The Health Clinic Crisis on Main Street

Things have been different at the Tumwater Family Practice Clinic since COVID-19 came. Its patients in Washington state are being triaged over the phone, tested at the curbside, and treated by the doorstep. Many patients, afraid of contracting the disease, do not come in. Revenue for the private practice has plummeted almost 50 percent. When it came time for Jennifer Tyler, Tumwater’s clinic administrator, to lay off half her staff, she was “as ready as someone could be.” Tyler hadn’t slept all weekend—Tumwater’s biggest expense is payroll. As Tyler drove past a local high school, now deserted, on her way to the office, she thought about her staff’s families—unemployed husbands, furloughed older daughters, frustrated school-age sons. “It would have been one thing if [staff] weren’t doing their jobs,” Tyler said, but “we fired them only because we couldn’t pay them. It doesn’t seem fair.”

Tumwater Family Practice Clinic is one of the many private primary care clinics, alongside myriad federally funded ones, that form the backbone of American healthcare. Nearly 28 million people rely on almost 12,000 federally funded clinics throughout the country for their healthcare, according to an analysis by , a health policy journal. Two million people depend on 1,000 or so free clinics, and millions more depend on the independent clinics like Tumwater nestled in rural areas and small towns scattered across the country. All told, primary care accounts for half of

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