The current market leaders could run into some challengers.
July 13--It once was a Columbus Bank and Trust office on Second Avenue, handling deposits, cashing checks and making loans to local residents for decades.
But in the fall of 2011, the 3,260-square-foot building became a labor of love -- and for the Lord -- with Dr. Grant Scarborough returning to his hometown with yet another dream of helping the less fortunate.
After the construction dust had settled, MercyMed of Columbus was born in January 2012, its former bank vault still intact, but now serving as a patient triage room. The walls were painted in bright, cheerful colors with artwork, Bible passages and uplifting phrases scattered throughout the waiting room and exam rooms.
Since opening, MercyMed has handled 10,000 patient visits on a sliding payment scale, meaning some people have insurance of some sort -- including Medicare and Medicaid -- while others pay what they can afford.
Scarborough's dream is getting bigger, however, with MercyMed now absorbing the Columbus Mission clinic on Steam Mill Road, with expectations of treating thousands of more residents, many of them impoverished, addicted to drugs or worse.
There also are plans to expand MercyMed on Second Avenue to nearly 4,700 square feet, adding seven more exam rooms, a procedure room, a blood draw area, offices, a counseling area and a new waiting room. About $500,000 has already been raised, with yet another $400,000 to go.
"Once we do that, we'll start digging the dirt. We'd like to get that (money) raised by the end of this year," said Scarborough, the primary care physician at Second Avenue. Dr. Sarah Barr is his counterpart at MercyMed of Mission Columbus.
This is Scarborough's second project geared toward offering good medical care to the poor and needy, while also providing faith-based spiritual assistance, sometimes through the mere comfort of reassuring words. He co-founded Christ Community Health Services of Augusta in 2007, building it into a treatment hub for that Georgia city's poor population before taking a true leap of faith in the summer of 2011 and returning home for his next endeavor.
Though he declined to talk dollars, it's likely Scarborough could have earned significantly more in the private sector. He had offers from a couple of medical clinics in other cities before the nod went to Columbus.
The U.S. Bureau of Labor Statistics, citing the Medical Group Management Association'sPhysician Compensation and Production Survey, said a doctor practicing primary care received total median annual compensation of $220,942 in 2012. Those in specialty fields earned median annual compensation of $396,233.
The Ledger-Enquirer visited with Scarborough Thursday, after a morning of treating patients, to discuss his job, what he hopes to accomplish, and why he practices medicine in such a setting. This interview has been edited for length and clarity, with an expanded version at www.ledger-enquirer.com.
With the expansion on the table, that means raising money is part of your job?
It is part of my job. But at the same time we have Heather Kersey here to help with that. To really keep this clinic going, it's an expensive thing to do. The more I do it, the more it takes away from me seeing patients.
What are your funding sources?
A little bit of everything. We do grants locally and statewide, and talk to churches and businesses and hospitals to try to see if they can help support us. It's not a free clinic, so we're able to bring in a lot of money through medical reimbursement, and we raise about 45 percent of our budget through medical reimbursement.
You're a non-profit, but you do cover all of your expenses?
With the donations, we do. We have a good amount of surplus to keep us going while we're doing this capital campaign. The concern always with a capital campaign is the folks who love you will give to it, but it might hurt a little operational. So we really have to try to deepen that pool of donors. We invite them into the MercyMed family and use their gifts and skill sets. It might be volunteer and it might be given (money).
Why did you choose this location on Second Avenue?
To go back a little bit further, I was in Augusta for four years, from 2007 to 2011, opened a clinic with a friend of mine, got the clinic up and going. It was really (Columbus pastor) Hal Brady and a couple of other guys who flew up from Columbus and said, 'We want a clinic like you have here.' I gave them the spiel of what I thought they needed to do to get a clinic up and running. They called back later and Hal said, 'We really want you to do it.' So after a few years, I decided to come down and do it.
There was a search for a site?
