Share the Health is a Madison clinic that offers free consultative gynecologic care and procedures in Dane and surrounding counties to uninsured women in need of treatment that is not provided by other providers who serve low-resource families. The procedures are thousands of dollars, which is much too expensive. These women then delay needed care, often leading to more complex problems, including preventable cancers. Share the Health patients are most often referred by clinics who have served low-resource families for decades, before Share the Health existed. Share the Health serves to support these clinics’ outstanding efforts, which are the bedrock of healthcare, as they address disparities that exist due to care barriers. These clinics deserve recognition for their service to patients, families, community, and women’s health needs.
Access Community Health Centers, a federally qualified primary care and dental clinic with five locations in Dane and Iowa County, has been caring for qualifying patients since 1982. With collaboration between medical and mental health providers, they serve as a model center for collaborative, comprehensive primary care. The clinic’s mental health staff, referred to as behavioral health providers, help patients cope and address common life stressors that impact health of self and family members. From the perspective of an OB/GYN, the quality of care they provide sorting through the complex gynecologic needs of women throughout the lifespan is outstanding, always consistent, and deeply caring. The referrals for our services at Share the Health are always appropriate, and the return of care to Access providers is always efficient and easy to coordinate. The clinic has a talented support staff that assists with patient referrals, scheduling, and connects families with local resources to address health barriers, including pharmacy services, transportation, and housing needs.
Planned Parenthood is the women’s health safety net for care in the Madison area and does an outstanding job providing preventative and problem-focused care. For women of all ages who do not have insurance, the two Madison area Planned Parenthood clinics are the source of Pap smear screening to prevent cervical cancer. Due to the last decade’s funding restrictions, they no longer perform diagnostic colposcopy to evaluate abnormal Pap tests, and refer women to the Waukesha Planned Parenthood clinic. Traveling hundreds of miles for care is a barrier due to cost, time, and time off work. Share the Health is an option, but as a clinic that is open one night a month, it’s a limited-capacity option.
Benevolent Specialist Project (BSP), which is located in Middleton, has provided free clinic services to patients since 2001 and, in addition to women’s health needs, provides access to providers of varied specialties. All providers are volunteers and care is free. When uninsured women with health problems need office procedures, like colposcopy, LEEP, biopsies, or hysteroscopy, BSP refers patients to Share the Health; however, they provide most other gynecologic specialist care. BSP remains the cornerstone of free specialist care in the Madison area and a collaborative partner with all clinics and programs addressing the needs of the low-resource members of our community. Over 15,000 patients have been served.
Just across the northern Dane County line into Sauk County resides Good Neighbor Clinic in Prairie du Sac. Established in 1999, this clinic provides free care and pharmacy benefits to area patients. Several local physicians, physician’s assistants, nurses, and nurse practitioners donate their time to provide primary medical care as well as high-quality women’s health preventative and problem-focused care at the clinic. Sauk Prairie Healthcare helps to support the Good Neighbor Clinic by donating basic outpatient diagnostic services, including lab work and diagnostic imaging. The three Sauk Prairie area pharmacies provide all medications to the clinic at cost (patients pay $1 per prescription). Local vision care providers also donate eye exams to diabetic patients.
Supporting these clinics and dozens of others across the state, two Wisconsin programs exist to fund free screening for cervical cancer: Wisconsin Family Planning Only Services and the Wisconsin Well Woman Program. The latter has served women since 1994 and also provides free breast-cancer screening. For female citizens in their reproductive years, Wisconsin Family Planning Only Services is available in the Madison area through Planned Parenthood. In addition to Pap screening for cervical cancer prevention, the Family Planning Only Services fund care that supports the reproductive health and prevention needs of women in their childbearing years, including contraception and sexually transmitted infection testing. For women past childbearing, many local health systems provide cervical- and breast-cancer- screening care funded through the Wisconsin Well Women Program—citizenship is not needed for eligibility.
Neither program covers Human Papilloma Virus (HPV) vaccination, an important way to prevent getting an infection with the HPV virus, which causes 99 percent of cervical cancer. When the HPV vaccine series is administered prior to sexual activity, it prevents 99 percent of cervical cancer caused by the seven most common strains of the HPV virus. Because the viral infection has no symptoms, it’s important to vaccinate against this silent killer in early teenage years, long before first sexual activity. Too often parents are naïve about when their child will become sexually active, which then exposes the child to this cancer-causing virus because the vaccine series is delayed. Now is the right time for anyone at least nine years old. A free vaccine is available to uninsured, low-income patients through pharmaceutical company assistance programs.
Healthcare is desired by all, and lack of insurance eligibility is a substantial barrier to accessing care that prevents costly cancer. Thanks to the all the clinics and providers in our communities that provide needed women’s care.
Mary S. Landry, MD, is president and cofounder of Share the Health Free Gynecology Clinic, Inc., and is a professor of obstetrics and gynecology at University Health Service Women’s Clinic at the University of Wisconsin–Madison.