CLOSE TO HOME: Finding Your Calling at Your Community Free Clinic - An Interview with Kristin Davis, Au.D.

AP Staff Reports

Dr. Davis, thank you for taking time to share information about your humanitarian service. What process did you go through to volunteer at the Greenville Free Medical Clinic?
Dr. Davis: I finally completed my first volunteer shift at the Greenville Free Medical Clinic (GFMC) in October 2020 after nearly two years of preparing. This is not typical! When I initially approached the clinic, they were very enthusiastic and welcomed the opportunity to add Audiology to the many healthcare services already offered. The staff and volunteers at GFMC have made the process for volunteering seamless and straightforward.
However, as we were building out audiology services from scratch, there were additional hurdles to overcome. By the time I was able to get the necessary equipment in place for Audiology services, and the newly reworked eye and ear room was set up, the COVID-19 pandemic was in full swing, which delayed start up of the new services.
It was worth the wait! My work at GFMC has allowed me to get back to the core of why I chose audiology as a profession—helping others! These patients aren’t critical about features or Bluetooth connectivity. They are purely grateful for their healthcare and professionals willing to help. Fortunately, GFMC has remained open following strict masking, temperature checks, and infection control protocols and been a valuable resource for the community.
How should audiologists who are interested in volunteering at a free medical clinic in their community prepare?
Dr. Davis: Based on my experience, I believe that audiologists will be welcomed and highly valued providers in free clinics; however, they should be prepared to build out the program as most clinics will not already offer dedicated audiology services. The great news is that this is right up the alley for private practitioners.
I found the process to be very collaborative. This was wonderful as I certainly did not have all the answers. We discussed our common goals for community patients. I was able to provide all the technical details of areas to cover to ensure sustainable care for a hearing program such as follow up frequency and necessary hearing aid supplies for maintenance and use. Together, we discussed possible solutions for providing patients access to batteries, supplies, and complimentary follow up hearing aid care.
You were able to contribute a sound booth and audiology equipment to the free clinic. Should audiologists be prepared to donate (or seek donations for) equipment that can be left at the clinic? Can you share a list of equipment that you provided/helped the clinic acquire?
Dr. Davis: Unfortunately, I believe most clinics will not have audiology equipment so that will be a necessary part of the startup process. There is much flexibility in how providing equipment can be approached. Perhaps, you have an older audiometer that your practice can donate, you can solicit your peers for equipment donations, or there are many portable equipment models now which could be used in a private paying practice and then carried as needed to a free medical clinic site. My specific situation is a hybrid of all of the above. I donated an older model audiometer which I already possessed and purchased a small booth for donation. In addition, I utilize a laptop, portable impedance bridge, and portable real ear system from my private practice.
What services and supplies does the clinic provide using other volunteers or staff?
Dr. Davis: The GFMC has incorporated the hearing clinic into its standard protocols. They handle all intake and screening for financial qualification for services, appointment scheduling, COVID-19 screening, cleaning and infection control, and recordkeeping. This has relieved any extra work on my part. All I have to do is show up and help patients!
The GFMC has volunteer providers in the areas of general medicine, dentistry, vision, ENT, and pharmacy. In addition, health education classes are available at the GFMC in the areas of diabetes management, women’s health, weight management, and smoking cessation. The nursing support staff are wonderful at coordinating referrals and following up to ensure patients are scheduled in as timely a manner as possible.
I am told eye, ear, and dental services are in high demand and many free medical clinics don’t have volunteers to provide services in these areas. Speaking with the clinic director recently, she mentioned what a blessing having these ancillary healthcare services is as other comorbidities such as diabetes and high blood pressure are able to be detected and treated when a patient seeks help for their tooth pain, vision difficulty, or hearing loss.
What ongoing challenges do you face related to providing sustainable audiology services?
Dr. Davis: The biggest challenges for a sustainable Audiology clinic are limited resources in labor and in supply of hearing devices, including the supplies necessary to keep devices functioning properly (i.e. batteries, filters). Currently, I am the only hearing services provider; however, I have notified other audiologists through our state organization, the South Carolina Academy of Audiology (SCAA), of the opportunity to volunteer at the GFMC on as little as a one-time basis. I am confident as more audiologists are able to be vaccinated, and as COVID-19 cases begin to trend lower, I will be contacted by more interested in volunteering their time and talent.
The current plan regarding hearing device supply includes utilizing national established non-profits, if a patient is financially able to pay the application fee. Unfortunately, most are not able to afford application fees. Most patients will need donated devices. I am currently establishing protocols for use of donated devices to ensure we operate within all state regulations. Donations and creative fundraising methods will be utilized for hearing aid battery and maintenance supplies for patients.