When I first came down, I really drove through all of Columbus a couple of times, starting from Victory Drive all of the way north, and just looking at different areas and at the needs and where things were.
There are a lot of needy areas in the city.
There are lots of needy areas, but for some reason it just felt like this area with North Highlands and Bibb City, and also with a lot of homeless ministries right there, that this would be a great place to at least get started.
So you narrowed it down to this area?
There were a lot of areas we were looking at, but we really ended up liking this area. The building became available and it just seemed to be a win-win. And I am actually so excited we're here. I really love this Highlands community. It's a very needy community, and I have got to know some folks here. It's just salt-of-the-earth people.
So this area needed more attention even with the homeless efforts such as Valley Rescue Mission and Open Door Community House nearby?
There's really no medicine ministry here. So to get involved and use the gift of medicine to care for folks physically, emotionally and spiritually was really important. But as you get to know people, you realize it's more than a body. There's a community and a family and all of that which goes along with them. So we're able to learn more about the community and the needs once we're here.
We also can't do every ministry and we don't want to do every ministry. We love what Open Door is doing and what Valley Rescue are doing. We don't want to do that; we want them to do that. But we want to come in with health care and, hopefully help be part of the increase in the dignity of the people that live in the community.
Do the majority of patients come from this area?
We have it broken into zip codes. This is, by far, our number one zip code: 31904. So we do get a lot of folks from right around this neighborhood.
To be honest, there are a lot of folks out there that we're still not seeing. We've talked about starting a community program where we go door to door and try to engage people and take their blood pressures and blood sugars and do a health assessment for risk, and to find out a little more about what's going on in the community.
Which is a bit of marketing?
It's marketing, but the reality is a lot of folks who are more impoverished don't trust physicians. And a lot of them don't know they're sick. A lot of them feel fine and have no idea that their blood pressure is 190 over 100. So it's just trying to identify needs out there and keep people as healthy as possible.
You've mentioned the economic impact of good health?
I've read that 70 percent of all bankruptcies have a medical billing aspect to it ... Most of my friends work an hourly job. So if they miss work to go to a doctor or have to go to the hospital for a couple of days, it puts them behind. They can lose their house and have to move out. There are so many different complications.
So if you can catch them here and try to keep them healthy and employed and doing their hourly jobs, and keep them out of the hospital, it benefits them in so many ways. It actually benefits the city. It benefits businesses. So being a part of the community is really important to us.
There is a large number of homeless people in this area. Do you see those people?
We don't see a lot, and there's a lot of different reasons behind that, and I don't know all of the answers to that.
A recent study showed that approximately 50 percent of the people that are homeless have a mental illness diagnosis. So a lot of them have some mistrust issues; a lot of them have some anxiety issues. It's really hard to get them into the office. The ones that come in love it. They feel like they're being taken care of very nicely and being given the best health care they can receive.
But everything's an obstacle. If you're homeless and have diabetes and need insulin, how are you going to keep your insulin cool? Some homeless guys get beat up and their medicine stolen. So there are so many different factors in figuring out how we're going to take care of them, how we're going to get medicines. Some we have to order through prescription assistance, so we have to send the medicine here and then we have to try to find them and give them medicine ... So it makes health care interesting.
Long term, do you see more MercyMed clinics opening around the city?
We have a 5-, 10-, 20-year vision. The next step is the expansion. It will allow us to bring in more providers to see more patients. Part of the expansion is we'll have a little dental area. We really need dentistry for a lot of our friends. Teeth from drugs or just from homelessness are so bad. This morning I saw someone with a tooth abscess. I gave them an antibiotic, but they need their teeth pulled.
Once we get the clinic done, I think the next thing is to really firm up our counseling department here and partner with more specialty physicians. Once that is secure, we would like to look at different locations. And the next place ... if you look at medically underserved areas, all of Alabama is medically underserved area. All of Lee and Russell County are, and a lot patients come from across the river. So I think eventually the next place we'll be looking at is over in Smiths Station or some place like that to try to put a clinic up.
