Health and Hope

Dr. John Vander Kolk was doing just fine with his suburban dentistry practice, where he sometimes would perform expensive cosmetic procedures on well-off patients.  But something began to nag at him when  he returned from a trip to Africa after seeing so many who needed basic care.
 
Suddenly, performing the discretionary procedures seemed less urgent, recalls Vander Kolk, 52.

That epiphany led him to a grassroots organization in the Burton Heights neighborhood serving those without health insurance through steeply discounted medical care --  a local safety net that has been catching more jobless than ever before.

“God was rocking my world,” says VanderKolk about the overseas experience that led him to leave commercial dentistry about four years ago and employ his training at Health Intervention Services.

A peek inside the three dental rooms at 15 Andre St. SE finds nothing extraordinary: Hygienists wearing regular smocks as they clean teeth using familiar equipment. Vander Kolk has made a point of setting up the rooms so they follow common dental standards. Yet using the same tools of his longstanding occupation, the dentist now makes less than one-half his former pay. And his patients pay a pittance to see him.

Vander Kolk has undergone a major vocational change. And from his perspective, it really wasn’t his choice. It was H.I.S.

“A lot of it was a call from God to move in that direction,” Vander Kolk says.

The 11,000-square-foot building off Division Avenue south of Burton Street looks like a number of other clinics, aside from a few notable deviations. Next to an assortment of magazines and an issue of El Vocero Hispano, a Bible sits on a table in the waiting room. On the wall is a framed poster of “God’s Little Instructions.” Prayer cards are given to interested patients.

“It creates an environment of greater healing,” says Sylvia Daining, executive director of the faith-based clinic for the past six years. “We really believe we’ve got something special to offer. We ask people if they would like prayer with their care.

“In the end, we all die. But if we can have conversations with people about who they are…”

Her thought got interrupted, but the conclusion was clear: They are H.I.S.

Two local doctors conceived of H.I.S. in the late 1990s, originally planning to provide pregnant women an alternative to Planned Parenthood. By the time it opened in 1998, the clinic had evolved into a point of comprehensive medical care for low-income patients who do not qualify for Medicare or Medicaid. Initially, the clinic doubled as a food pantry and clothing bank, but those services later were shed to focus on the primary medical mission. It is part of the Free Clinics of Michigan network.

Though the neighborhood has changed through the years in ethnicity, the overriding socioeconomic status remains poor. With few exceptions, patients lack any medical insurance and earn incomes within 150 percent of the poverty level . Signs in both English and Spanish cater to a growing Hispanic base that now makes up almost two-thirds of clientele. Women make up about that same share of patients, while visitors age 65 and older, or under 18, are rare because they can be covered by Medicare or the state’s MIChild program.

“There’s a lot of people who are falling through the cracks of the system,” Daining says. “We have some long-term patients, but for many of them we are a transitional bridge. For awhile, we saw a lot of laid-off Steelcase workers.”

The clinic had about 350 patient visits per month when Daining arrived after a 30-year career as an administrator at Wedgwood Christian Services. That volume rose to about 650 monthly visits last year, and now often exceeds 900 per month.

Daining credits the surge both to a struggling economy leaving more people without health insurance and to a rising number of medical professionals volunteering their time and talents. The clinic involves 11 full- and part-time staffers and about 130 volunteers, including 75 doctors and nurses -- some retired and others still practicing -- who typically work in half-day increments. Many volunteers are bilingual.

“There’s a lot of Christians who want to give.," Daining says. "That’s why it works here in Grand Rapids. This is just one of those little gems. We do have a broken (health care) system. There is not enough access to care for the poor. People can go to the emergency room, but you don’t get treated for chronic diseases. You don’t get primary care.

“We’re not really in that fight as to what we think should happen (legislatively), other than we think people should be served.”

Dental care was added around the time Vander Kolk made the jump to H.I.S. The clinic also provides care in obstetrics, orthopedics, optical and ophthalmology. Specialists in cardiology, physical therapy and psychological counseling are available. “A lot depends on who steps forward,” Daining notes.  And a medical appointment at H.I.S. also comes with an offer of spiritual guidance.

The Rev. Anwar Khan came to H.I.S. as a patient in need of routine monitoring after an open heart surgery. Now, in what the recently immigrated Pakistani calls a “divine appointment,” the retired pastor volunteers at the clinic to provide the spiritual component of H.I.S. holistic care.

“I came here for my own checkup and that’s how I was introduced to this building,” says Khan, 65, who for four decades led evangelical churches in Pakistan and Bahrain before last year moving to Grand Rapids where his daughter lives. “We talk to them and we can give them scripture to explain how God helps his people, and then we pray with them.

“It’s a wonderful combination of helping them physically, spiritually and emotionally.”

And, of course, there’s a financial discount. Patients pay $20 per visit -- more for certain procedures and lab work -- and also can get medicine at a discount. Service fees cover about 11 percent of the clinic’s $650,000 budget, with foundations, individual donors, grants and fundraisers paying most of the rest. Church and business donors contribute about one-sixth of the budget.

“We really think it’s a dignity thing” to charge a small fee, Daining says. “All the patients want to participate. They are incredibly grateful. They don’t come in with an entitlement attitude.”

Eusebia Martinez has been coming to the clinic since before the birth of her son, Raymundo, now almost 6 years old. She works a part-time job in the food court at Woodland Mall in Kentwood and her husband, Jose Ruiz, works full-time in a local tortilla factory. Because the health insurance premium share through her husband’s employer “costs too much,” the family does not obtain the coverage. And since “we don’t make a lot of money in our jobs,” the $20 visits to H.I.S. are life savers.

“When I have allergies or any kind of problems, they help me all the time,” says Martinez, 28. “When they have the medicines (I need), they give me the medicines.”

Fresh off a routine physical at the clinic last week, the lapsed Catholic says she also appreciates the spiritual attention.
 
“It’s not just a clinic,” she says. “They always ask how we are and about how we’re feeling. It’s like friendly. It’s not just a doctor.”

Though Vander Kolk is still a dentist, he began to see himself as more than that, as a kind of community caretaker. And that “made it difficult to continue on the profit route.” So he sold out to his partners and now oversees the dental office in Burton Heights. In some ways, it’s not all that different from what Vander Kolk did before.

Only now, it’s H.I.S. work.

“The definition of a ‘profession’ is different than the definition of a ‘business,’” Vander Kolk says. “If you look at what the profession is supposed to be, it’s care of the public. There are people in pain and unable to get care. There are people that have never seen the dentist and they’re in their 30s. We’re starting out from square one with them.

“We’re going to see that happening more and more with this economic trend.”


Matt Vande Bunte writes about business, government, religion and other things. His work has appeared in newspapers including The Grand Rapids Press and Chicago Tribune and in assorted sectors of cyberspace.
Photographs by Brian Kelly - All Rights Reserved
Dr. John Vander Kolk
Dr. John Vander Kolk and Dr. Laura VanderMolen
Exterior of H.I.S.
Dr. John VanderKolk

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