Story and photos by Bill Brewer
Reimbursements for medical care given by the St. Mary’s Legacy Clinic come in various forms when the mobile doctor’s office makes its rounds treating East Tennessee patients.
“Thank you,” “I appreciate what you do for me,” and “We are glad you are here” are received most often. Then there’s the occasional handmade show of appreciation.
Heartfelt gratitude is currency for the clinic and worth its weight in gold for Sister Mariana Koonce, MD, a Religious Sister of Mercy and medical director for the St. Mary’s Legacy Clinic, and her team of volunteers that bring free health care to the uninsured in more than 35 counties served by the Diocese of Knoxville. The mobile clinic’s medical services are available to anyone, regardless of religious affiliation.
Emily, an Athens resident who is seen regularly by the medical staff when the clinic makes its monthly visit to the McMinn Senior Activity Center in Athens, expressed her appreciation by presenting Sister Mariana and the volunteers with a framed picture of a young girl and boy holding hands that she spent more than a year cross-stitching. Sister Mariana also has received crocheted items and money donations.
Emily, a middle-aged caregiver, found out about the mobile clinic from her mother’s caregiver and is thankful for its continuum of care.
“I’m glad God sent them here. This is very needed in McMinn County,” she said. “It meets my needs physically and spiritually.”
Holly Currier agrees.
The parishioner at St. Mary Church in Athens and former executive director of the McMinn Senior Activity Center has watched as the community has embraced the mobile clinic.
“I think the clinic has been very successful here,” Ms. Currier said, noting that other clinics in McMinn County are beyond capacity, with wait times of hours to see a physician. “It was really important to me for the clinic to come here because there is such a gap in health care. I feel this is filling a gap for health services.”
Frustrated by watching people “fall through the cracks” because of income level, age, insurance status, or medical condition, Ms. Currier has been determined to bring relief to people in the county.
“The clinic has made a great difference in some people’s lives. The quality of care is very good, and our patients feel like they’re being thoroughly examined and all areas are being addressed,” she said.
The mobile clinic began seeing patients in January 2014, and Athens was one of its first destinations. Now, two years into the ministry, the not-for-profit clinic also is seeing growing lists of patients in Washburn, Decatur, Crab Orchard, and Rutledge, sites where the clinic can reach people living on the margins in rural, impoverished areas of Appalachia.
Sister Mariana describes the mobile clinic as a ministry of mercy for those without access to mainstream health care. The clinic was born from proceeds of the sale of St. Mary’s Medical Center’s parent company in 2011, when the St. Mary’s Legacy Foundation was formed by Bishop Richard F. Stika and the Diocese of Knoxville. The foundation provided funds to purchase the mobile clinic and continues to provide grants to the clinic operation.
The Sisters of Mercy, who have been involved in St. Mary’s Hospital since its opening in Knoxville in 1930, have continued to serve that longtime medical facility through ownership and name changes, and are inspiration for the mobile clinic.
Sister Mariana brings that inspiration to the clinic each time it goes out to communities. The diminutive doctor can be seen behind the wheel of the large triple-axle diesel van as it travels across the region. But she often has a volunteer assistant drive the truck while she leads prayer and says the rosary in the cab to begin and end each clinic day. The travel prayers often are to the Virgin Mary, St. Michael the Archangel, St. Raphael, St. Gabriel, and Venerable Catherine McAuley, foundress of the Sisters of Mercy.
Prayer is a critical part of the mobile clinic’s healing ministry, and Sister Mariana shares that part of the primary-care practice with her team of volunteers, now numbering more than 70. At each clinic destination, Sister Mariana gathers that host location’s volunteers in a circle, where announcements and introductions are made, the day’s instructions are given, and the sister leads her team in a prayer of thanksgiving, praying also for the patients, the volunteer medical staff, the host location, and for God’s mercy.
