For the past four years, I have had the privilege of being the primary medical provider at Oasis Free Clinics. I was drawn to Oasis because we have common values. I believe all people deserve access to quality health care. I believe every person should be treated with dignity and respect, and I believe we must be flexible and adapt to meet the changing needs of the people we serve.

Since the beginning, Oasis has had an interesting juxtaposition, balancing the individual patient needs with the overall community needs. With the patient in front of us, we practice slow medicine and build relationships at the rate of trust. Simultaneously, we continuously assess the needs of our patient population and our community, adjusting quickly to meet those needs.

In my time at Oasis, these are just a few of the ways we have adapted, and continue to adapt, in response to changing patient needs.

Mobile medicine

In October 2021, recognizing transportation as a struggle for a lot of our patients, our board of directors challenged us to develop a mobile medical clinic plan by the end of 2022 and start offering mobile medical clinics by the end of 2023.

In the last days of 2021, we were asked to provide on-site medical care at a local overflow emergency shelter. We said yes and got to planning. We completed a two year challenge in two and a half weeks.

In January, 2022, we began providing our first mobile clinic visits. By the end of 2022, our mobile clinics had provided 613 medical visits. While the location has changed a few times, we still continue to provide weekly mobile clinics throughout our community, bringing care closer to our patients.

Community health workers

With the number of asylum seekers arriving in our community increasing, our executive director, Anita, was researching ways to use community health workers (CHWs) at Oasis. We knew the value CHWs would bring but needed to find a way to add them to our team with the flexibility to increase or decrease hours as needs changed. Anita was able to contract with a local non-profit with similar values to provide CHWs with the flexibility we need. Since 2022, CHWs have been providing invaluable support, helping us bridge language and cultural differences and build trusting relationships.

Vision care

One of the recurring themes I heard from the patients at our first mobile clinics was the story of lost glasses. As we were brainstorming ways to meet this need, a local optometrist, Dr. Mark Alexander, reached out to inquire about volunteering to provide eye exams for patients at Oasis. Dr. Alexander and I spent months researching and purchasing equipment and setting up an optometry suite while Anita worked to secure grant funding to cover the cost of equipment and supplies. After much preparation, in September 2022, we were able to begin providing eye exams for Oasis patients. To date, we have provided more than 200 eye exams and glasses.

Mental health counseling

As anyone who has tried to access mental health support will tell you, there is not enough help to go around. In the fall of 2020, in response to increasing requests for counseling, a group of our volunteers and staff gathered to brainstorm ways to increase access to mental health support. Out of these meetings, we developed a formal brief intervention model for counseling, developed a plan to actively recruit local mental health counselors to volunteer at Oasis, and identified the opportunity to partner with student practitioners to provide counseling.

We now have an amazing mental health coordinator, a group of five dedicated community clinicians who volunteer their time, and a partnership between Oasis and USM’s Licensed Clinical Professional Counselor program. This has allowed Oasis to provide much needed mental health counseling for our patients with a relatively short waitlist.

The missing piece on our team now is a psychiatric mental health nurse practitioner (PMHNP). Family nurse practitioners (FNPs) have specialized training in diagnosing a variety of physical and mental health conditions. PMHNPs spend the same length of time in training but are even more specialized with a focus on diagnosing and treating mental health needs. As a FNP, I have the education and knowledge to prescribe mental health medications, and I comfortably do so for many of our patients. But for patients who do not respond well to the first one or two medications, or who have more complex needs, I need someone with more training and expertise.

I often go to Julia, our mental health coordinator, or Dr. Rabin, a volunteer psychiatrist who is available for case review and clinical consults, with questions. I am grateful for their support and expertise but as a primary care provider, I am ultimately responsible for the care of my patients.

And so, in keeping with my personal values of access to health care, respectful, caring relationships, flexibility and adaptability and service, I have found a way to add a PMHNP to the Oasis team. Much like all the other changes I have faced since being at Oasis, I am excited and anxious to be returning to school in pursuit of becoming a PMHNP so I can be a better provider for the patients we serve.

Giving Voice is a weekly rotating column written by Brunswick-area nonprofits. Michelle Barber is lead clinician at Oasis Free Clinics, a nonprofit, no-cost primary care medical practice and dental clinic, providing patient-centered care to uninsured adults living in Freeport, Durham, Harpswell, Brunswick and Sagadahoc County. For more information, visit OasisFreeClinics.org or call (207) 721-9277.

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