From nurse to crunching numbers on Wall Street to nonprofit, a worthwhile journey

Karen Gottlieb has always had a passion for helping the “working poor” receive proper healthcare. So much so that she quit a job on Wall Street to join Americares Free Clinics in Norwalk.

For Gottlieb, working for the Stamford-based disaster relief and global health organization was a return, of sorts, to her first passion job: a nurse.

“I’m a nurse by background and in my early 30s I thought I wanted to leave healthcare altogether and went to Columbia Business School because I wanted to work on Wall Street,” Gottlieb told The Fairfield County Business Journal. “And I realized crunching numbers wasn’t going to do it for me. I missed patients. I missed seeing them get better. I missed that whole side of my career.”

That whole side of her career eventually led to her being named executive director of Americares Free Clinics in 1996. She was able to combine what she learned from earning her MBA at Columbia University with her nursing degree from Russell Sage College and turn that into a mission to treat more than 28,000 patients with comprehensive healthcare.

Gottlieb is also a member of Norwalk Hospital’s board of directors and served on the board of the National Association of Free and Charitable Clinics.

When she started at Americares, she threw herself into a nascent program to provide free clinic services to those without insurance earning below the poverty line.

“In the early ’90s, I started to focus on Americares and all the good things they were doing,” she recalled. “At the time, I had little kids. So, the international (of the organization) side wasn’t something I could easily do. I was fortunate to become involved in early conversations on a free clinic.”

She mentioned how Bob MacCauley, the founder of Americares in 1992 became aware of the fact that 9% of the population in Fairfield County was uninsured and 9% was underinsured. He decided he wanted to address these inequities.

“So, he came up with the idea of a free clinic,” Gottlieb said. “That just resonated with me. It was beyond my wildest dreams that we could do a free clinic and take care of people who were falling through the cracks.”

Having just celebrated the 30th anniversary of the first free clinic, Gottlieb and Americares have now built a program that includes four clinics in Fairfield County serving about 2,000 patients each year, Gottlieb said.

The first clinic started out in South Norwalk and has since added clinics in Danbury (1997), Bridgeport (2003) and Stamford (2014). They are all linked to area hospitals: Norwalk Hospital, Danbury Hospital, Bridgeport Hospital, and Stamford Hospital. Additionally, Americares Free Clinics has partnerships with Quest Diagnostics, Boehringer Ingelheim Cares Foundation, and Odyssey Group Foundation.

“In 1997, the mayor of Danbury called Americares and asked if we could have one of those free clinics in Danbury,” she said. “In 2003, we were approached by a group in Bridgeport. They went to the state Department of Public Health. And they said to just go to Americares. They know how to do it.”

Clinic history

The free clinics concentrate on adults with chronic diseases who cannot afford health insurance and don’t have livable wages.

“When you think about people with diabetes and they don’t control their diabetes. And if they have hypertension. What happens if you don’t control that?” Gottlieb said. “Sixty percent of the adult population has at least one chronic disease. It is prevalent and it impacts those people who are low-income more seriously.”

The services Americares provides include medical care, diagnosis, and early prevention for adults who are 18 years and older.

“We do a bit more than what your private doctor’s office would probably do,” Gottlieb said. “Most of our patients stay with us, unless they get insurance or they move. We have some patients that have been with us for at least a decade, some that will never get insurance for whatever reason.”

The clinics grant full access to laboratory services. They partner with local hospitals, who provide diagnostic testing, specialty care and emergency room visits at no costs to the patients.  They also provide medications and offer a health coach, who teaches patients how to take care of themselves.

Gottlieb has about 35 people working for her and about 32 volunteers, including 17 doctors. “It started with one person – me,” she said. When we started, other than myself it was a total volunteer staff.”

As they expanded, the clinics changed over to a paid staff model and an executive director.

“When we opened our Bridgeport and Stamford clinics, we used the mobile clinic as our first entrée to those areas,” she said. “We opened on board a bus and parked it two or three locations next to a building that had a waiting room space. The mobile medical unit was a wonderful startup vehicle, but it’s small. It was school bus. It served its purpose for us.”

The intake process

“They (the patients) call us and we ask them a few basic questions,” Gottlieb said. “We set up an appointment. They have to bring in a photo ID. They have to bring us a tax form from last year or a paystub. Depending on the clinic, all of our patients must make less than 250-300% of the federal poverty level.”

In some cases, some of the patients may qualify for Medicaid and don’t know it. Gottlieb said the clinic helps them determine Medicaid eligibility.

The free clinics cannot accept anyone with insurance or making 250-300% above the poverty level because they have to qualify for charity care at the four hospitals in order to receive free services.

“The partners we have provide us with services at no charge,” she said. “Quest Diagnostics has given us upward of $16 million worth of testing since we started with them in 1995.”

For Gottlieb, her mid-career change has turned out to be one of the most fruitful decisions she has made.

“I started out as a nurse a long time ago,” she said. “I was in the nursing field for 10 years. I progressively went from the bedside to education. I came back in my 40s after I had a couple of kids to something that made me feel really good.”

For more information about Americares Free Clinics, go to Americares.org