We have some folks coming from Opelika, Auburn, Eufaula, LaGrange. So it kind of puts it a little farther outside of Phenix City and, hopefully, kind of catches some of these other people coming from a different direction.
The Victory Drive area already has Valley Healthcare System, operated by Sarah Lang, with a great, new facility?
In Columbus, one in five people don't have health insurance, which means you don't need one or two little clinics. You need maybe 10 clinics to care for all of the folks with that much need. So we need Valley to get bigger and bigger and bigger. We need to expand the services just so we can come close to taking care of all the need that's in the city.
Another good resource is the residents' clinic at Columbus Regional. The doctors in training go through a residency program, so they have a clinic there that sees people without insurance.
There's another clinic trying to get started called Tree of Life. Hopefully soon, when it gets up and going, that will be another resource. The problem isn't how many clinics. The problem is the need is so great it will saturate what's here now.
So other similar clinics and health-care facilities aren't considered competition to you?
Oh, no. This is hard work and we need all of the friends and partners that we can get. Sarah and I have talked a little bit. We've brainstormed a little bit on some ways to actually partner to get some of the specialized needs of our patients taken care of. I really think that we'll collaborate even more as we go forward.
Is it hard for you attract good medical talent for the clinic and can you pay as much as the private sector?
No. I tell everybody that we are well-paid missionaries. I am loaded as a missionary. But we're poorly paid physicians. And that's OK for me because I feel called to care for the lowly. The whole deal is this -- you have to feel called to do something like this. It's not meant for everybody. You have to feel called to care for those who have a hard time getting health care.
Because of that I'm willing to sacrifice a little of my payment because of the reward I get from caring for folks who are deeply in need. That is part of my payment. So, yes, we don't pay well, but if you're called to it, we pay well.
If you went overseas, you would get paid a lot less. So here's an opportunity and a great need right here in our own community to take care of folks and be a well-paid missionary.
In percentages, what kind of a cut in compensation are you likely taking by not being in the private sector?
I don't have a good value for you. Financially, I could make probably twice as much. But that's not the point. The point is that ... the loss is covered up by so much gain. Some of the beauty of it is to let my kids know that we sacrifice a little bit, for them to realize there's something better out there than just having all of this stuff. It's loving and serving people. So for them to see dad sacrifice a little, it's well worth it.
Are they already getting that message, and I presume they are of various ages?
They are, 13, 11, 9 and 5. I think the older ones are starting to. When you're young, you're just excited that you can walk out and play in the yard, and you're happy. But the older ones are starting to see that a little bit. I think it's a life lesson that I want them to know, that there are some things in life worth sacrificing for. And I think they'll get that.
I tell them all the time, the greatest commandment is to love God; the second is to love your neighbor. And as Christians we love to love God, and we love other people to love us, but then we need to actually go out and love someone else.
From the standpoint of this clinic, it's basically loving strangers until they become acquainted with you and you with them?
That's the story of the good Samaritan. Here you have some guy walking from Jericho to Jerusalem. Jesus is setting this picture up. The road from Jericho to Jerusalem was so dangerous that the Romans finally came in and built a post there to try to prevent people from getting robbed. ... Let's say you're walking up that hill and you get knocked off your donkey and robbed, beaten and left for dead. So you're physically hurt, you're broke and now you have post-traumatic stress disorder from being robbed and left for dead.
What does that look like here in America? Is it Victory Drive, 3 in the morning, the lights are out, and all of a sudden you walk up and someone's moaning on the side of the road. (Most people think) I'm going to walk on the other side of the road. Everybody blames the first two people.
It makes total sense to me. The beauty of the story is that someone stopped, and the person that stopped was the sworn enemy to the Jews; he was a Samaritan. So the whole point of the story is not just love the neighbor that's like you, but love the person who's most unlike you. That's your neighbor. Go and love them.
