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It has been about a year since Charlotte De Sesso has seen a doctor. Lacking health insurance, her physical condition is monitored by staff at one of the city’s 10 health centers — that is, once she passes the hurdle of getting an appointment.
Instead of attempting to schedule one over the phone, De Sesso tried her luck in person Monday at Health Center No. 2, 1720 S. Broad St. Though not feeling under the weather, she noted it’s better to be safe than sorry. When a doctor checked her blood pressure at a health center last year, it was a bit high and she was placed on medication.
Less than five minutes after entering the building, De Sesso exited with a look of disappointment. She clutched a yellow card noting her appointment date: May 18.
"Summertime will be here by then," the former resident of the 1300 block of South Mole Street said. "It shouldn’t have to be like this, for people to wait so long to see a doctor."
The 49-year-old said she had no choice but to wait and, in the event of an emergency, "I might as well just go to the hospital."
Such instances have been documented in a report released last month by the Philadelphia Unemployment Project (PUP). Since 1975, the membership organization has fought for jobs and economic justice for low-wage workers and the unemployed.
July 6 and Oct. 26, PUP members and volunteers contacted nine of the city’s health centers (No. 1 is for sexually transmitted disease and HIV testing only), asking to set up appointments for a first-time checkup. After 44 calls, 30 resulted in appointment offers more than three months in the future and 18 of the 44 were four or more months out. The callers did not finalize the appointments.
According to PUP, of five calls placed to South Philly’s Center No. 2, four appointments were for at least three months out.
"There are a lot of uninsured people who come through our office who just don’t use the health centers because you can’t get in in a timely fashion," PUP organizer Brady Russell said.
Another "brutal image," Russell added, is the line of walk-ins waiting outside in the winter cold — as well as year-round — before the centers typically open at 8 a.m., in hopes of getting treatment.
"We’ve been in touch with the Department of Health and other people specifically related to [the issue]," he said of the appointment delays. "None of this is any surprise. They all wish it was different. It’s just a question of resources."
Calls to the local center’s director were forwarded to city health department spokesman Jeff Moran, who noted certain districts are experiencing appointment delays.
"In some health centers, the wait is potentially as short as two weeks; in others, it can be as long as five months," Moran said. "The cause is really a shortage of staff.
"Those areas with a large number of uninsured people, the demand for service is greater in that district."
Moran included district two, which encompasses all of South Philly, in this category.
Staff shortages also contribute to the inability to keep centers open at times conducive to working residents, Russell said. Every center has one day a week when it is open past normal business hours — which vary from site to site — but Center No. 2, is the only one seeing patients Saturdays, from 8 a.m. to noon.
"Expanding hours is something we would like to do," Moran said. "However, we cannot consider it at this point in time until we are fully staffed during our existing hours."
All centers are required to have a community board, which monitors individual centers and, at times, compares their needs to other sites. Walter Palmer, chairman of Center No. 2’s board, said a request was placed over the past year to hire two each of additional nurses, clerks and doctors. The building, with about 75 staff members that serve about 500 patients daily, hired one pharmacy technician, he said.
One clinic serving the entire South Philly population also isn’t helping matters, Palmer said, adding the building desperately needs to be expanded.
"We certainly need more doctors there," he said. "That’s always a complaint — even from the doctors — that they are overloaded and overworked."
As a whole, "it seems very clear that the health centers are not functioning at the capacity at what the buildings are capable of providing," Russell added.
Both health center proponents believe the shortages are out of the health department’s hands. Palmer suggested implementing citywide efforts to promote holistic health and disease prevention. These steps, he said, would offer a more proactive solution to healthcare dilemmas.
For those in the here and now, waiting for appointments, Palmer said, "If your condition is such that you can get by in two or three months [without seeing a doctor], you make that decision and that’s fine. If you’re not clear about what your condition is, you need to be screened sooner."
Last month, the health department approved the hiring of 100 new staff positions to be placed throughout the centers, including nurses, pharmacists, medical assistants and clerks. Moran could not say when the positions will be filled, but noted specific professions — nurses and pharmacists included — will be challenging to fill since they are in great demand and short supply nationwide.
With a report quantifying the problem complete, Palmer offered some advice: "The centers should use that as a driving force to coalesce and use it as a vehicle … so they can talk to their respective councilmatic people and mayor — and particularly people running for mayor."
