Contributed photo, with Dr. Jill Cottel in the center Lackey Virtual Urgent Care free of charge
Contributed photo, with Dr. Jill Cottel in the center

Since 2010, a total of 140 rural hospitals closed, including two in Southwest Virginia. A Yorktown clinic is expanding free urgent care throughout the commonwealth to combat barriers to accessing healthcare.

In 2020, as the COVID-19 outbreak started to grow, medical offices across the country switched to offering virtual telehealth services. Facilities in Yorktown were no different, including Lackey Clinic, a free and charitable healthcare center serving the uninsured.

Dr. Jill Cottel, the medical director of Lackey Clinic, said that at the beginning of the pandemic, the facility switched to being “nearly completely 100% virtual.” That format remained until the early summer in 2020, when the clinic gradually started offering in-person appointments. 

Even after more patients were able to experience an in-person visit again, Cottel said that up to 30% of patients chose to continue having virtual visits.

“We were kind of expecting at some point, you know, the percent would drift down because that’s what we’ve seen at other doctor’s offices,” Cottel said.

At Lackey Clinic, that decline didn’t happen. Taking the patients’ virtual preference into consideration, the Yorktown clinic saw an additional opportunity and took their care offerings a step further. Now, a volunteer team of doctors serve at Lackey Virtual Urgent Care, providing free medical care to those in need anywhere in Virginia.

Barriers To Accessing Health Care

Have you ever felt sick, but haven’t gone to the doctor? You’re not alone. According to a 2021 OnlineDoctor article, nearly one-in-five Americans hadn’t seen a doctor in over five years. 

According to the survey the site conducted, expensive co-pays due to poor insurance coverage and a lack of trust in medical professionals based on a past misdiagnosis were two of the leading reasons that some people didn’t seek medical attention.

Through working with the public, Cottel noted additional barriers people faced when trying to access healthcare across the commonwealth. Some of the barriers she saw most often included:

  • Access to transportation 
  • Access to childcare 
  • Getting time off of work
  • Financial constraints 

Distance can also be a barrier for many individuals, especially those living in the rural pockets of Virginia. The Sheps Center at the University of North Carolina found that since 2010, a total of 140 rural hospitals closed. Two of those closed hospitals were in Southwest Virginia, and three additional were near the Virginia-West Virginia and Virginia-Tennessee state lines. 

In 2017, Pioneer Community Hospital of Patrick — the only hospital in Patrick County — closed its doors. That left two options for those in the mountain community: drive to Martinsville, which was 40 minutes from the county seat, Stuart, or cross the state line to Mt. Airy, North Carolina. Neither of those options were particularly ideal in an emergency, when the hospital used to be just down the road. 

Earlier this year, Chicago-based Foresight HS Property Holdings – Blue Ridge, LLC purchased the former hospital property, announcing that more details would come at a later date. Multiple local news outlets speculated that the purchase could signal the hospital reopening — with the Martinsville Bulletin providing a July 22 update hinting toward a January 2023 reopening date — though many also noted the disrepair the former facility was in when it closed.

The Lackey Model

The introduction of the Lackey Virtual Urgent Care option eliminated many barriers to accessing healthcare. 

Beyond offering free care and taking away the need for transportation to get to a visit, the option also provides opportunities for those that don’t require medical intervention often.

“There’s a lot of people out in the community where they might not need, you know, a medical home or a primary care doctor,” Cottel said. “Maybe it’s a one-time thing; you’re a young, healthy person who got a sinus infection. They don’t have a doctor. Where can they go, and could we save them a lot of money? Because these patients usually just end up in urgent care or the ER. You know, the ERs don’t want to be overwhelmed with things like that and the urgent cares get really expensive for patients. So we thought, why not offer it to the community for people who aren’t our patients yet, but who are in that income bracket that we serve?”

Recently, a Virginian sought medical care from the virtual model for a tooth that lost its filling months prior. 

“She’s been having pain since then. And the past couple of weeks, she’s having swelling, you know, it’s getting really bad. And she doesn’t have a doctor; she doesn’t have access,” Cottel said. 

By the end of the Lackey virtual appointment, the patient not only had a prescription for an antibiotic, but she also had a referral to a dentist providing free care near her. 

“It’s just something so simple. She’s going to be pain-free, probably, within 24 hours of starting the antibiotic. I sent it to her Walmart pharmacy. I texted her the GoodRx coupon to go with it,” Cottel said. “Things that seem so easy and seem so simple can make such a huge difference to someone who’s really struggling.”

Lackey’s free virtual healthcare option is available to patients who fall between 138% and 300% of the federal poverty level. If additional in-person services are needed following the telehealth appointment, the volunteer doctors are able to connect patients with additional resources in their area, like one of the dozens of facilities in the Virginia Association of Free and Charitable Clinics.