Reaching the Ghetto

Like many big-city hospitals, Chicago's St. Frances X. Cabrini Hospital has been declining with the neighborhood. As white middle-class families left their sturdy brick houses for the suburbs, poor black and Spanish-speaking families moved into the residential sections surrounding the hospital. Doctors began to shun the area, partly because of crime, partly because 60% of its residents were on welfare. By 1970, Cabrini's hospital beds were only 68% full and the hospital was $1,000,000 in debt.

Anxious to replace the doctors who had traditionally served adjacent neighborhoods and referred patients to Cabrini, the hospital board last year tried a unique approach. It bought an abandoned movie theater a few miles from the hospital, also in the ghetto area, refurbished it and added examination and waiting rooms. At the same time the board launched a search for two doctors willing to staff the theater-turned-clinic. Conditions: Cabrini would guarantee salaries of $3,000 per month for each doctor in return for referrals to Cabrini.

Two Filipino internists accepted the offer last May. Word of the program spread through the neighborhood, and the doctors now average about 30 patients a day, with ailments that range from a child's simple cough to stomach cancer. Since the clinic opened, it has referred 196 patients to Cabrini, raising the hospital's "bed census" by about 5%. "The idea is working," says Hospital Board Chairman Sister Irma Lunghi. "We're not saying that this is going to save the hospital, or the community either, but it is a start."

It has also proved a good start for the two clinic doctors. "I didn't think I'd ever be able to have a practice because I didn't have the money to put it together," says 30-year-old Henry Carag. Though they charge less than most doctors for their services ($8 for the first visit, $6 thereafter), the two men are beginning to pay their own way. When the clinic opened in May, the hospital was paying each of them a full $3,000-a-month subsidy to fulfill the guarantee; it is now down to $2,100, and the hospital estimates that by next year the doctors will be earning their entire salary from the community. The physicians are motivated by more than their paychecks in working long past the closing hours posted outside the clinic. Says Dr. Antonio Bautista, the second member of the team: "We see people with all kinds of problems, who really need help. We'll continue on like this as long as our strength holds out."

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