Face to Face
More than Pretty Pictures
Sam Willis is using his creative instincts to provide much-needed medical care to the arts community.
By Kim Kiser
Step inside the office of Doctor Sam in northeast Minneapolis for the first time, and you might think you’re in the wrong place. Rather than the typical reception desk, rows of padded chairs, and tables covered with old magazines, the first thing you encounter are artist Jack F.X. Pavlik’s SUV-sized kinetic sculptures, their gears and arms waving thin bands of metal like wheat in a field. Behind rice-paper shoji screens that separate the front part of the space from the back is a desk, a contemporary sofa and two chairs, a kitchen, and a smaller Pavlik creation. The only clues that this is a medical clinic are the scale, some lab equipment in a corner of the kitchen, and two small exam rooms off the “living room.”
A converted artist’s loft, the Quincy Street clinic is the handiwork of Sam Willis, M.D., a family physician and artist who is combining his passions and at the same time creatively challenging the way medicine is practiced. “It’s almost an artistic endeavor,” Willis says as he gives a tour of the space. What distinguishes the Doctor Sam clinic, which opened last August, from others is more than hip surroundings and industrial-looking sculptures. “The idea is for it to be community-building—to find ways to bring the community in,” Willis explains. In addition to showcasing the work of local artists, the clinic also hosts yoga classes and others on topics such as Asian medicine and eating locally.
Most noteworthy is Willis’s business model. For the most part, his patients pay cash for office visits and lab services. They also have the option of becoming members of the clinic for $45 a month. Membership entitles them to discounts on office visits and classes. The idea is to make the financial exchange between doctor and patient tangible. “In our current system, there is that exchange, but the patient is removed from it, even though they’re responsible for it,” he says. “While it’s sort of comfortable to not talk about medicine and money, it’s a suspension of reality.”
Willis has always accepted Medicare and Medical Assistance, and earlier this year, he became a member of Blue Cross and Blue Shield’s Aware network after discovering that a number of his patients had high-deductible policies with Blue Cross. “It creates some cumbersome machinery,” he says of being part of an insurer’s provider network. “But it’s worth it to give people the peace of mind knowing there’s a connection between me and the rest of the system.”
Reinventing Medical Practice
The soft-spoken, boyish-looking Willis views the clinic as his canvas—a work that continues to evolve in the same way his career has. Having grown up in Pennsylvania and come to Minnesota to attend Macalester College, his path to medicine was a winding one. In fact, after shadowing doctors during the summer between his first and second years of college, he actually ruled out becoming a physician. “I couldn’t stand the sight of blood,” he confesses. The biology/liberal arts major considered a career in teaching, then went on to work as an outdoor educator. While doing that, he became certified as a wilderness first responder—a paramedic who works in remote settings. “It made me think that maybe I could be involved in medicine in a different way and help people live the most full life in their present context, which is natural for family medicine,” he says.
Willis returned to Pennsylvania for medical school and did his residency in Philadelphia, where he worked in several small clinics that cared for the underserved. During that time, he cultivated his interest in art by taking classes in drawing, painting, and figure studies.
After residency, he came back to Minnesota and worked at Park Nicollet’s Blaisdell Avenue clinic in south Minneapolis. “I enjoyed the patient population,” he says of the experience. “You have people who’ve grown up in the community and people who’ve immigrated from Africa and Southeast Asia.” But unlike during his residency, when he was able to spend a lot of one-on-one time with his patients, the clinic required him to see many patients in a day, limiting the amount of time he could devote to each one. “I really missed that ability to say ‘When you get home, take this, and see how you feel in two hours, then call me.’ For me as a doctor, I practice much better medicine in a small setting,” he explains.
Willis started thinking about how he could create a more intimate practice. He left Park Nicollet in December of 2008 and spent nine months doing locum tenens and urgent care work while studying different business models. He knew he wanted to offer a membership option, and he knew he wanted to serve people who otherwise might not feel comfortable or be able to afford going to a doctor—those who have no health insurance, those who have insurance but struggle to meet high deductibles, those who are transgender, those who’ve contended with substance abuse. He also knew he wanted to integrate art into his medical practice.
