s house. It squeaks as it opens and bangs shut. Inside, there’s a river rock fireplace, exposed logs on the walls and ceiling, and steaming mugs of cappuccino. Residents work on their laptops. And, since this is Woody Creek, an entire bookshelf is dedicated to the community’s zaniest former resident, Hunter S. Thompson.
On a recent Wednesday in September, a portable exam table sat in the back room. Three doctors were volunteering their time. One brought his assistant, a technician who set up a $20,000 table-top ultrasound scanner on a long, tall sideboard that looked like it could double as an altar for an impromptu church service.
Welcome to the Neighborhood Clinic in Woody Creek, a monthly health gathering that brings medicine to residents right where they live.
The clinic started five years ago when Peg O’Brien, a local physical therapist, noticed some neighbors in the adjacent trailer park were barely able to afford their homes, much less health care.
The clinic is now maturing with a new full-time manager and outreach efforts to find and survey people in trailer parks throughout this valley about their health needs.
Clifton Prince is one of the residents who became a patient at the clinic after strolling in to have coffee. A self-employed construction worker, he lives in Woody Creek trailer park, and like many in Aspen area, gave up his health insurance when jobs dried up at the same time that health costs were soaring.
“I had insurance. But the rates kept going up. It was a question of paying my mortgage or paying for health insurance,” Prince said.
He purchased his lot in the mobile home park and built a straw bale home there in 2007. Back then, he had plenty of work and put well over $200,000 along with lots of sweat equity into the project. Home values in the trailer park reached as high as $350,000. Then the Great Recession hit.
“There was no work in 2008 or ’09,” he said.
In 2009, he saw net profits of just $15,000. Last year was slightly better at $20,000. But there was nothing left for health insurance. So, about six months ago, Prince, an avid rock climber and skier, dropped his coverage.
He’s been experiencing sharp pain in his left toe, but his strategy has been to ignore the pain.
He worried about being pegged with a pre-existing condition, so, he avoided getting care. Then, he happened upon the clinic.
Within minutes, Prince’s shoe is off. Peg O’Brien examines him, then suggests that Dr. John Hughes take a look. Hughes asks his assistant, Mary Blakeley, to get quick ultrasound images.
In the middle of the exam, one of the clinic organizers hands Prince the egg sandwich he ordered with his coffee.
“Here you can eat and be treated at the same time,” she says.
Prince grins and takes a bite while the health practitioners peer at his foot.
Blakeley finds the problem almost immediately: a calcium spur in Prince’s big toe.
“You can ignore this, but pretty soon you’ll lose complete motion in your toe,” she says.
“Come by my office. I’d be happy to help you,” Hughes says, offering to comp the treatments.
An osteopath committed to combining Western and Eastern medicine, Hughes prefers non-surgical options to treat people for their aches and pains. In his office, with the help of a local anesthetic to reduce the pain and guided by the ultrasound, he’s confident he can break up the spur. The procedure will be painful, but he expects the toe to heal fully. In the meantime, Hughes urges some good old-fashioned therapies: hot baths and lots of movement for the toe.
Prince is surprised and relieved to have a definitive answer to this nagging problem.
“When you don’t know, you don’t do anything,” he says. “I thought one day I’m going to wake up and not be able to go to work.”
Prince laces up his shoes, takes Hughes’ card and sits at a nearby table with his coffee.
In walks Holly Timms. A longtime accountant for the Aspen Skiing Co., Timms just dropped her kids off at school, then decided to grab a coffee at the community center on her way to work.
She has suffered a streak of bad luck over the past year. First, she had a fire in her home. Then, in May, when she was inspecting the damage with a contractor, she fell through a damaged ceiling, broke three ribs and tore a ligament in her knee. Her doctor wants her to get some physical therapy. She has health insurance, but hasn’t had time to call anyone. By coincidence, she happens to meet Peg O’Brien as she walks in the door. It turns out that O’Brien is one of the physical therapists on Timms’ list to call. And within minutes, O’Brien is examining Timms’ knee while the newest patient sips her drink.
“I was meant to pull in here and get coffee,” she says.
“I feel very at home here. You’re relaxed. There’s jazzy music. At the doctor’s office, it’s completely different.”
Timms tells O’Brien she’s been “throwing Advil at the problem.”
Not surprisingly, O’Brien finds that Timms’ muscles are weak. She needs to get them moving and has an easy prescription: riding a bike. The exercise gets the muscles moving without putting weight on recovering ligaments.
For the doctors, the clinic provides a chance to interact with friends and patients in a relaxed, informal setting.
“They seem to be really interested in stepping out of the walls of their office,” O’Brien said. “I’ve been surprised and delighted by the practitioners’ interest.”
Practicing medicine in a rural area, especially in a down economy, can hearken back to the old days of medicine. Dr. Hughes says patients sometimes want to barter for care. He’s been offered elk jerky and stays at a patient’s hunting camp. When patients don’t have insurance or can’t afford to pay, he will sometimes discount care for them.
“It’s kind of a Robin Hood effect. You rob from the rich to pay for the poor,” Hughes said. “I’ve taken care of people with private jets who own hotels. I don’t discount my services for people who can afford it. You don’t want to have a double standard, but you have to take care of local people.”
Hughes enjoys volunteering at the clinic. It’s fun to get out of the office and frankly, it’s a good marketing opportunity too.
For Dr. Maddie McDowell, the clinic gives her a chance to have longer conversations about topics people might not discuss in a formal appointment.
McDowell is a pediatrician who practiced for 10 years in Aspen and Boston. She has been a faculty member at Harvard and now conducts research from home on how children’s hospitals can adopt high-quality practices.
McDowell volunteered her morning at the clinic and was able to bring along her 3 ½-month-old son. She also gave her time last spring and plans to team up with a nutritionist to give an evening talk about healthy foods.
The Woody Creek clinic is certainly unconventional, but McDowell sees it bridging gaps.
“People could have questions about nutritional balance or social/emotional issues with changes in families. Pediatricians can provide information about a child’s overall health and wellbeing,” she said. “People can ask questions which they may not think they can ask at a regular well-child visit.”
McDowell has seen many parents and children whom she already knows from the community or her former private practice.
She has helped with an array of questions ranging from how to handle hearing loss, to school problems and eczema.
“We live in a very small community. It’s nice for physicians to be able to meet with the community in a non-clinical setting,” McDowell said. “It’s not rushed. It’s a lot more comfortable. It’s a relaxed atmosphere. A lot of what the clinic does is to help triage patients and let them know where the best services are available. Even if they don’t have insurance there are ways to get affordable care in the valley.”