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GORDON DANIELS

Dr. Susan Lowery, volunteer physician at the Amherst Survival Center, recently received an award for service from the state.

AMHERST - Dr. Susan Lowery would love to see her volunteer work at the Amherst Survival Center made unnecessary by reform of the U.S. health care system.

But until that day, she'll continue seeing eight to 12 patients every Monday from noon to 2 p.m. at the center, kicking the executive director of the center out of her office to set up a makeshift clinic there. With Dr. Daniel Clapp, who sees patients there on Thursdays from 5 to 6 p.m., she keeps tabs on the health of 287 people, many of them homeless.

Lowery recently received a Community Leadership Award from the state's Department of Public Health. Department official Cathy O'Connor praised her "unstoppable energy and devotion."

Lowery, 52, lives in Montague Center and until 2004 practiced at Amity Medical Associates in Amherst. She was forced to retire because rheumatoid arthritis affected her stamina and the sensation in her fingertips, she said.

"I have more fun now, and I don't have the incredible aggravation of dealing with insurance companies, which is exhausting for a physician,"; she said.

With politicians debating the fine points of health care, Lowery said that any reform short of a single-payer system would not be meaningful to her patients.

"As long as insurance companies are profit-driven and have to reward stockholders, we're going to be hindered in delivering good care," she said. "There are so many groups with significant financial investments in the status quo that it will be difficult to change things."

Among Survival Center clients, 75 percent are underinsured or uninsured patients whose last visit to a doctor may have been over a decade ago, said Executive Director Cheryl Zoll. But the health problems Lowery deals with - such as hypertension, high cholesterol, diabetes, asthma, allergies and insomnia - are not all that different from what she saw in private practice, she said.

One patient with heart failure she sees every week, while others come sporadically, she said. Because of the proximity of the University of Massachusetts, she sees patients from all over the world, she said.

She's detected some tuberculosis, which she said isn't too surprising among poorer people living in cramped quarters. She also sees many patients with mental health issues, and said that "the shortage of psychiatric care for the poor is staggering."

The Survival Center's free clinic was awarded a $54,000 grant from the attorney general's office to pay for prescriptions for patients. Before that, their prescriptions were paid for only through donations, Lowery said.

She works with a group of Amherst College and UMass students who volunteer their time to help her take patients' vital signs. She has basic medical equipment, but said she could greatly benefit from an electrocardiograph machine.

The free clinic's services have expanded by partnering with local hospitals, the Salvation Army and other groups. The Survival Center can now offer on-site registration for state health insurance, mental health counseling, health education and immunizations.

Considering her own health limitations, Lowery is doing close to the maximum of what she can, she said. But other doctors have expressed an interest in volunteering their time, and the limitation on expanded hours is the lack of space at the Survival Center.

"We can't elbow anyone else out right now," she said. "It's not like we can do more health care and serve less food."

And it's important for the clinic to be at the Survival Center so that it is easily accessible to the people who come there for free meals or clothing, she said.

Zoll said she is exploring long-term options for providing the center with more space, perhaps in a separate building. The client base is 3,600 people, and on average 113 visit on any given day, and the free lunch averages 50 people, she said.

The free clinic has meant a lot to people with acute or chronic conditions who are homeless, have lost their health insurance, or need a pre-employment physical, Zoll said.

"On a basic level, it means the difference between no health care and connections to very good health care," she said.