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Laura Seitz, Deseret News
Dr. Ryan Taylor sanitizes his hands as he goes from one patient to another, Gloria Martinez.

SALT LAKE CITY — A middle-age Hispanic woman visited Maliheh Free Clinic on a recent snowy morning. She sought respite from sharp chronic pain in her neck and shoulders, a condition catalyzed by a November fall down the stairs and exacerbated by her inability to afford an appointment with an orthopedic specialist.

An appointment at Maliheh, though, afforded her face time with Dr. Jonathan Horne, an orthopedic surgeon who volunteers at the clinic one morning per week. The consultation occurred in a cramped 7-by-7-foot examination area cordoned off by only a curtain.

"Can you touch the top of your shoulders with your hands?" Horne asked.

"No," she replied.

"Can you touch your head with your hands?"

"Yes, I can do it, but only with one hand."

"OK. Now, put both arms up in the air like an Iraqi soldier."

At Maliheh Free Clinic, a cadre of volunteers like Horne enhances the quality of life for Utah's poor and under-insured by providing free medical services to 80-100 patients every day. However, Maliheh will undergo a significant remodeling, tentatively scheduled to begin in May, because its case load has outgrown the physical infrastructure.

"The need (for care) is bottomless," clinic executive director Jeanie Ashby said. "There is a three- to five-month waiting list to get in, and we fill up every square inch of our building. It seems like we keep trying incrementally to meet more need, and there's just so much need out there that I don't know if we'll ever be able to meet all of it. … But with the remodel, it will be set up so much more effectively that I think we'll be able to increase our ability to see patients just by the virtue of the improved space flow."

A space planner with expertise in designing medical offices helped develop the remodel plans, which will require three to six months and cost $400,000-$500,000. The clinic will continue operating throughout the remodeling time while construction takes place in stages. Changes will include the five exam rooms on the south side of the building, becoming eight exam rooms, and the pair of 7-by-7 curtain-enclosed "rooms" on the north side of the building receiving bigger physical dimensions and some permanent walls.

"The actual space of the building will not increase by that much," Ashby said. "We're going to expand as much as we can legally within the parameters of our existing property, and then reconfigure the interior space so that it's used more effectively."

The remodel won't just enhance the patient experience; it also will help the volunteer physicians, nurses and students to feel more at home. These volunteers, who combined to donate more than 16,000 hours of work in 2010, are accustomed to working in medical facilities that were designed with the physical efficiency of patient flow as a primary concern.

"We could potentially continue to exist as we have been, but the layout of the clinic is not necessarily conducive to the amount of patients that we see," said Dr. Ayesha Khan, the clinic's medical director. "Just creating a more standard clinic flow would be a positive step. That's what we don't have right now."

Ashby and Khan are part of a thin crew of only half a dozen paid employees that coordinates and supplements the scores of volunteers. The clinic opened in 2006, thanks to seed money from the charitable foundation of Khosrow Semnani, the nuclear-storage magnate who founded EnviroCare, since renamed EnergySolutions after Semnani sold controlling interest of the company in 2005.

The Maliheh Free Clinic will largely fund the imminent construction with proceeds from its annual fundraising gala May 10 at the Salt Palace. Nobel laureate and University of Utah professor Mario Capecchi is the keynote speaker. For more information, visit malihehfreeclinic.org or call 801-266-3700.

"We're running as fast as we can and pinching every penny along the way, but it won't meet all the need," Ashby mused. "We just have to look at each starfish on the sand and say, 'made a difference for that one,' and make a difference for as many people as we can."

EMAIL: jaskar@desnews.com twitter: askargo