The Wallace Medical Concern (WMC) is a federally qualified health center located in Gresham, Oregon. The clinic has been in operation in some form for over 30 years and has filled many roles in the community, from providing urgent care for adults to offering a mobile medical clinic to now offering primary care. Wallace Medical Concern is a mission-driven non-profit organization. Their mission “is to provide an open door to exceptional health services and connections that support individuals and their families in healthy living.”

The organization of the Wallace Medical Concern is very complex, due in part to the large number of key external stakeholders, and the impact of the external environment on the clinic. WMC is community-based and community-driven, and therefore the community it serves is extremely important to the organization. As the community WMC served was pushed out of the inner-city due to rising costs of living and out into East County, WMC followed this community and moved their clinic from downtown Portland to downtown Gresham. The Wallace Medical Concern has patients and community members on its board, emphasizing both the importance and value WMC places on the community as a key stakeholder, but also the literal involvement of the community in the governance and management of the clinic.

WMC is federally funded, and therefore the federal government and specifically the Health Resources and Services Administration (HRSA) is a very important stakeholder for the clinic. The approval of HRSA is required for the clinic to continue operations, to keep its status as a federally-qualified health center, and because it allows the clinic to provide innovative and comprehensive services to not only address the immediate physical health needs of the patients, but to look upstream, go into the schools and provide health education, get patients engaged in physical activity through on-site zumba classes, and more.

The external environment has a large impact on WMC. Physically, the neighborhood and community that the clinic is located in plays a major role in the patients who seek care at the clinics. The co-location with an affordable housing complex reaffirms the clinics’ commitment to serving low-income individuals and families, as well as impacting the rapid expansion the clinic has recently experienced. The neighborhood impacts the patient population, and leads the clinic to find individuals who can relate to the community – through language or cultural background – to work in the clinic, and helps to explain the large number of Latino/Latina, Spanish-speaking front-line staff employed by the clinic.

Finally, the political environment has had a large impact on the clinic. The federal political environment with the initiation of the affordable care act incentivized the clinic to move towards the provision of comprehensive primary care rather than urgent care, and led the clinic to greatly expand the services provided to the community. The Wallace Medical Concern provides a significant service to the community. However, as it grows and adapts, it has and likely will continue to face organizational and structural challenges. Adapting from a small, limited hours clinic to multiple sites with comprehensive care requires significant change in management structure, supervisory roles, and more.

-Sylvia Peterson-Perry MD/MPH Student, OHSU School of Medicine, OHSU-PSU School of Public Health

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