July 26, 2010 — They came by the hundreds last week to sleep in their cars, vans and tents. Whole families, elderly people and young adults endured heat hovering around 100 degrees, a little rain and long lines to get free health care – the only health care many will receive all year.

As they gathered, some getting rides from friends because they had no transportation of their own, volunteers from the University of Virginia and numerous other organizations set up tents and triage and treatment areas, established communication links through Telemedicine, prepared food and water, and handled a host of other logistics.

The U.Va. volunteer team at the 2010 Remote Area Medical – or RAM – Clinic in Wise was the largest yet with 260 people, nearly 10 percent more than last year. Nurses and nursing students, doctors and medical students, IT specialists, social workers, a physical therapist, health system executives and people from throughout the Health System shared a common mission – to bring health care to people who do not usually get it.

On-site volunteers were joined by scores of others who covered shifts for colleagues, helped pack and load supplies and equipment, handled pathology needs, read images and provided other key support. The volunteer service and institutional support from U.Va. is a key component of the event, which also offers dental, vision, audiology, mammography, pharmacy and other medical services.

Official numbers are not yet available, but preliminary figures show that more than 1,000 patients received medical care through the U.Va. team. Many RAM patients get dental and vision care not covered by their insurance –  if they have insurance, and many do not.

Triage for all patients before receiving care often uncovers significant underlying health problems, such as uncontrolled hypertension and diabetes. These people are referred to the U.Va. medical area for treatment. Nurse practitioners, internists, cardiologists, endocrinologists, ultrasound specialists, dermatologists, podiatrists, orthopedists and a plastic surgeon were among the providers, working in teams that also included practitioners from other institutions.

U.Va. also maintained an on-site emergency room tent, where more than 40 patients had been seen by early Saturday afternoon, many of them affected by the extreme heat.

Nursing professor Audrey Snyder and medical school faculty member Scott Syverud conducted classes and clinical labs for a group of nursing and medical students who trained together for their work at RAM. The students were delighted to be able to apply their clinical skills to treat patients, and while their supervision was much like it is at U.Va., they had the opportunity to see more patients in a clinical setting over these three days than they would possibly see throughout their years of school.

Three newly graduated nurses learned just days before the clinic that they had passed their state exams, and RAM became their first professional work as RNs. Two of them had conducted research on the patient experience at RAM as students.

By the end of the weekend, everyone was feeling the effects of fatigue and heat, but as many acknowledged, it was a "good tired." The volunteers reported that they received more than they gave, and commented on the patience and good humor of the patients.

Final statistics showing the number of patients treated and the dollar value of the care they received are not yet available. For now, the results are measured simply in the heartfelt thank yous from grateful patients.

— by Dory Hulse