By Noah Smith

Austin, Texas was the fastest-growing metro area in the United States from 2010 to 2022 and is now one of the 10 largest U.S. cities. But the growth has not buoyed all residents. 

“It’s a tale of two Austins,” said Marci Roe, executive director of Volunteer Health Clinic. Volunteer Health Clinic (VHC) is a free clinic in Austin that has cared for the area’s most vulnerable residents since its founding by a church group in 1966, making it the oldest active charitable clinic in the city. About 1,000 patients receive care there each year. 

Like many free and charitable clinics, VHC relies on volunteers. Annually, about 400 people volunteer, one of whom happens to be Olympic medalist Gabby Thomas. 

Thomas, a gold medal contender in the upcoming Paris Olympic Games, initially contacted the clinic via email while training for the Tokyo Olympic Games and pursuing her since-completed master’s degree program in epidemiology at the University of Texas. 

“Who I am off the track has always come first,” Thomas said in an interview with olympics.com. “Track is an added bonus. It’s something I love. I think it’s an important perspective that all athletes should have, which is that your sport is not who you are,” she said. A representative for Thomas declined Direct Relief’s interview request, citing the proximity to the Games. 

The Safety Net of the Safety Net

“In Austin, we are so affluent; we have universities and politicians and the capital, and then there’s another Austin where people struggle to support themselves with bare necessities. They’re having to make difficult choices,” Roe said. 

Since its founding, many federal and state government programs like Texas’s Children’s Health Insurance Program and the Affordable Care Act, in addition to the expansion of the Federally Qualified Health Care clinics, have sought to ease barriers to health care for people in the U.S. with low income, leading some to expect a declining need for free clinics.  

However, “there have always been people” who need free clinics, said Roe, citing the VHC’s constant stream of patients. Many hail from neighboring counties where economic realities make Austin’s cost of living prohibitive. 

“We are the safety net of the safety net clinics. We are where you go if you’re sick, you don’t have insurance and you don’t have money to pay… we’ve got the hardest working patients around but the cost of living here is very high,” she said. 

Since the pandemic, patients who sought care at the clinic have been “much sicker,” Roe said. Whereas before Covid-19, patients usually came in for one ailment, now it’s far more common for patients to have multiple issues. 

“They don’t seek out care until their lives are really challenged,” she said. “The medicines are just too expensive.” 

A Commitment to Care

Volunteer Health Clinic maintains a major focus on addressing and preventing chronic diseases like diabetes and hypertension. For patients who have diabetes, local retinal specialists and optometrists offer screenings and, if needed, will offer appointments and care in an attempt to save the patients’ vision. 

Diabetic patients are also able to work with dietitians and pharmacists to receive education on diabetes and how to control the condition. 

Other VHC specialties include dermatology, mental health, pediatrics, and well-woman care. While a $10 donation is suggested, no one is turned away due to a lack of ability to pay. For patients whose needs fall outside of those offerings, VHC assists in connecting them with other clinics, including FQHCs, programs, and support networks in the area. 

For its own patients, VHC also has the goal of finding them a permanent home for care. “We are not set up to be someone’s permanent medical home indefinitely,” Roe said. 

While patients are receiving care at the clinic, they benefit from individualized care and attention, including from Thomas personally. The Olympic athlete calls patients individually to encourage them to attend their appointments, observe their blood pressure levels, and follow any other doctors’ orders. Thomas also connects with clinic patients to find out if their experiences receiving health care are positive and if they’re able to make it to their appointments. 

Thomas also got her sponsor, New Balance, to donate over 100 pairs of shoes to patients, in an effort to encourage patients to stay active and to boost morale. 

“She wants to make a difference in people’s lives. She’s so nice, fun, cool. For about a year and a half, she was helping almost on a weekly basis,” Roe said. 

As Austin continues to grapple with the repercussions of rapid growth and socioeconomic disparities, VHC remains resolute in its commitment to bridge gaps in healthcare access. 

“Our care is incredible with our doctors, nurses, students, and all of the volunteers who donate their time and medical expertise. Even if you don’t have insurance or the money for a medical visit, but you need care, we’ll still see you,” Roe said. 

Direct Relief has provided more than $350,000 in medical support to the Volunteer Health Clinic in Austin since 2011.