Clinic By the Bay: A Decade of Care for the Medically Underserved

Paul Turek, MD

The Clinic by the Bay mission: To understand and serve, with dignity and respect, the health and wellness needs of the medically underserved in the San Francisco Bay Area.

There is a little free-clinicthat-could, right here in the heart of San Francisco, that you should really know

about. It provides free medical care to the working uninsured. In fact, it's the only free medical clinic in the Bay Area that is entirely dedicated to this medically undeserved population. And, it takes no federal monies to carry out its mission, but relies solely on donations and volunteer providers for its utter existence. It’s called Clinic by the Bay (ClinicbytheBay.org) and it is flourishing!

Caring Roots

I was first approached by Janet Reilly and Scott Hauge in 2007 to help develop the Clinic’s care model. Philosophically, the Clinic was based on a national system of clinics called Volunteers in Medicine (VIM) that began back East and that was powered by volunteer retired doctors and other care providers. Given a blank slate for how we would structure our Clinic in San Francisco, in addition to treating every patient with kindness, respect and patience (a tenant of the VIM clinics), I also suggested that providers have old-school, long visits and that they not be burdened with paperwork in attempt to reverse the trend in modern medicine toward 12-minute visits chock loaded with documentation. An electronic medical record with scribes working alongside providers would do just fine to restore that lovely provider-patient relationship that drew us into medicine in the first place. The Clinic opened in 2008 as a 501(c)(3) non-profit in the Excelsior district after a needs-analysis was performed to identify the best location for the population we serve. The Clinic’s opening was attended by several luminaries including Senator Diane Feinstein, Representative Jackie Speier and founder of the VIM clinics, Dr Jack McConnell. And it has simply taken off from there. We care for patients in San Francisco and San Mateo counties who are ineligible for Medi-Cal or government assistance

and cannot afford private insurance, a population that consistently “falls through the cracks” in our health care system. Our overarching goal is to improve access to comprehensive, quality healthcare while also providing meaningful opportunities for volunteerism and civic engagement. We now serve as a training and experience environment for medical students, interns, and residents from Architectural rendering of the renovated Alemany Hospital at 35 Kaiser, UCSF, and Sutter/CPMC. Onondaga Street, San Francisco, CA. We engage 100 volunteers per month, of which 30% of those volunteers have been active for more than two years. To date, these volunteers have provided more than 70,000 hours of service, valued at more than 5 million dollars.

An Overgrowth of Care

But there’s more! We have now served nearly 5,000 community members and oversaw 2,652 visits in 2020, with 90% of patients reporting better health and ability to work. For six years, we have been a state-licensed community clinic and more recently we added mental health services and launched an innovative health coaching program to provide personalized support for patients with chronic conditions. In 2020, we began to address food insecurity and supporting chronic disease management through our food access and “food as medicine” programs. In essence, Clinic by the Bay seeks to reduce preventable emergency room visits, add to the capacity of the primary care safety net, and improve health outcomes among the working uninsured. And all of this is driven by an incredible culture of volunteering. As highlighted in a Huffington Post blog in 2013, we are a clinic that is “powered by pro bono.” This is one agile, evolving, modern little clinic! And with growth comes growing pains. After a decade in our currently leased Excelsior location, we are running out of space for our day-to-day operations. As we add patients, services and a growing cadre of volunteer specialists, including

ENT’s, orthopedists, health coaches and mental health specialists, we have now found a new home in San Francisco: the old Alemany Emergency Hospital. This newly renovated historic space not only gives us the ability to meet the growing need for affordable healthcare, but it also allows us to provide free dental care and pharmacy services to our patients—brand new services for Clinic by the Bay.

Historic Care

Funded by a 1928 public bond measure and built in 1933, the Alemany Hospital is an historic medical space in San Francisco. It was designed almost 100 years ago to extend the City’s emergency hospital system to cover the Excelsior District. In fact, the Alemany Hospital site was the final piece of a model citywide emergency hospital system, one that was nationally known and respected. Indeed, as it stands today, the building is a remnant of a noble and controversial effort to provide free and efficient emergency health care to underserved areas of San Francisco. Clinic by the Bay is currently restoring this historic structure, frescoes and all, and returning it to its original use as a site for free health care for our community. We are very excited to move into this historical building and revitalize a longstanding history of volunteer-powered, high-quality healthcare. Our plans include opening San Francisco’s first free dental clinic and first free pharmacy, and to expand our mental health, health coaching, and specialty care services.

Amidst this growth, expansion and historic goodness, what we at Clinic by the Bay value most and greatly need are volunteer care providers. Retired or not, you are essential to our continued success as a model of urban medical care for the underserved. Is this a call to action, you ask? Why yes, it is! Recall the words of Winston Churchill: “We make a living by what we get, but we make a life by what we give.”

Dr Turek graduated from Yale College with summa cum laude honors and attended Stanford University School of Medicine, also graduating with honors. He then trained in urology at the nation's first hospital: The Hospital of the University of Pennsylvania. He received fellowship training in Male Reproductive Medicine at Baylor College of Medicine in Houston TX, and then joined the faculty at the University of California San Francisco. After retiring as an Endowed Chair in Urology, he started The Turek Clinic in San Francisco and Beverly Hills.

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