Shabana Izhar, a new immigrant who lives in Bowie adjusts her shalwar kameez and settles down in the chairs in the waiting pavilion at the Muslim Community Center Clinic. A regular United Nations of patients surrounds her; a Hispanic woman coming from a nearby church, Gambian sisters getting their thyroid checkups, a Caucasian man with a long ponytail filling out forms. She does not have insurance and the clinic is a life saver. She pays the $35 co-pay as she is not a Montgomery county resident. "I am more than happy with everyone here, the staff and the doctors, they are so polite and cooperative," says Izhar.
Known county-wide as the Muslim Clinic, it first opened its door almost ten years ago. The new expansion project is complete. A vast open space welcomes patients. 6 examination rooms, a kitchen, a procedure room and a pharmacy; this is not a hole in the wall but a well-run practice. The ribbon-cutting ceremony is scheduled for February 15, 2013.
$350, 000 paid for a new pavilion on the MCC grounds on New Hampshire Avenue in Silver Spring, MD. $70,000 of the funds came from Montgomery County Executive, $50,000 from Montgomery County Council, $150,000 from State of Maryland for capital improvement and the rest from Clinic's own funds.
This expansion augments the clinic's space by a third to 4500 square foot. Four sleek windows seat receptionists. Sr. Naseema Rehman and Sr. Mensura Imam, visibly Muslim in their hijabs register the patients as they come in for their appointments. The clinic aims full digitalization by next year.
The MCC Medical Clinic's sustainability are made possible by the generous financial and technical support from the Montgomery Care and Primary Care Coalition, both part of the Montgomery County government’s initiative to provide health care to over 80,000 uninsured, low-income residents of the County. The MCC Medical Clinic has received generous grants from the Kaiser Permanente, Susan G. Komen Foundation, Healthcare Initiative Foundation, Maryland State, Montgomery County, and the Muslim Community Center.
MCC Clinic is the second largest Islamic faith-based clinic in the U.S. The dream is to make a full fledge Muslim hospital one day.
Dr. Asif Qadri, the Clinic's Medical Director had been writing prescriptions for family members of the MCC community visiting from overseas. "My wife and I used to bring the kids here; I joined the board and would see elderly who had a lot of health issues," says Dr. Qadri, his soft disposition that makes him popular with the patients evident with the many staff members that walked into his office. "We used to wonder what can we do to show that Muslims care."
Top, MCC Medical Clinic's Dr. Asif Qadri (right) and another volunteer doctor and below, a view of the clinic at work. Photos by the Muslim Link.
There were many doctors in the local community. The effort trickled until a health committee of seven doctors formed, including Dr. Khawaja. It stalled again over the fear of malpractice litigation until Dr. Qadri, a cardiologist and Dr. Muhammad Yousef, bought private malpractice insurance. It took years of convincing, but in June 2003, the clinic started in a few rooms of the defunct childcare center. Dr. Yousef gave the donation to make the initial purchases and MCC provided matching funds for grants.
Through the years, MCC continued to provide direct financial aid to those patients who are unable to pay for the diagnostic tests and medicines needed for their treatment.
A significant breakthrough occurred in 2007, when Doug Duncan, the former Chief Executive of Montgomery County invited the MCC Clinic to become a part of the safety net clinics which would provide the much needed funding of $80,000. Under the grant, the clinic receives $62 for every resident seen. The clinic is part of the Primary Care Coalition (PCC), a network of 14 clinics.
Washington Adventist Hospital, Holy Cross Hospital, Chinese Culture and Community Service Center, Community Ministries of Rockville are all part of the coalition. The PCC implements the program and manages operations and infrastructure development. It offers practical technical assistance to the clinics, billing, information technology or quality control of clinical services. These clinics and hospitals provide support services and population expertise. In addition, they participate in the general policy of the Montgomery Cares program through their representation on the Montgomery Cares Advisory Board.
Strategic partnerships with Quest Diagnostics, Silver Spring Radiology, University Radiology in College Park, Lab Corp etc. give substantial discounts to the patients. Catholic Charities, USA Healthcare Initiative Foundation provide additional services. "We never get stuck wondering where to send the patient," says Dr. Qadri. All the cardiology, Hepatitis B & C cases are referred to the National Institute of Health. Many times costing the patients about a $1000 out of pocket. A well established network enables the clinic to refer all cancer, thyroid and complicated cases to other hospitals in the region.
Until 2007, the clinic was providing only primary care services. At that time it was decided to add additional specialties so patients could access most of their care at the clinic.
Last year the clinic had 11,000 patients visits. This year the projection is 12,000 to 15,000 consultations. "We could easily double patient visits," says Br. Quraishi, the Chairman of MCC.
Montgomery Cares program has provided medical care to about 30,000 underprivileged adults. This represents over 200,000 consultations. "An increase of around 27% per year in the number of patients who have access to the program thanks to the new care centers, better internal management of consultation times in clinics and better communication. This is especially thanks to the fact that four clinics are taking part in programs to improve health care organization." This includes MCC.
"They have been a wonderful partner and a strong presence in our work. In terms of their relative role, for the fiscal year they served 2500 out of the 30,000 patients that we serve yearly. They are not one of our biggest clinics but have a large impact as they do serve many from outside Montgomery County," says Jean Hochron, Senior Administrator with Montgomery Cares Department of Health and Human Services.
In 2010, the clinic launched the "Women Wellness Program". Dr Abdullah, a prominent OB-GYN, is on board. A Komen grant of $150,000 provided for a 20 hour-a-week patient navigator, a 2-hour-a-week physician consultant, a 20-hour-a-week nurse coordinator, and a program evaluator. 15 cases of breast cancer were diagnosed.