While exploring his options, Willis became involved with Springboard for the Arts, a St. Paul nonprofit that connects artists with business, legal, health care, and other resources. The organization had surveyed artists in the state and found they are twice as likely as members of the general population to lack health insurance. Those who do have it are likely to be underinsured. “The big challenges are the high rate of self-employment, plus the fact that artists often have low incomes and erratic incomes. It’s hard to plan for a monthly insurance expense,” says Laura Zabel, executive director of Springboard.
Willis says the findings enlightened him about the financial realities of being an artist. “It’s a Catch-22,” he says, explaining that if an artist has enough income to support himself, he isn’t eligible for government-funded health care but he likely also won’t be able to afford to purchase a comprehensive policy. “So even if they do have insurance, they are usually paying out of their pocket for health care.”
Willis knew then that he wanted to reach out to the arts community with his practice. Since opening his clinic, he has been involved in Springboard’s Artists’ Access to Healthcare program, which provides up to two vouchers a year to uninsured or underinsured artists to use at either his Doctor Sam clinic or the Neighborhood Involvement Program community clinic in Minneapolis’ Uptown neighborhood. The vouchers not only eliminate the financial barrier to health care but also connect artists with physicians and other providers, many times leading to a relationship that lasts beyond a single office visit. Zabel says Springboard surveyed the 200 artists who have used vouchers since Springboard started offering them two years ago and found that 100 percent said they would go back to the clinic they visited.
Steep Learning Curve
Although a number of artists have made Willis their physician, he admits it’s hard to tell yet how successful his practice is. He says fewer than 25 percent of his patients are members and that he needs more than half to join if his model is to succeed. He says many of his patients have high-deductible health insurance policies or no insurance at all. “It’s been a steep learning curve,” he says. “But what I do know is that patients seem to love what I’m doing. They’re comfortable here, and they know I’ll return their calls, and they know when they come here they’ll see me. And even if they have insurance, they won’t walk out of here wondering what their bill will be. They really appreciate that.”
He admits that from a financial perspective, the endeavor has been challenging. “I’m a recent graduate with medical school loans,” he explains, “and we’re in an economy where credit is difficult to come by.” Willis, who continues to do urgent care work on the side to help pay the bills, says he’s bringing together an advisory group to help him decide whether he should sign on with more insurers. He’s also applied to the state for health care home status so that he can be reimbursed for coordinating the care of Medical Assistance patients with chronic illnesses.
Willis says he would ultimately like to see the practice grow to the point where he could add another provider. Currently, it’s just him, a part-time office manager, and two part-time medical assistants; he also has cultivated a network of specialists who are willing to consult with him and work with his patients, including those who have no insurance. “I’d like it so that we could have 60 to 70 direct patient-contact hours a week,” he says. Currently, about half of the time he allots for patient visits is filled. He’d also like to one day provide advice and support to other physicians who want to start their own practices.
Regardless of how the Doctor Sam clinic evolves, Willis doesn’t want to lose the personal connection with his patients that he now has—the ability to sit down in the living room and discuss what’s going on in their lives and how it’s affecting their health. He also wants to continue supporting the arts community in other ways. “I want to create at least some small economy for artists,” he says. Since the clinic and gallery, which goes by the name Conduit Gallery, opened, about 10 pieces have sold. Willis donates his commission to a charity of the artist’s choice—usually Springboard; Portico Healthnet, which helps the uninsured access affordable health care; or COMPAS, which brings arts programming to hospitals and clinics.
In between his urgent care work and clinic practice, Willis continues to pursue his own art. He recently started research for a project in which he wants to depict his grandparents’ immigration to this country from the Hungary/Romania border in the early 1890s. And like any artist, he seems to see patterns and parallels that others often overlook. “In the brief time I’ve explored art and medicine, one piece that’s been surprising to me is how well they integrate,” he says. “Art is the process of exploring, observing, and describing. Medicine is the process of exploring, observing, and healing.” MM
Kim Kiser is associate editor of Minnesota Medicine.