Healthcare for all. Dr Gerald Pierone’s Whole Family Health Center expanding its space and its
The Whole Family Health Center is celebrating its second anniversary by expanding into the empty office next door.
Although construction workers are currently demolishing that adjacent space, Whole Family Health Center’s office manager, Irene Moore, is confident they’ll be happily settled into their roomier digs in June. The expansion means more examination rooms, a larger waiting area and prescription dispensary and a better environment for staff and patients alike. That’s good, since the Health Center will soon extend its hours till seven in the evening and treat even more patients.
The Whole Family Health Center’s mission is to provide comprehensive medical care for local men, women and children who can’t pay a “regular” doctor’s bill. They may earn low incomes or be unemployed and without health insurance. Some are homeless. Regardless, there’s no profit in treating them. But that doesn’t stop Dr. Gerald Pierone Jr., the driving force behind the Whole Family Health Center.
Ask a handful of Pierone’s patients how he’s helped them with their serious illnesses. Again and again, you hear these words: “That man saved my life.”
Relay that to Pierone and he dismisses it with, “I didn’t save them. The medicine saved them.”
Pierone really doesn’t care about his public image. What he cares about are his patients. That’s why he starts at six in the morning and works a 12- to 14-hour day. His patients need him.
One patient, Maria, who asked that her last name not be used, has been seeing Pierone since 1986. She met the doctor when she was a patient at Elmhurst Hospital in Queens, N.Y. Maria may win the award for “patient with the longest track record” – 29 years and counting. She sees Pierone for everything except eyes, teeth and gynecology.
“If I could, I’d see him for everything,” Maria says. “The man has a calling. I moved here from N. Y. in 1996 for two reasons: it was warmer and Dr. Pierone was here. It’s that simple.”
Pierone says that the Whole Family Health Center is the result of a group-effort by dedicated individuals wanting to offer comprehensive primary care to the community. Whether or not the patient can pay is not a criterion for receiving medical care.
Other facilities also provide affordable care, locally. A low-income patient can go to the Treasure Coast Community Health clinics (two in Vero Beach and two in Fellsmere) or the Indian River County Health Department in Vero Beach. Pierone says that patients “who aren’t desperately poor may choose the hospital’s emergency room.”
But none of these are designed to offer integrated care the way the Whole Family Health Center does. In other words, they don’t treat just one problem, but the whole patient. They also offer a strong mental health component for depression, anxiety and other issues.
Plus, Pierone and his staff establish a relationship with patients.
“Dr. Pierone has saved so many lives, including mine,” says Steven Hoke, 63, of Sebastian.
Hoke is president of Care Networks of the Treasure Coast, an organization that works to improve the quality of life for people living with HIV/AIDS in Indian River, St. Lucie, Martin and Okeechobee counties. He was diagnosed with HIV/AIDS and severely ill in 2005.
Today Hoke is healthy and active, something he credits Dr. Pierone with accomplishing. “Dr. P. takes the time to talk to his patients. He explains why it’s so crucial they take their medications every day,” Hoke says. “He’s compassionate with everyone.”
Today, Nelson Staunton lives in Sebastian, but in 2001, he was a resident of New Jersey and diagnosed with Hepatitis C. He was in the end stages of liver disease.
“I was on the transplant list for a new liver at Mt. Sinai and I was sent to the hospital in Jacksonville for the surgery. But I had to wait. So I came to Sebastian to be with friends. That’s how I met Dr. P.,” Staunton says.
After that initial meeting, Staunton transferred all his medical records from New Jersey to Pierone.
“I trusted him. I wanted him to be in charge,” says Staunton. “Dr. P. kept me alive while I waited for my liver transplant.”
The long haul
Staunton finally got his new liver in August 2005 at Jacksonville Memorial Hospital. They assign all liver transplant recipients a coordinator to assist with complicated ongoing care.
“My coordinator was in Miami, a great guy named Elmer Cacoryorin who’s in regular contact with Dr. P. even now, because treatment is ongoing. Elmer told me he’s never worked with anyone who took the time to help a patient like Dr. P. does. That’s what impresses me most,” Staunton says.
Just a touch
Irene Moore, Pierone’s office manager for the past 12 years, remembers when people were afraid to touch anyone diagnosed with HIV/AIDS – even if it was a family member.