In a strategic shift in patient care, the clinic has started charging a co-pay from its patients. "Adding the co-pay has given [the patients] their honor back," says Dr. Ejaz as he helps the reception staff get ready for a blind visitor by clearing out the small bookshelves that lined the back wall. In June 2006, a mission statement was formulated to “provide quality medical care to low-income uninsured residents.”
With Obamacare looming in the near future, the clinic started accepting Medicaid insurance in December 2012, as the funding from the county will not be renewed. The clinic activating protocols for Medicare and other private insurance in the near future. "Regardless of the outcome of healthcare reform, we will be able to survive," says Dr. Qadri. Hochron says that despite the changes in healthcare reform there is still a need for the services that Montgomery Cares provides as many people will not be covered.
"Their expansion of mission is really important, gives them greater ability to serve a variety of people. It is one thing to have insurance and quite another thing to find a comfortable medical home that accepts that insurance," said Hochron. The acceptance as a Medicaid provider is a long and complicated process, MCC Clinic is going through all the administrative hassles of setting up billing protocols, site visits, and registering with Managed Care organizations. "They didn't lose their nerve, and are serving as a model and leader among our clinic community," says Jean Hochron.
It started as a volunteer project to provide free care, but the clinic's continued success can be attributed to two key decisions. One to make this a community project, not a family or individual project. The other was that the clinic management were not afraid of changing the organization model to reflect growth and circumstances. The transition from all volunteer to paid staff, and then the handing over of the administration by the Medical Director, Dr. Qadri to Dr. Ejaz all aided in the phenomenal growth. They also hired a grant writer. Now if one person leaves, the organization will not fall apart which often happens to other volunteer projects.
The clinic is appointment only, although no one is turned way for not having an appointment. "No social security numbers are kept in our records," says Dr. Qadri. The clinic follows county directives that no patient is refused care.
MCC Clinic is the second largest Islamic faith-based clinic in the U.S. The dream is to make a full fledge Muslim hospital one day. Pioneers like the Ummah Clinic in Los Angeles and MCC are cynosures for the many Muslim clinics emerging throughout the nation and Dr. Azad Ejaz, the Clinic's Executive Director hopes that a network can be established. "Many Islamic Centers are trying to establish their own clinics, we need to make a large scale effort," says Dr. Ejaz. Br. Quraishi shared that they didn't have a model to follow but MCC makes their own experience available to any organization who plans to start their own clinic.
The hope is that Muslim organizations and Islamic Centers can cooperate, and other Islamic Centers in the area can start specialty departments in their clinics; the dream of building a Muslim hospital could be owned by everyone.
As the staff gathered in the small lunch room, the Diaspora of ethnicities and religions was evident. 50 percent of the staff and patients are non-Muslim. Sikh doctors and African American RNs work alongside each other. Easy banter between the Physician's Assistant resident from George Washington University and the staff pharmacist while eating rice pilaf makes a family feeling. Eating with them is Carrol Brown, NP a Kaiser Permanente employee, she and two others are on loan to the clinic by Kaiser. The Kaiser Permanente Community Ambassador Program sends nurse practitioners and physician assistants to selected safety net health clinics including MCC.
MCC Clinic's attitude towards healing is about making the patient comfortable."We are very careful to make appointment with same sex doctors, accommodate language concerns as much as we can, as communication aids in healing," says. Dr. Ejaz.
R.Y. drove from Virginia. He comes to the clinic every 6 weeks. A diabetic patient, he called in the morning and is given a same day appointment. A Christian from India, he has been in the US for the better part of 25 years but does not have insurance. "There is nothing like this in Virginia," says R.Y., "the doctors are patient, they ask in depth questions; alert you if something is not right." Comparing the services to regular doctors office who are charge high fees and spend a limited time with patients, his only suggestion was to add a paid transportation service.
This is a well thought out part of the MCC Clinic culture. "We are very strict with our staff, no one cuts corners, [our patients] do not come for a handout," states Dr. Qadri. Staff and volunteers have been removed who do not mesh in with the culture. of diversity, inclusiveness and punctuality.
Every patient interviewed said that the staff is courteous and very friendly. "We try to bring humility, an Islamic principle, in our people. We believe communication help in the healing process," emphasizes Dr. Ejaz. Sensitivity training is given to the 24 multicultural and multilingual staff and 40 volunteers who man the clinic about the variety of people who walk through the doors. The Muslim Clinic is known county wide for its reputation of "not prioritizing access to consultations according to religion".
The voluntary doctors allow the barriers between doctors and patients to be lowered and that it makes dialogue easier and care premium. Money does not factor in, so the time devoted to the patient is only limited by the number in the waiting room. The doctors can also expand their roles becoming health advisors rather than just service providers. "If the doctors need 2 hours to spend with the patient they can, they are not under time pressure," says Dr. Qadri.
Other services offered are a volunteer psychiatrist, a diabetes prevention program, a social worker for domestic violence cases, sonograms, ECHO, EKG, and pulmonary function testing is available on site. There is a full-fledged eye clinic on the premise. Plans include adding a dental clinic and looking for satellite offices.
"The largest area of job growth is in the medical field, esp. technicians. We need to help our youth find jobs," says Br. Quraishi. Helping the Muslim community remains a primary concern. "We encourage volunteers; 16 high school students who volunteered with us are in various stages of becoming physicians. Our next major plan is to start a nurse training center and a health vocational center for the community's women and youth," announces Dr. Ejaz.
Dawah is the principle that guides the MCC clinic. "The largest impact we have had is we have taken the fear out from the public about entering a masjid," says Br. Quraishi. " After 9/11 non-Muslims who were reluctant to meet Muslims have no fear [about coming] to MCC," states Dr. Ejaz.
The Prophetic Tradition of mercy to all mankind is evident in the halls and examination rooms of the MCC Clinic and there is no better call to Islam.