The staff at St. Catherine Labouré Medical Clinic spent so much time and energy taking care of others, it neglected to care for itself.
The doctor, physician's assistant and nurse practitioner at this Germantown clinic have worked without pay for the last three months.
"People's lives are at stake," said Michele Palos-Samsi, the physician's assistant, who helped open the clinic in 1999. "We're going to find a way to keep this place open."
But others who say the clinic's closing would be a huge loss aren't so sure.
"I see the whole thing unraveling," said Ann Torregrossa, deputy director of the state Office of Health Care Reform. "That would be a real shame. It's an amazing little place."
"They need money desperately," said Marvin Schatz, chief of the hospitalist division at Albert Einstein Medical Center, who just two weeks ago joined St. Catherine Labouré's board.
He said the clinic's service was indispensable. The number of uninsured has reached at least 47 million nationwide. And 25 million adults who have some insurance still can't afford their care, according to a study released this week by the New York-based Commonwealth Fund.
"With the economy the way it is, it could be you, could be me," Schatz said.
Palos-Samsi and physician Sheila Davis started the clinic on the sidewalk in front of the St. Vincent de Paul parish church in East Germantown. They were church members and felt the calling.
They soon moved the clinic to the YWCA across Germantown Avenue, and then a few years ago to a building at 5838 Germantown Ave.
Davis and Palos-Samsi never developed a business plan, or spent time trying to build a base of private contributors.
"We just opened," said Davis, 47. "We saw the need and decided to meet the need. That worked for a lot of years."
"As we grew larger and larger," she added, "our time became more crunched. We didn't have time to build the organization and do the fund-raising. We lost track of how quickly we were getting to the point where we can't do it all ourselves."
The clinic, open Mondays through Thursdays from 9 a.m. to 3 p.m., operates much like a professional doctors' office. It gets about 60 patients a week. Each pays $10 a visit.
"We're like old-time country docs," Palos-Samsi said.
The clinic has a devoted group of volunteers without whom it could never succeed.
It has survived primarily on grants from a few faithful foundations. The annual budget is $330,000, with two-thirds going to pay the three medical professionals.
The clinic counted on this year's grants arriving in the winter and early spring, but for a variety of reasons, the grants won't be available until late summer and fall - creating the financial crunch.
"That community is so blessed to have the clinic there," said Steve Fera, vice president of government and social mission programs for Independence Blue Cross, which gives the clinic $100,000 a year, and now supports 31 clinics in the five-county area. "They are an inspiration to anybody trying to do this kind of work."
Davis, Palos-Samsi and Katarzyna Calderon last got paid in February.
There have been many lean times over the years. In 2002, Davis went 10 months without a salary. As she did then, Davis said, she has been living lately on credit.
Palos-Samsi said her salary helped pay tuition for her two college-age children.
Calderon, the nurse practitioner, cannot afford to send her children to day camp this summer, Davis said; she will cut back to one day a week and bring her children with her.
The clinic is revamping its board of directors, and Davis said one of the first initiatives would be to hire a development officer to seek more individual donations.
Perhaps the best testimonials come from patients.
Omenihu Amachi, a cabdriver, stopped in a few years ago because of back pain, and staff discovered high blood pressure. During a routine exam, Davis noticed an enlarged pancreas.
Davis was sure it was a tumor. The clinic managed to get him a free MRI to confirm her diagnosis. Then he went to the emergency room at Einstein, the surgery covered by medical assistance.
His tumor was six inches long, the size of a small football. Even though it was benign, Davis said, it would have killed him had it gone undetected much longer.
Amachi, 55, is also a painter, and in gratitude he painted a giant canvas, titled
, which hangs in the waiting room.
The image came to him as he lay in the recovery room after surgery, he said. The painting depicts angels (the clinic staff) giving eggs (representing life) to a grateful man (the artist).
"It's a lifesaving place for me," he said.
The St. Catherine Labouré Medical Clinic is at 5838 Germantown Ave., Philadelphia 19144. The phone number is 215-438-5799.