Systemic racism is on full display when one goes to find a COVID-19 testing site. North and South Dallas have the largest discrepancy between the number of private and public testing sites of any Texas City–just another data point demonstrating the city’s historic geographic inequity.
Dallas has a scarcity of primary care physicians practicing in neighborhoods with large minority populations, which also have high rates of uninsured residents. The problem is exacerbated by mistrust between minority populations and traditional health systems and a shortage of primary care physicians nationwide.
Dr. Christopher Crow has created the Catalyst Community Foundation, a nonprofit to address these needs in Dallas and make affordable, advanced primary care accessible to everyone. Crow is the founder of Catalyst Health Network, a collaborative of primary care physicians in Texas and Oklahoma that work to share best practices, implement value-based care, and advocate for better care. The pandemic left many independent physicians looking for support and guidance, and the network has seen more than 100 percent growth across the state.
“Texas leads the nation in uninsured people, with more than 4.3 million Texans lacking health insurance. Furthermore, we have millions more that are functionally uninsured through high deductible plans that leave them using the emergency room as a last resort when they get very sick, causing a massive amount of people not to receive care until it is prohibitively expensive,” said Crow via release. “The Catalyst Community Foundation aims to give those with philanthropic hearts for healthcare and healthcare disparities a highly-impactful way to direct funding to the frontlines of the community, connecting primary care to people who need it most.”
Crow wanted to leverage the network’s success to expand services where there haven’t been any and has been meeting with churches, community organizations, and other leaders to see how primary care might be extended into these neighborhoods. With the move to virtual schooling and a general acceptance of telemedicine, technology has provided a way for care to get into areas that might have been prohibitive before. “It opens up a whole other world of possibilities,” Crow says. “We now have an access point to utilize to deliver primary care and ongoing care management.”
Crow sees the foundation as a way to have an immediate impact on the community’s health by providing access to primary care. Relationships with primary care doctors can mean significant downstream savings, allowing those funds to be used for other society’s needs.
He hopes the foundation can come alongside what already exists and enhance interventional primary care, creating a sustainable model that will allow physicians to make a living while expanding care to underserved areas. The effort is also targeting COVID-19 specific needs and adding testing sites in southern Dallas.
“Catalyst stepped in to help when state and local officials couldn’t – or wouldn’t – offer testing at the rate our hardest-hit communities needed,” said Ritchie Butler, founder of Project Unity and senior pastor at St. Luke “Community” United Methodist Church via release. “They have quickly become a trusted partner in neighborhoods that are understandably wary of the health system, and I’m looking forward to helping the Catalyst Community Foundation develop more initiatives that continue to improve quality of life here well past the pandemic.”
Crow began the foundation with six months of his salary and is passionate about addressing these issues and providing caregivers in the communities that need them most. “We don’t have all the answers,” Crow says. “But they don’t trust the health system or someone who doesn’t live near them.” Crow wants to add to or develop more direct primary care, local telehealth (where the physician is nearby), care coordination, and nursing care in the area, “instead of waiting and hoping physicians should show up.”
Initially, the foundation will work on education and advocacy about the importance of primary care and having a relationship with a physician. Eventually, the foundation hopes to find a revenue model or subscription service subsidized by the foundation, employer, and other community organizations to offer primary care to residents. Expanding Medicaid in Texas would also make the effort more feasible. “We don’t think that will happen immediately,” Crow says. “But how do we catalyze something new like that, even though there probably isn’t going to be any immediate return?”
But there are returns on providing quality healthcare upstream. “We are creating a tax down the road for the next generation,” Crow says. “They will cost more if we don’t invest now. It will allow us to cut taxes in the future if we invest in their health now.”