News :: Packard Health

We caught up with founder and Medical Director Emeritus Dr. Jerry Walden on a sunny February afternoon, when he had a rare hour to himself. The following excerpts are taken from that interview.

Q: Tell us about the process that led up to the founding of Packard Community Clinic. Where were you in your life and career at the time? Was there one provoking, inspiring incident? Or was it the result of a long series of events and realizations?

A: It was an incremental process, a gradual building of experience upon experience. It began back in the mid-60s, when I was in my last year of Medical School at the University of Michigan, searching for a career of meaning, considering what to do with my life. Part of that personal struggle was the result of a conversion experience back to Christianity. Eventually, I joined the Christian Students Medical Society and, I spent three months in Nigeria. It was a very challenging time to be in a thirdworld country, and during those months I was introduced to the tensions between the black and white races in a very real and visceral way. Later, as an intern at Philadelphia General Hospital, I had another major brush with an urban, multiracial patient base. Then, as a public health officer during the Vietnam War, I was assigned to work in a U.S. penitentiary in Terra Haute,Indiana. It was a very trying, very instructive period. Together, all of those experiences made me realize that I wanted to do something to help bridge the black and white communities.

But you didn't found the clinic immediately after medical school.

No–I joined forces with Dr. Ed Pierce and went to work at the Summit Medical Center, which he founded in Ann Arbor. Four years later, I decided it was time to move on. That's when I started Packard Community Clinic.

It must have been a very costly undertaking. Where did the funds come from?

A good portion of the funding came from a wonderful program known as the Community Development Block Grant or CDBG. It was those dollars that helped us remodel the building-a poured-concrete structure on Packard Road that an architect claimed he had built in three days. We spent the summer of 1973 renovating the facility and began seeing patients in September.

So what was it like in the early days? How many people were on staff? Who were your patients?

The building itself was about 2,000 square feet. There were two of us physicians working at the clinic in those early days, and about 300 square feet of our facility was occupied by several dentists involved in the Model Cities Dental Program. I can still recall our first day of operation. We saw four patients, charged eight dollars for our services, and took in a total of six dollars.

Wow. It sounds like another world.

In many ways it was. But it was also an exciting time in health care. Simpler.More fluid. Remember, there was no managed care at the time. Most patients were fee-for-service or, if they were poor, were covered by Medicaid.We had a sliding fee scale. Some people paid the going rate, even a few dollars more if they were well off. And while it was difficult for physicians to survive on the income we generated, we also did a fair amount of hospital work-which helped considerably.

What kind of response did you get from friends, family, colleagues, the community?

The Clinic has always been a little bit of a mystery to most people. A lot of local physicians still don't realize that PCC is as nontraditional as it is. The fact is, our practice has always had a significant base of paying patients. I also brought a number of patients with me from the Summit Clinic to start the practice. The community was very receptive from the start. Happily, that support has continued to grow, and today approximately 8 percent of our income comes from donors. Since we are subsidizing care for over 40% of our patients, we are relying on this community support more than ever.

The Clinic itself has certainly grown and changed since then.

Yes, we've remodeled the facility five or six times. We enlarged the waiting room, which was originally about ten feet by ten feet. Then we added a second story. One of our patients, who were a carpenter and were working on the building, even lived temporarily on the second floor while it was under construction. The last expansion was in 1995. We raised $300,000 over a three-year period, changed the configuration of the lab area, added a new waiting room and treatment rooms, made all kinds of changes.

Given the nature of the Clinic, has it been difficult to recruit office and staff providers?

Not at all. We've been able to recruit a wonderful staff, a tremendously talented group of people, from the receptionist through the providers. Many people come to us. In fact, both of our current providers-Dr. Wilkerson and Dr. Ryan-contacted me. Of course, one of the hard things is that people have to be willing and able to make some financial sacrifices in order to work for us. There's simply not enough money in each health care dollar, at least not the way we've structured our clinic. I'm especially grateful to my wife, Julie Tiplady, who has been both a great visionary and a great organizer, using her MSW and MBA skills to move the clinic forward. We also have a wonderful Advisory Board, Development Committee and Governing Board made up of highly talented people who believe that Ann Arbor is a better community when its non-profit organizations are doing well. Their goal is to increase our donor contributions by anywhere from 75 percent to 100 percent.

I know you're absolutely committed to the work of PCC. But was there ever a time when you wanted to chuck it all and walk into a more "normal" practice?

No, I don't recall ever feeling that way. Oh, there are times when you get overwhelmed by the work. It's a struggle sometimes, when there are too few resources and the patients are seriously impacted by poverty. But most days are so rewarding, and it's such a very great privilege to work with the people who come to us.

What's your view of the current health care situation in this country? Is it better than it was in 1973? Or worse?

It's worse. Back in the 1970s, people didn't feel as disenfranchised as they do now. I find it amazing and appalling that the number of uninsured people continues to grow, and that our government has chosen not to respond-even back in the days when we had a big budget surplus. Depending on the source, estimates of total uninsured Americans range anywhere from 40 million to 70 million. That's just plain wrong. I've been a supporter of national health insurance for a long time. Although I'm alternately optimistic and pessimistic about the prospects for that, I do think it will happen someday.

What do you see as the Clinic's greatest accomplishment in the last 30 years?

Being successful-socially, medically and spiritually-in offering excellent medical care to the entire community. We've been able to honor our mission of providing equal access health care for all, regardless of ability to pay, and still manage to be the provider of choice for thousands of patients. In the process, we have become a family medical practice that crosses racial and economic lines and binds generations together.

What are your hopes, expectations and aspirations for Packard Community Clinic in the years to come?

I hope we continue to be a universal access health care practice. A place where people of many cultures can feel comfortable and welcome. Also, I'd like to see another wing added to the building, with facilities for exercise and nutritional counseling. And I hope we continue to inspire young providers to be available to people struggling with their health care. For myself, I plan to step down from the position of medical director in the next few years, but of course I'll stay very involved with the clinic-as well as other good organizations in Washtenaw County. Overall, I must say, it's been a real pleasure being involved in this great risk-taking adventure.

PCC Passion

This place has its
Hold on me - the smiles exchanged
From faces of mahogany, ochre,
Sandalwood, burnished shades of smiles
Too numerous to list
Helped me to grin back filled with
The promise that a Michigan
Country boy could bridge a little hurt
In our culture of haves and have nots
And put my arm around some differences,
Some of age and of race and of gender
As well as of class.

The ownership of this place for the ones who
Claim it, and many do - is to feel
That the best of treatment - no the
Best of intention will be offered. Embrace
The one who's sad and discouraged.
Enjoy the coworker's song. Listen as story upon
Story like fresh paint on Ann Arbor's
Rock satisfies you.

Yesterday it was Gerda tromping up the
Stairs with her illness plain for all
To see. Good mentoring is practiced here.
This place has a hold on me.

– Jerry Walden