When women come to see Laura Bishop MD, an obstetrician and gynecologist with the Ruch Clinic in Germantown, it's usually to have an annual physical, breast exam, or prenatal care. But several times a month, Bishop also attends to patients referred to her through the MEMPHIS Plan, a healthcare plan offered by the Church Health Center (CHC) to small business owners and their employees. It is one way the CHC helps ease the burden of the uninsured.

 

Primary care physicians within the plan refer patients to Bishop, who treats them at her office. The women are typically experiencing trouble with fibroids or other female complications that require surgery.

 

 "Most of the time when patients are sent, it's because they need a surgical hysterectomy," said Bishop, who specializes in robotic-assisted gynecological surgery. Such laparoscopic procedures enable women to have a hysterectomy that's much less invasive. The robotic-assisted surgery involves a much smaller incision, and results in only a one or two-day hospital stay before the patient is released to continue her recovery at home. Since the incision is much smaller, there is less blood loss and the recovery rate is quicker.

 

All of the medical professionals involved with the procedure, from Bishop and her surgical assistant, to the lab pathologists who do the blood work, to the Methodist Hospital nursing staff on-hand during the operation, provide their services free of charge. There is no cost to the patient or the employer. "Everybody in the community comes together and does this for free," said Bishop. It is one way physicians and other members of Memphis' medical community can give of their time and talents, by offering quality health care to the working poor.

 

The plan was created as a safety net, since the working poor often make too much money to qualify for TennCare or federal assistance, but too little to afford self-pay health insurance.

 

It also gives the Church Health Center a way of reaching beyond its borders to provide care to those in need without requiring doctors to volunteer their services at the CHC facilities. Instead, patients who are enrolled in the program are assigned a primary care physician who donates his or her services and see patients at their clinics. If a specialist is needed, patients are then referred to doctors like Bishop within the plan network. 

 

Considered employer-sponsored healthcare, the plan serves 4,200 workers in the Memphis area; individuals who hold low-wage jobs with small, Tennessee-based companies with fewer than 200 employees, or who are self-employed. It is not health insurance. In fact, a state law had to be passed in 1991 to allow the program to function as a managed care plan, according to CHC spokesman Marvin Stockwell.

 

More than 1,300 businesses now participate; companies as diverse as Huey's restaurants and Graceland Enterprise to self-employed musicians, office cleaners, and gardeners. The program started in 1991 as a way of extending the vision of CHC founder Scott Morris to provide quality healthcare to workers who might otherwise fall through the cracks.

 

"Because of the MEMPHIS Plan, the Church Health Center touches more than 60,000 patients within the Memphis area," noted Jennie Robbins, CHC assistant director for the Plan.

 

The plan covers workers, spouses, and children. The cost is $45 a month per employee (at least $10 is paid by the employer), $25 per dependent, and $5 per doctor visit, $10 per dental visit. Currently, more than 400 physicians participate in the plan, including 82 primary care doctors, 24 pediatricians, and 148 specialists. "All of the doctors don't just volunteer, they do all of the referrals and payment collection, which generates $1.2 million annually," said Stockwell. It's money, which the CHC then plows back into the program.

 

And doctors aren't the only ones who volunteer. Methodist, Le Bonheur, and St. Francis Hospitals offer their services pro bono as well. Last year, Methodist doubled their support for the program after completing an internal study that showed MEMPHIS Plan participants had a lower use of emergency room and hospital services, according to Stockwell.

 

Angie Qualls, practice administrator for the Family Physicians Group PC, says their group has long been involved. "We feel it is part of our job to do charity work and help people locally," said Qualls. "They're working but they have small employers who can't afford health insurance."

 

As primary care physicians, their office typically see patients who need to have diabetes monitored or blood pressure brought under control. "But they can come in with anything. The only limit we have is on vaccines and immunizations," said Qualls. "They must do that through the Church Health Center. Otherwise, they're just regular patients of ours. We don't treat them any differently than anyone else."