Dr. Wendy Bonnell Cares for Kids at Ruth’s Place Clinic
The pediatrician considers numerous determinants of health in her practice at the Granbury, Texas, nonprofit.
Dr. Wendy Heger Bonnell ’95
TCU Major: Neuroscience
Medical Specialty: Pediatrics
The Nonprofit: Ruth’s Place Clinic
Past propane businesses and gun shops sits Ruth’s Place Clinic. Dr. Wendy Bonnell has been part of the clinic in Granbury, Texas, since its second inception.
The founding organization closed the clinic after deciding to withdraw from the health care field. In 2009, two of the original leaders asked Bonnell and her husband, Ric, both pediatricians, to help restart the medical service and work as physicians at the clinic.
“We were both on board right away,” Bonnell said. “I think from the time they talked to us until we opened our doors was only a few weeks. They were ready.”
The re-established free clinic operated out of a single-wide trailer in Oak Trail Shores, an unincorporated community. Benefactors later purchased a more central location in town on Crawford Avenue and sold it to the nonprofit for $1.
Even though practicing medicine in the trailer was challenging, Bonnell said, it proved insightful. Medicine today focuses more on social determinants of health.
“Working in that single-wide trailer was a perfect example of that,” she said. “You get to know the patients that much better when you know where they’re coming from and what they’re going back to.”
Healthy People 2020, the nation’s 10-year goals and objectives for health promotion and disease prevention set by the U.S. Department of Health and Human Services, identified five key areas of “place-based” social determinants of health. They are economic stability, education, social and community context, health and health care, and neighborhood and built environment.
With this place-based perspective, Bonnell considers factors such as lack of transportation as an obstacle to obtaining prescriptions or the challenge of treating head lice on a patient who shares a room with four siblings.
“For me, I had always practiced in an emergency room setting, in kind of a social bubble,” Bonnell said. “I knew that my patients struggled with other aspects of health that kept them from accessing it. I don’t think I fully understood that until working at Ruth’s Place that first year.”
The U.S. Census Bureau estimates that 7.9 percent of residents under age 65 in Hood County, Texas — where Ruth’s Place is located — did not have health insurance in 2016. In 2017, about 10.6 percent of the population was below the poverty line.
Bonnell treats two to 15 patients in an average day but never the 40 patients a day she would treat at a regular pediatrician’s office. Many of her patients have fallen off Medicaid for a short time, she said, and she sees them in that gap period as they work to get back in the system. Some patients have insurance but do not have access to health care.
Navigating the labyrinth of health care is important for Bonnell, who wears the hats of both physician and social worker. She said she spends half of the time treating patients and the other half asking questions about their social circumstances and determining how the clinic can access the appropriate treatment for them.
In 2012, Ruth’s Place converted the building’s garage into a dental clinic. The house is connected to a 3,200-square-foot addition donated by Mueller Inc. as part of its Helping Hand Project in collaboration with the television show Texas Country Reporter.
The Oak Trail Shores location is still used for a food pantry, an after-school program, English as a Second Language classes and parenting programs. The nonprofit even hosted a mechanic to fix cars.
If someone has an idea to help others, “we’ll figure out how to do it,” Bonnell said. “Just providing medicine itself isn’t always going to be effective without addressing everything else.”
Despite the challenges of working through patients’ socioeconomic statuses, there is an element of freedom in practicing medicine at a free clinic. No one tells Bonnell which prescriptions to push, and there are no third-party payers to deal with or emphasis on running a business with an impractical patient quota.
October 2018 — At the clinic, in a room with a Goodnight Moon print on the wall, Bonnell asks a young girl named Gypsy if she knows the location of her heart. The pediatrician lets the girl wear her stethoscope and applies the chest-piece to her heart.
“She was born at 25 weeks,” Gypsy’s mom, Katie Hott, says. “She spent her first 104 days in the hospital.”
Gypsy’s brother Shelton, dressed in a red Spider-Man shirt and Spider-Man shoes, asks for a turn. “Come on, Spider-Man,” Bonnell says, lifting him onto the exam table. “Where’s your heart?” Bonnell helps him listen to his heartbeat, too.
After the exam, Bonnell leaves the room to check her chart for her next patient, her heels clicking down the corridor. The physician says she used to come to the clinic in flip-flops and a ponytail, but Dr. Romeo Bachand, the clinic’s medical director, encouraged the team to show patients the same amount of professionalism as in a mainstream hospital.
“Every Thursday do I want to necessarily get up and get dressed and go to Ruth’s Place and have a million other things to do? I don’t. But it’s a great reminder for me: I’m always happy once I step foot in the door,” Bonnell says. “By the time I leave, I’m always crazy happy because I know it’s what I’m supposed to be doing.”