Some of these people (I treat) are very much like me; some are very much different. But I get to care for them. There's a crack house in the community and I get to take care of folks. There's a prostitution house and I get to take care of some prostitutes from time to time. I get to give them the best health care in the city.
Do you go there or do they come here?
They come here, and I tell them, 'Drugs aren't good.' So I get to take care of them physically, but also try to encourage them to stop what they're doing. The prostitutes, I tell them, 'You're more valuable than that, you're worth more than this.' So you get a chance to interact with a lot of folks and, hopefully, tell them about the love of Christ and give them a medicine that will hopefully keep them healthy physically.
So many Columbus natives want to seek their careers elsewhere, and you did for a time. Did you ever think you would come back to Columbus?
My wife and I had no desire to come to Columbus. (laughs) We really didn't. To be honest, we felt called, and when you feel called to a place you can't go any other place. I'm from Columbus, and I felt like I knew the city, and because of that I thought I wanted to try to put a clinic in a different place (in Augusta).
But it just felt this is exactly where I'm supposed to be. We have felt at home ever since we moved here. We found a church and found friendships and relationships.
A speaker at the MercyMed of Mission Columbus ribbon-cutting said you were heavily recruited before coming here. Was that the case?
I did interview at a couple of different places. It was hard to figure out if I should leave Augusta or not. That was really hard because you poured into something and you birthed it and you're growing it up.
But one of my prayers was, 'Lord listen, if this is true and you want me to move forward, you've got to make it obvious.' Out of nowhere, I started getting these random people calling about job offers. So I looked at a couple of different locations.
But it came down to the fact that I really do like building stuff. I like taking something from the ground and building it. The thought of coming back to Columbus was, one, where I felt God was telling me to, but also I just like starting from ground zero and working my way up. I got to do that here.
Which begs the question. Do you think you'll still be in Columbus in five or six years or will there be a another desire to build something somewhere else?
I think I'll be here, because my vision for this is a couple of small clinics ... Someone gave me a phrase one time that's really helped stabilize me a little bit. (They said) I'm like an aircraft carrier and now I get to build little ministries and we send them out. And when I get tired of that one I build another one.
So for me to start this, awesome. To help join up with (Mission Columbus), exciting. Expand this clinic, exciting. The next thing is getting specialists involved. The next thing is getting the counseling ministry up and running. After that, we've already driven over in Alabama and looked around. It's three or four years down the line, so I said, alright, we've got something over there next.
It's the thought of building a ministry to help this whole community area, which I think is very exciting.
Your father is Otis Scarborough, a Columbus businessman and now head of the real-estate development and management firm, Woodruff Company. You never had thoughts of going that route and following his lead in business?
Well, he stuck me at Carriage Hill Apartments in Phenix City to manage them for a year, and that's all I needed to go into a different direction. I said, let's do something different.
Why is that?
It was fine. It was just a lot of ...
Putting out fires?
Yeah, but fires that really aren't fires. I don't do well with small complaints, is the best way to say it ... It was good. I enjoyed it. The part I liked was the relationship part, the people I met. But all of the little problems people had ... there were a lot of problems.
After that, you wanted something completely different?
I went into the ministry and loved it. I was in Atlanta and was doing Young Life, a church youth group, and I started working with the poor in Atlanta, and I thought I'm going to do nothing but work with the poor my entire life.
What was your path from there? You said several counselors advised you to become a doctor to help the poor?
I believe God works in processes. I thought he surely wanted me to go to med school and meet somebody along the way (to steer him in a certain direction). But I got in. I almost wept the first day I got my letter of acceptance. They were tears of dejection because I didn't want to go. It was hard to go to med school because all I wanted to do was care for the poor.
When I went to school, I ended up reading a book about a man in Memphis and all he did was care for folks who were very impoverished there. The county just south of Memphis was the poorest county in the U.S. for a long time until they brought the casinos in. I read about him and I thought, maybe this is what I'm supposed to do. Maybe I'm supposed to start clinics to care for the poor in the U.S.
