Called to serve the underserved

Known as Dr. Karen to her patients and Sister Karen elsewhere, Karen Willenbring, M.D., '98, has been clear about her life's purpose since graduating from college.

Accepted to medical school at the University of Minnesota, her home state university, Willenbring deferred for a year to volunteer with Young People Who Care, a mission-driven organization providing social services to rural poor in Appalachia.

She landed in central Pennsylvania, where she spent time painting houses, visiting elderly, handling errands for homebound individuals, and running children's programs. She loved it so much that she deferred medical school for a second year, then a third, thereby losing her spot.

During this time she discerned a calling to become a sister in community. After much prayer and reflection, she entered the Community of Anawim in Frenchville, Pennsylvania.

Becoming a Catholic nun, however, did not deter Willenbring's pursuit of medicine. In fact, it fit perfectly with her vision: To establish and run a free clinic for those who have no health care. As she put it, "Being part of the religious community here is my vocation. Working as a doctor is my ministry to live out that vocation."

With the support of her community, Sister Karen began the arduous process of re-taking the MCATs and re-applying to medical school. She had her heart set on Penn State College of Medicine because of its focus on patient-centered care and commitment to primary care and rural medicine.

Her prayers were answered, and she spent the next four years in Hershey. Throughout medical school, she never wavered in her dream of becoming a family practitioner. "I like the variety of ages and the whole relationship aspect of medicine," says Willenbring. "The continuity of care you can provide truly makes a difference over the long term."

She adds, "In medical school, Dr. Simms was really influential for his approach to medicine and patients. That it's not about the illness, but about focusing on the patient as a real person. And that it is a privilege to be in that relationship."

Willenbring happily spent her residency at Saint Vincent Family Practice in Erie, Pennsylvania–always keeping alive her dream of building a free clinic for patients back in Frenchville. With the help of her community, they started fundraising and officially incorporating as a non-profit.

The rest, some might say, showed the hand of God.

One night during her second year of residency, Willenbring found herself chatting with Margaret Laukitis, M.D., while both were awaiting lab results for critically ill patients. When Laukitis asked, "What are your plans after residency?" Willenbring gave her standard answer: "I'm in the process of starting a free clinic to take care of the uninsured."

Laukitis immediately took out pen and paper, jotted an address and said, "Meet me here after you're off call. I have some things for you."

It was the last thing Willenbring wanted to do after thirty-six hours on-call. But when she dutifully showed up at Laukitis' five-exam room medical office, Laukitis simply said, "Tell me what you don't want. You can have everything here lock, stock and barrel." She and her partner, Debbie Radner, M.D., had decided to leave private practice to become hospital-based physicians, and they were more than happy to donate everything to a free clinic.

Willenbring was stunned. "I wouldn't even think of asking God to drop an entire medical office in our hands, but that's how it happened." With help from her father, who came from Minnesota with a U-Haul, and her fellow residents, they loaded and shipped everything to Frenchville for storage.

Now they just needed a building, and here is where the second miracle occurred. Despite extensive searching, the community could not find a building to renovate. One day, they received a call from Frenchville's Lion's Club, who told the Sisters: "We heard you are starting a free clinic, and we would like you to locate it in our town. So we're donating three acres of land." The club also donated their services to dig the foundation, do ground work and install electricity, while the Sisters took on a mortgage for a new building.

Completing her residency in July 2001, Willenbring returned to Frenchville in August and worked with her community to design the building. They broke ground in October, and by January 2002– just six months later–Willenbring was caring for her first patients.

"Some people said we should have all our finances first before going into a large venture like this," says Willenbring. "But if you wait for that to happen, it's years later, and people's lives were at stake. So we just went forward, existed on gifts, and the donations came through."

This labor of love and faith has grown tremendously over the past decade. Supported exclusively by donations and volunteers, the Susquehanna Rural Free Clinic started out providing primary care and routine women's care, including mammograms.

When an ophthalmologist volunteered his services, they added eye care, offering low-cost eye glasses for $40 a pair. Their local hospital–Clearfield Hospital–also has been extremely supportive, providing lab testing for free.

In 2009, recognizing the vital importance of dental care, they added another building on the same site and obtained an $80,000 Department of Health grant from the Commonwealth of Pennsylvania to pay for dental equipment. With the help of five volunteer dentists who bring their assistants and hygienist staff with them, the clinic now offers dental care, including a work room for dentures.

The clinic also boasts a volunteer dietician, who works closely with diabetic patients on nutrition issues, and two years ago the clinic added volunteer pastoral counseling. Willenbring also provided a full family practice rotation for a Penn State medical student and hosted two other students for a week of clinical observations, providing education and exposure similar to LionCare, Penn State Hershey's student-run clinic, which provides free health services to the uninsured and underinsured population of the greater Harrisburg region.

A local cardiologist handles all the echocardiograms and stress tests for free. "If he didn't do that, many patients would be worse off or dead," says Willenbring. "He's saved many of our patients' lives."

The only paid employees are a nurse, who works two days-a-week, and the front office coordinator, who also handles bookkeeping, schedules patients, and generally manages the volunteer staff.

"Our overall focus is body, mind and spirit," says Willenbring. Her next project is to work with an Eagle Scout troop to add an exercise path including eleven stations on the grounds.

"This is the fun part of medicine," says Willenbring. "We can help make lifestyle changes that impact a patient's overall health and well-being, where you can really make a difference in people's lives that isn't just about writing out a prescription. That's what medicine is all about."

With 600 active patients (evenly split between men and women) and a $150,000 operating budget, the clinic survives through donations and fundraisers. Willenbring provides primary care Tuesdays and Fridays, spending the rest working at Clearfield Hospital. Her entire salary is donated to cover the clinic's mortgage. The community also holds benefit concerts and organizes an annual golf outing that raises about $15,000.

As a non-profit, the free clinic cannot accept insurance. While this adds financial pressure, conversely it provides freedom. "As the paperwork part of medicine has increased, this has automatically decreased face time with patients, with pressure for ten to fifteen minute visits," says Willenbring, who typically spends thirty minutes with each patient and an hour if they're new.

Each visit includes a screening for depression, help filling out forms to obtain medications or low-cost services, and lots of education. Willenbring has more stories of grateful patients than she could ever recount; from uninsured patients who have not seen a doctor in twenty years, to newly unemployed patients who used to have insurance and now find themselves desperately seeking care.

For many, this free clinic is a lifesaver. One patient, unemployed for five years, came in with decayed teeth, severe mouth pain, obesity, high blood pressure, and severe depression. She received free medical attention, including a full mouth extraction and new dentures. Four weeks later, she was employed; three months after that, she had lost forty pounds and gained back her life. Willenbring notes, "The dental part of our program is where you can tangibly see the difference in their lives."

As a free clinic, financial viability is a constant struggle. So why does she feel called to do this? "To give people hope, to bring healing and to use the gifts I've been given to make people's lives better," she says simply.

She urges her fellow alumni to volunteer at a free clinic in their own community, adding "You'll find it a joyful and renewing experience to take care of people who have no other option for health care."

Click here to read additional stories on the Penn State College of Medicine Alumni Update.