Rolling into Athens, the large van lumbered its way into the parking lot of the McMinn Senior Activity Center, driven by registered nurse Carla Neale, a parishioner at Sacred Heart Cathedral. The Athens volunteer contingent, numbering about a dozen, greeted the van as it parked, and they jumped into action to set up the clinic for a day of patients. Within 30 minutes, a check-in table was set up, and patient assessment stations were readied inside the center to prep patients for their one-on-one visit with Dr. Koonce just outside in the van. Other volunteers were assisting Sister Mariana inside the mobile clinic.
Along with prayer, Sister Mariana said volunteers are critical to the clinic’s success. That success can be measured in the steadily growing number of patients signing up for treatment. At some locations, the sister/physician must limit the number of patients she sees in a day.
And while the patients express gratitude to her and the volunteers, it is Sister Mariana who heaps praise and gratitude on the volunteers.
“The sheer generosity of our volunteers has been a pleasant surprise. Some of them drive an hour to get to us. They are extremely generous people, and I try not to ever take that for granted,” she said.
Judy Schmidt has been volunteering with the clinic for nearly three years – since its inception. She joined up with the clinic through the diocese’s St. Luke Guild and works with Sister Mariana at the Athens location.
After retiring from Parkwest Hospital in 2014, Mrs. Schmidt turned more of her attention to the St. Marys’ Legacy Clinic, where working with “wonderful people” is what she said she gets out of volunteering.
“We are their doctor. Some of our patients haven’t seen a doctor in five or 10 years,” said the All Saints parishioner, who pointed out that the patients “need a little pat and a hug in addition to health care.”
It’s that kind of small hometown doctor’s office feel that attracts patients and volunteers.
Elsa Baumann, a Vonore resident and member of St. Thomas the Apostle Church, formerly worked at Fort Loudoun Hospital in Lenoir City and has been volunteering with the mobile clinic for a year. She and neighbor Lorraine Molloy, former hospital co-worker, buddy each other at the Athens clinic, where they are part of the medical history team that gets a comprehensive picture of the patient.
They hope the patients are getting as much from the clinic as they are.
“It’s fulfilling. I feel like I’m giving back to the community, to those less fortunate,” Mrs. Baumann said. “We do not judge here. We’re just here to help. This fills a void in health care and then some.”
Volunteer RN Connie Dickey drives to Athens from Chattanooga, where she attends St. Stephen Church and is retired from Parkridge Medical Center. The mobile clinic was an answered prayer because she has missed working with those in need of good health care.
Through the decades of medical experience the volunteers bring to each clinic location and their desire to create a more personal atmosphere for patients, the clinic locations have developed a family-practice atmosphere, part of Sister Mariana’s strategy since her specialty is family-practice medicine.
“I think many of the patients see us as family, and they let us share in their lives,” said Mrs. Dickey, who also volunteers at the Crab Orchard site. “We encourage them to talk and to feel at ease.”
Sister Mariana’s assistants have noticed that the patient load has steadily grown since they began volunteering.
And as more patients arrive at the clinic locations, Sister Mariana finds she is dealing with a good dilemma. When she began the clinic, she prayed response would be positive. And it has been.
The clinic is scheduling 12 patient appointments a day and must spread out the patient load. That trend may result in more site visits.
“I think we’re on track with the patient number. I’m thankful they’re up, but there will be a maximum. Then what do you do? Do you add a day?” Sister Mariana said. “It took a little longer to build our patients than I thought, but our patient numbers certainly justify us going out.”
Sister Mariana said Athens has been the most consistently busy location, with Crab Orchard a close second. She noted that Rutledge is brand new, opening in September, but should be quite busy. Decatur also is new, and Washburn is growing.
St. Mary’s Legacy Clinic has established relationships in the communities it serves, reaching out to organizations and individuals within and outside of the diocese. Sister Mariana emphasizes that the mobile clinic always was meant to be an ecumenical mission, as evidenced by partners and patients, and she is pleased that Meigs Ministries, a non-denominational social services agency, and the Decatur United Methodist Church are hosting one of the newer sites.
“It’s a real testament to the attractiveness of the mission,” Sister Mariana said.