“Dr. Pierone taught me that our patients need the human touch. Back then, when a person was diagnosed, their relatives and friends shunned them. They wouldn’t touch or hug them,” said Moore. “So, it became my mission to touch, shake hands, hug, talk, laugh, bring coffee and generally make them feel at home, welcomed and loved.”
It sounds like a simple thing, perhaps, but to these patients, a hug or laugh means the world.
Pierone hasn’t left his work with HIV/AIDS patients or the two AIDS Research and Treatment Centers of the Treasure Coast (ARTCTC) he started in Vero Beach and Fort Pierce. He’s broadened their scope.
“The Whole Family Health Center really grew out of my work with HIV/AIDS patients in Vero and Fort Pierce,” Pierone said. “We observed that while we’d be successfully treating the family member with HIV/AIDS, others in the family were uninsured and receiving no medical care whatsoever. So expanding to treat the whole family seemed a natural.
“You could say Whole Family has grown up around the HIV/AIDS patients. We want to be a one-stop-shopping health clinic for everybody.”
Pierone’s clinics can afford to treat HIV/AIDS patients partly because they are a nonprofit organization with support from the nationwide Ryan White HIV/AIDS Program, which provides services to an estimated 536,000 people each year who lack sufficient health care coverage or financial resources to cope with HIV.
But the Whole Family Health Care Centers see patients of every age and treats every kind of health problem.
“Our over-reaching goal is to help a real mix of patients. We’re definitely skewed towards the lower income ones,” said Pierone. “We want to provide everything we can here. If a patient needs a prescription filled for an antibiotic or antidepressant, we have a dispensary right here. We have two psychiatrists and a psychologist as well as a part-time pediatrician. We can give children all their vaccines for example.”
Sara Dingwall, the center’s pharmacist, says that an in-house dispensary like this is highly unusual.
“I haven’t seen it before but it’s such a help,” Dingwall says.
Now in her second year with Pierone, Dingwall loves her job. One reason? Every day is different with its own set of challenges.
While the dispensary has a limited stock, Dingwall says she can always find a way to connect the patient with the medication. On the other hand, the Health Center is well supplied with all the recommended childhood vaccines. Dingwall sees about 10 children a week.
There’s another reason why the one-stop-shopping model makes sense: the emotional and mental health of the patient. Take a serious, long-term illness, and then add losing your job or home into the mix. People can become overwhelmed and need behavioral care, (psychiatric and psychological) whether they’re adults or children.
“As a clinician, it’s a great help to talk to a psychiatrist or therapist about a patient and have that person right down the hall. HIV goes hand in hand with depression and severe depression makes it more likely you’ll become more physically ill,” Pierone says.
He points out that a deeply depressed person feels pain more severely too. Pierone marvels at the difference proper behavioral care makes.
“Once we get their medications adjusted and on the right anti-depressant, they’re so much better right away,” said Pierone. “They can handle the day-to-day maintenance required for managing an ongoing illness.
“Anyone who is poor and ill needs a medical home. They can’t always manage to go from one doctor’s office to the next. They may not have a car. That’s another reason it makes sense to see parents and their children in the same office.”
Pierone is pleased that a handful of new doctors including a pediatric psychiatrist will be joining the team soon.
On the road
Every other Tuesday evening, Pierone and his team take health care to the people. That’s when they go to the Homeless Family Center.
“There’s someone living there with his kids and working at McDonald’s. Our going there twice a month means he doesn’t have to leave work to take his kids to the doctor,” Pierone says.
Tim Brooks works at the Homeless Family Center as assistant to the executive director, Mary Ellen McGuire. Brooks estimates approximately 85 people live there now. At least 75 of them are children.
“It is such a help for these people to get the care they need. Homeless people come in for help and Dr. Pierone and his team treat them too,” Brooks says.
Pierone says he’s proud to be associated with the Homeless Family Center and he knows there are many more homeless people out there that he never sees. To that end, he’s trying to get a van so he can bring more people to the Health Center.
Finally, while Pierone spends about 40 per cent of his working life at the Whole Family Healthy Centers in Vero Beach and Fort Pierce, he also has a private practice in Vero Beach and is married to cardiologist Nancy Cho. The couple has two daughters.
We can only hope – for the sake of the underserved in our county – that this tireless caregiver discovers a way to add more hours to a day.
For more information about the Whole Family Center visit www.www.wholefamilyhealthcenter.org or call 772-257-5785. The Vero Beach location is 981 37th Place. The Fort Pierce location is 725 North US 1 and the phone is 772-468-9900.