So I went to do my training there in Memphis to see how they did their clinics. There are two clinics there. That's why I decided to go to Augusta and start a clinic.
The point is, (with medical school) I really went into the ministry, I felt called there. The longing in my heart was to care for folks less fortunate than I was, and I felt initially that med school was not the way to do it. And, now, it's what I do everyday.
I get to see one friend after another, and I get to talk about life, get to talk about hard times, talk about what brought them into poverty, take care of their blood pressure, pray for them, encourage them and, hopefully, get them back on their feet.
Where did you grow up in Columbus?
Initially, I grew up kind of by Clubview and then in Overlook (neighborhood) ... behind the Aflac building.
Where do you live today?
I actually live in the old house because we moved from Augusta and we couldn't sell our house. My dad hadn't been able to sell his house; he moved to the farm. So I actually moved in there until we sell our Augusta house.
Have you thought about living in the Bibb City?
Well, it's a dream of ours. When you read books about community development, all of them say the best way to change your neighbor is by being a neighbor.
So you don't rule out having a home in this neighborhood?
Not at all. A lot of impact will come from sitting on the front porch at 9 o'clock at night talking to your neighbor. But we've got to do it justly. We don't want to turn it around by kicking everybody else out. Yes, we want to get rid of the riff raff, but also we want to lift the folks there up.
I read a lot of books and one phrase I like says, 'Give a man a fish he eats for a day. Teach him to fish and he eats for a lifetime.' What happens when there is no more fish left in the lake? Back here (near the clinic), it's what I would call a resource-less neighborhood. There's no more fish back there. We need to create jobs in this community. You have create learning and training programs, and teach leadership programs. All of that has to be done to lift this community up.
If you just move in and kick folks out, that's not the answer. The answer is how do we take these folks and lift them up and get them in a better spot. The other vision we have besides a clinic is to do community development.
Some of your outlook came from your father?
All of this comes from my father. My dad, since he was a kid, would always bring home less fortunate people than himself. Growing up, he would always be out there helping folks less fortunate. We would always be the family taking Christmas presents to families less fortunate. We would always be the family going to House of Mercy to serve and do different things.
This is modeled from my father and my mother (Sandy), and even to this day he's doing it. So, yes, he's a well-known businessman, but probably what's not well known about him is he has this love for the less fortunate that he's instilled in us. That's why we're doing what we're doing.
In closing, would you like to add anything?
The beauty is God's the one that talks about caring for the poor. He actually talks about it more than any other subject in scripture, caring for the poor. You think it might be reading the scripture, no it's not. You think it might be prayer, no. He talks about caring for the poor and the widows and the orphans more than anything else.
And I think it's the left-out part of scripture of the Bible that America doesn't like to talk about. In America, it's pull yourself up by your bootstraps. It's make a name for yourself. It's build your kingdom. We like Christianity as long as we can do it alone in our closet by ourself.
But if we have to live up to the second commandant and love our neighbor, we have to walk outside the closet and go across the street. And that's the part that makes it so much more challenging, but I think so much more of blessing.
Mother Teresa said we need the poor more than the poor need us. And when I'm in this room and a patient says, 'Doctor, can you pray for me?,' the first thing I say is, 'I will, but will you pray for me,' letting them know that I'm just as broken as they are, that I don't have my life all figured out, that I'm still struggling in sin in different areas, and that we're all broken.
And as you do that and start praying for one another, you realize some of my strongest examples of faith are some of the people that I take care of. They have nothing. I love this one lady, she's had a tracheostomy because she's got throat cancer. She talks with one of those little machines. She has nothing and lives in a tiny little place, and she has more hope and faith and peace than I have.
So when you start giving yourself away to other people like Mother Teresa did, I agree. We need the poor more than the poor need us, because we're the ones that really get blessed.
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