In 2010, the enactment of the Affordable Care Act enabled as many as 20 million low-income individuals to receive health care coverage in the United States. Despite this law’s enormous success, about 28 million people in the United States remain uninsured. However, free or low cost primary health care has been available for uninsured patients at community clinics within the Bay Area and throughout the country.
Still, many of these patients suffer from serious medical conditions that require specialty or surgical care not offered within these clinics. Operation Access — OA — was established in 1993 to bridge this gap in health care. In response to the needs of the local community, OA allows health care providers to donate their specialty care services to uninsured, underserved patients.
The organization began as an idea brainstormed by surgeons Bill Schecter, MD, Douglas Grey, MD and healthcare executive Paul Hofmann, DrPH, FACHE. These three men noticed how frequently the operating rooms of their hospital were not being utilized and they saw an opportunity. They figured out that by receiving referrals directly from community clinics, they could make use of these empty ORs by providing specialty outpatient care to those who otherwise wouldn’t have access to it.
All of the founders of Operation Access have remained actively engaged since its creation. OA now serves uninsured patients from all nine Bay Area counties and has coordinated over 17,600 surgical procedures for over 12,600 local residents. As of 2016, the organization has received over $19 million of donated care. “We are an action-oriented organization,” stated Jason Beers, president and CEO of Operation Access. “We partner with institutions and donors who also want to take action to achieve the common goal of equitable access to healthcare and broaden the involvement of others who share this goal.”
Kaiser Permanente and California Pacific Medical Center are two of OA’s top participating hospitals within San Francisco, while Clinic by the Bay and SF Free Clinic are OA’s top referral sources in San Francisco County. Operation Access has partnered with 57 hospitals and facilities and currently receives referrals from over 80 different community clinics. The specialty services provided through the organization include but are not limited to: Gastroenterology, Ophthalmology, Colorectal, Plastic and Reconstructive, General Surgery, Gynecology, Urology, Vascular and Orthopedics.
It is essential that Operation Access maintains its visibility, as it is funded by institutions and individual donors. “It’s life changing work that our volunteers provide under the radar,” Beers said, “Visibility does not often extend far past the staff and patients, partially due to the private nature of health and medical care.”
OA’s active board of directors is constantly reaching out to existing and potential donors in order to keep these groups ever-expanding. Some of the organization’s top donors include Kaiser Permanente, John Muir/Mt. Diablo Community Health Fund, and a generous bequest left by the Celle family.
Developmental Director Scott Benbow said that the most important aspect of Operation Access’s fundraising is spreading awareness about the significance of what they do.
OA serves individuals who earn less than 250 percent of the Federal Poverty Level and do not qualify for federal or state medical insurance — many of whom are immigrants. Working hard to provide for their families and simply trying to make ends meet, these members of our community often forgo their own health needs. “Operation Access reaches out to these people to let them know that there is hope, that their health matters and that people in the community want to help them,” said Beers.
Program Director Ali Balick emphasized the importance of making patients aware of their own rights to healthcare and private, protected information. Effective patient outreach means incorporating a variety of languages into the material that OA sends to their patients. “This is part of the organization’s core practice, offering culturally competent care in all its forms,” Beers explained.
This care includes interacting with patients through their own language, Spanish being the most predominant. OA has made interpreters available for patients at every appointment. A rigorous training program has been built within the organization by speciallycertified interpreters. With a network of qualified interpreters to support their work, Operation Access upholds the standards of interpretation as a professional skill.
While most of the medical care coordinated through OA is integrated within surgeons’ typical schedules, surgical events are also scheduled on specific dates throughout the year. These Saturday surgical sessions take place throughout the Bay Area 1?4 times a year, serving up to 30 patients in a single day at several different medical centers. One of the sessions that took place in December of 2017 was located at the Eye Surgery Center of San Francisco, where patients were treated for pterygia. Common in migrant workers, pterygia are painful growths on the eyelid that can obstruct eyesight unless they are surgically removed.
During the same month, eleven GI procedures took place at a session held at a South San Francisco medical center, also affiliated with Kaiser. Because colon cancer is one of the few cancers that can be prevented if it’s caught early, OA prioritizes colon cancer screenings and provides them to an above-average risk population.
“Surgical care inherently requires more actors than primary care,” Beers explained. “Surgeons, nurses, anesthesiologists, community clinic and hospital staff must all come together and work as a team in order to donate specialty care to uninsured individuals.” Operation Access exists to occupy this vital role as a coordinating and connecting agency.
One of OA’s most devoted surgical volunteers — Dr. Lorne Rosenfield — was recently reappointed as chair of the board of the National Safety Committee and as a Traveling Professor. Dr. Rosenfield spends his time performing elective as well as nonelective, charitable surgeries and traveling nationally and internationally to give lectures and volunteer his care. He was mostly performing elective plastic surgeries until the housing market crashed in 2008, and fewer persons were able to afford cosmetic surgery. This is when Dr. Rosenfield decided to offer his resources and surgical care to people in need. Seeking an organization that could help him orchestrate this endeavor, he discovered Operation Access. Dr. Rosenfield has been a volunteer with OA for almost ten years now, having provided around 1,000 cases of donated care through their partnership. “I have found no other organization as robust and successful as Operation Access,” stated Rosenfield. “The direct and immediate treatment they provide is unparalleled.”
Among the array of cases Dr. Rosenfield has handled through Operation Access, several distinctly stand out to him. One of these cases was a 55-year-old man with congenital ptosis, a disease that caused his eyelids to droop to the point that he could barely see. Due to his obscured eyesight, this man spent his whole life walking around with his neck hyperextended, facing the sky, attempting to see in front of him through the slits in his eyes. After connecting with this patient through OA, Dr. Rosenfeld was able to completely repair the man’s eyelids and restore his eyesight. An hour later in the recovery room, Rosenfield found the patient moved to tears and beside himself with joy and gratitude. “I have never had my neck straight in my entire life,” he said to Dr. Rosenfield through the help of an interpreter.
Operation Access has never failed to connect Dr. Rosenfield with cases that bring him incredibly close to his work. “There is nothing more rewarding than helping another human being,” Rosenfield stated. “When you are volunteering care like this, there is no friction between you and the enormity of what you’re doing. In whatever ways the sociopolitical environment shifts over time, there will always be people facing financial barriers, and there will always be people in need of health care and the vital service that Operation Access provides. “If you have the ability to provide life-saving care to a person in immediate need, why wouldn’t you?” Rosenfield asked.
This ideology is the centerpiece of both his practice and OA’s practice. It doesn’t make a difference who the patients are or where they come from, everybody deserves access to the health care they need. For more information about Operation Access visit www.operationaccess.org