Is there a minimum time commitment (either number of days or length of each shift)?
Dr. Davis: There is no minimum time commitment. Since audiology shares space with the vision team, the audiology clinic has specific dedicated times on Mondays 9-5 and Fridays 9-12. I simply coordinate and communicate time I can commit away from my private practice, on a monthly basis. There is no shortage of hearing patients. The nurse practitioner who is the clinical operations manager has been extremely helpful in scheduling hearing patients from the waitlist and managing new hearing referrals. The more volunteers we have the greater number of patients we will be able to serve. The eye and ear room availability would allow us to run hearing clinics a maximum of two days per week if we had the audiology volunteers to fill the clinic time.
I am also excited about the possibility of offering volunteer opportunities to audiology students and audiology assistants in the future. The general medicine and dentistry programs frequently have medical and dental student volunteers participate in their clinics. The possibility of offering volunteer spots to students is attractive as it helps with the demand for audiology providers while at the same time allows students a chance to experience humanitarian audiology. My hope would be more than a few audiology students would feel the call to implement similar programs in their home communities once they begin their professional careers. Logistically, regulations need to be vetted to allow SC audiologists to serve as temporary supervisors of visiting students from out of state. As more patients are fitted with hearing devices, opportunities for audiology assistants to volunteer on maintenance/device clean and check clinic days will likely become available.
What recommendations do you have for people who are seeking opportunities to participate in humanitarian efforts at the local level?
Dr. Davis: I highly recommend checking The National Association of Free & Charitable Clinics at https://www.nafcclinics.org/ to see if there is a free medical clinic in your area. The Greenville Free Medical Clinic is a member of this organization, and as I have described has made the process of giving back locally, manageable. Perhaps, having your own non-profit organization is deeper than you want to dive. Volunteering your services at a local free clinic does not require you to establish a non-profit. You can simply volunteer and be part of the solution for greater access to hearing healthcare. By providing audiological services, you are able to counsel patients providing access to assistive listening devices through state and federal programs and hearing devices through available national and possibly local non-profit organizations.
Do you have any recommendations for audiologists who are considering starting a non-profit organization?
Dr. Davis: My best advice is just start! If you feel called to humanitarian audiology, then start and learn as you go. There are many audiologists out there forging this path, who are happy to share their knowledge and provide advice. I also encourage anyone considering starting a non-profit to research any state-specific requirements! Â Â In addition to your volunteer service at the Greenville Free Medical Clinic, you have decided to establish a non-profit, charitable organization. Why did you decide to do that and what was the process?
Dr. Davis: I sort of put the cart before the horse as my first decision was to start a non-profit, Carolina Hearing Foundation. I wanted to serve our community and provide a channel for our private practice patients to give back locally when they choose to donate their older hearing devices. I hadn’t figured out the delivery model until I discovered the Greenville Free Medical Clinic and the pieces started to fall into place.
The timeline for me to fully establish our nonprofit has been a long one. There have been periods of time when it has been placed aside due to other priorities. Honestly, I became overwhelmed with the process. In South Carolina, state requirements for starting a charitable organization include creating Articles of Incorporation and By Laws for your entity, to comply with the S.C. Department of Revenue corporate filing requirements. I soon discovered that a federal tax identification number must be established prior to filing with the Department of Revenue in South Carolina.
Having an attorney in the family offered me more flexibility as I was not paying professional attorney fees or working on someone else’s timeline. Once I started seeing patients for the GFMC, I recommitted myself to the process, and reached out to other audiologists who had experience with non-profits for advice. I am hopeful to have the non-profit completely established in the next month via a shorter form. From my research, the cost to establish a non-profit organization varies based on attorney fees involved, but costs can be kept lower if the non-profit is established primarily for delivery of donated goods and services and the annual fundraising stays below a certain threshold.   Kristin Davis, Au.D. is the owner of Davis Audiology in Greenville, South Carolina. She currently serves as the president-elect of the Academy of Doctors of Audiology (ADA). Dr. Davis holds a Doctor of Audiology degree from A.T. Still University.