The road to Rutledge, Decatur, Washburn, Crab Orchard, and Athens and rising patient numbers hasn’t been without challenges. Sister Mariana has had to navigate the complexities of the constantly changing health-care environment while running a non-profit ministry that relies financially on the diocese, grants and donations.
“There are plenty of challenges,” she said. “I have to remind myself of the positive impact we’re having on patients because you can get bogged down in the challenges. We get feedback that they really feel cared for. Patients have come back to me and said they’ve never been treated so well. That’s a real testament to our volunteers.”
Despite the challenges, Sister Mariana and the clinic team are determined to remain flexible, which is essential for effective patient care.
Mrs. Schmidt recalled a patient with an amputation who had been treated by another physician and was told there was nothing more that could be done to treat him and was released. He has sought out the mobile clinic.
“So we continue to see him even if he isn’t scheduled,” Mrs. Schmidt said.
Patient care comes first at the clinic. And while patients with insurance aren’t eligible to be treated by the clinic, they aren’t summarily turned away. The clinic staff assists them in finding health care that will be covered by their insurance.
Also, patients who require more extensive treatment for a medical condition diagnosed by Sister Mariana are referred to specialists who can take them.
Bob is an Athens resident who frequents the McMinn Senior Activity Center. He was introduced to the mobile clinic and has become a fan of the clinic and its team. High blood pressure and a few other age-related conditions make it necessary for him to be under a doctor’s care, so he has become a regular patient.
“Not only is it very good, but the people are very friendly. The staff remembers me and is very personable,” he said, complimenting Sister Mariana and her staff for being thorough in monitoring his respiratory and blood pressure conditions.
“She (Dr. Koonce) didn’t want to prescribe one drug for me until she checked my blood work to make sure I wouldn’t have adverse effects from the drug,” Bob said, noting that he likes the clinic well enough to keep coming back. “It’s the one regular place I can go. Once you stop learning new tricks you’ll become an old dog.”
Just like the expressions of gratitude, positive reviews are valued by the St. Mary’s Legacy Clinic staff. And with the work that Sister Mariana and the clinic volunteers do, they have become inevitable.
The relationships being established in Athens, Decatur, Crab Orchard, Washburn, and Rutledge are ones of mutual admiration –and appreciation. And in this jubilee year established by Pope Francis, Bishop Stika believes the Sisters of Mercy-inspired clinic is doing just that on a weekly basis – performing acts of mercy.
Bishop Stika said the clinic demonstrates a cooperative effort between the diocese and the Religious Sisters of Mercy of Alma, Mich., whose charism includes health-care ministry. Sister Mariana has been assisted by Sister Stella Maris Linder, RSM, and Mother Barbara Ann Marie, RSM, in operating the clinic.
“Sister Mariana has put together a great volunteer force and established contacts in the health community across East Tennessee in serving areas where there is very little health care,” Bishop Stika said. “Their ministry, their mission, in cooperation with the diocese, is about mercy, charity, and compassion.”
Bishop Stika said the clinic also is about evangelization, noting that in some cases the clinic is the first experience East Tennessee residents have had with Catholics.
“It shows the commitment of the Church to serve those who may not be Catholic. Just like with Catholic Charities, the people we serve overwhelmingly are not Catholic,” Bishop Stika said. “As Catholics, we serve the community around us.”
Two years into the program, the mobile clinic’s mission is unmistakable. It is even written on the side of the van: “Extending the healing ministry of Jesus to East Tennessee.” And for Sister Mariana and the St. Mary’s Legacy Clinic volunteers, healing and ministry are inseparable and invaluable for an important and often overlooked segment of East Tennessee: those living in the shadow of poverty.
Sister Mariana and all those supporting the mobile clinic want to make sure fewer of them fall through the cracks. “We treat them the way they deserve to be treated, with dignity and respect,” Sister Mariana said.
If Emily is any indication, the mobile clinic is a wealth of support and good will.
“I am very well pleased. They care about everything about the patient,” Emily said. “They care about you, and they love you also.”