Whitney: 
So my guest today is a good friend and neighbor of mine here in McMinn County, Tennessee. Jeff Eastman is the CEO of Remote Area Medical, a major nonprofit provider of free pop-up clinics in small towns, all over the country with the help of more than 172,000 volunteers, Remote Area Medical or RAM delivers free dental, vision, and medical services to underserved and uninsured individuals. And over the course of time, RAM has treated almost 900,000 individuals, delivering more than $174 million worth of free care. 

Whitney: 

I am excited to talk to Jeff today because I reached out to him back in 2020, around this time during the early days of the pandemic to see how RAM’s delivery model might be affected by COVID and social distancing requirements and just the unknowns of the COVID-19 virus. So today I’m happy to check back in with Jeff and hear more about what this last year has been like, how the RAM operation has continued to serve rural and remote populations across the country, and how conversations about the COVID-19 vaccinations are playing out in our communities. So, Jeff, it’s really great to talk to you again. Thank you so much for checking back in with me. 

Jeff Eastman: 

Whitney, it’s always a pleasure and honor to speak with you, and thanks for reaching out and touching to see how things are going with Remote Area Medical in our efforts to provide free health care to those in need. 

Whitney: 

For sure. Thank you so much for joining me again today. And I wanted to check on you first. How are you doing? 

Jeff Eastman: 

Oh, I’m doing fantastic as you all know, this is not a job for me, this is fun. Helping lead the organization for seven years and it’s just a dream come true. 

Whitney: 

Where you calling from today? 

Jeff Eastman: 

I’m at the office, we’ve got a significant number of people working from home. However, I find that it’s more productive by coming into the office and help lead the team from here. 

Whitney: 

And your headquarters are in Rockwood, Tennessee. Is that right? 

Jeff Eastman: 

Rockford Tennessee, right over by the airport in Alcoa. We’re about five minutes outside of Knoxville. 

Whitney: 

And I know it’s a nationally focused nonprofit, so you travel all the time too. And I wondered if you could tell me a little bit again about RAM clinics. What are RAM clinics? What do they look like before COVID-19? 

Jeff Eastman: 

We’ll get down to the brain basics of what a RAM clinic is, RAM provides free medical, dental, and vision care to those in need, whether it’s through uninsured, under-insured, we use a model called the Community Host group model, and that’s where a group of individuals come together in a community. It can be just individuals, it could be lion’s club, a church, any kind of group. And they say, “We have health care issues, we need to provide some healthcare to our community.” They go to our website, there’s a tab to pull down, bring RAM to my community. We send them a digital little folder, as far as what that entails, we don’t charge. We still need help from the community whether it’s food for the volunteers, lodging various sort of different requirements, but that doesn’t scare them off. 

Jeff Eastman: 

They have a conversation with clinic manager, Vicky Greg, and they sign a committee host agreement. What the most frustrating thing about my job is, we have to turn away over a hundred a year requests from communities. We’re already fully booked for 2021 and halfway booked for 2022. So what’s really interesting is when you look at these communities across the United States, and we’re talking from rural Rexburg, Idaho to Rural Retreat, Virginia, where we were this weekend, Ingellico, all across the country. Because if you look at those counties, they’ve got lower, positive health outcomes, higher CLPD, lower birth rates, higher obesity. You can go down the list as far as negative outcomes, then when you go to resources, they’ve got the least amount of resources, least number of specialists, dentists all the way across the board. So would that tells us, is that we are going to the right places. It’s not a magic wheel, we spin here on the wall, it’s actually people reaching out and we’re getting to the right places. 

Whitney: 

And you’ve served in the course of the years over, what did we say about 900,000 individuals- 

Jeff Eastman: 

Correct. 

Whitney: 

In this country and what are they coming there for? What sort of services do they experience- 

Jeff Eastman: 

The first thing they’re coming for, is their immediate needs. They coming to relieve that dental pain, they’re coming to get those total eye exam and free glasses, they’re not coming for medical because due to high copays, not having specialists and not being able to take time off from work. And when you look at our patients, you’ll see county employees, you’ll see federal employees, you’ll see private employees, you’ll see working moms, working dads. That one, can’t take time off from work during the week to go to see a medical or dental or vision provider and two, can’t afford it. Or they may not even be one in their area, as you well know where we live, if you’re an Anglewood, Spring city, some of these rural communities, there’s not resources there. 

Whitney: 

I appreciate you kind of describing who is coming to these clinics because it offers a different picture than some of us may have about who are the uninsured in our country. They are working parents, mothers, and fathers, they’re government employees. They’re folks that maybe have a health care plan, but maybe it doesn’t provide the coverage that they ultimately need. So RAM is filling the need for all kinds of people. So when those clinics happen, this is before COVID. My memory is that there are hundreds gathered in a parking lot or in a stadium or together in close proximity to one another. So is that still how it’s been going over the last year? Or how has it looked different? 

Jeff Eastman: 

Are people still coming and waiting for free health care? You bet. What’s it look like, sure looks a lot different. We can start in the parking lot and work our way through, previously there were those dynamic images of individuals lined up at the front door, hundreds of them with little tickets in their hand, waiting to be called by myself, staff members, Stan Brock when he was with us. Number one in calling them all in and starting at six in the morning, they’d been waiting since the day before in the parking lot for those precious numbers to come in. Now when they do arrive, we asked them to stay in their cars, they are assigned a number. So they’re called in, in the order that they arrive, but we asked them to stay in their car and we use a process to bring them up in groups of five, 10, or a dozen to the facility. 

Jeff Eastman: 

Once they come up, social distancing of course, masks are required to come into the building. We do a temperature scan prior for the patient registration and then we also ask the normal COVID-19 screening questions. Once they come into the building, which we’ve got great volunteers for this whole event, for welcoming people in. Because these are our neighbors, helping neighbors. They register, the only question that they have to answer, “Where does it hurt?’ We do ask some other questions, so we can kind of know more about who we’re serving and how we can do a better job. They go to triage where nurse checks their blood pressure and it’s that point where the nurse would just, things have slowed down they’re in the building and they can say, “Hey, by the way we’ve got a podiatrist here, we’ve got dieticians, we’re doing COVID-19 vaccinations.” 

Jeff Eastman: 

So it’s that point in time where those nurses to have those conversations, to let them know what’s available, besides that immediate need. If their meeting need is dental, here’s where the big change is, they go into, generally it could be a fairgrounds building, it could be a school gymnasium instead of those rows and rows of portable dental chairs, all set up, lined up and maybe 30, 40, or 60 all lined up in a row, a lot of hustle and bustle people lined up in the chairs or in the bleachers waiting for their turn, looks a whole lot different. There may very well be just a small seating areas, six feet apart, anywhere from six to a dozen people spread all across. And now the dental procedures are delivered in 10 by 10 easy pop-up tents with clear vinyl sides, connected to a HEPA air filter that circulates the air completely within every one to three minutes. 

Jeff Eastman: 

When they go into the tent, they stay in there with the provider, the whole time. Instruments are passed in and out through the operatory to avoid any contamination and once the procedures are over with, then each one of those is sprayed with a bottle oxide and spent 20 minutes to make sure that any viruses or bacteria are killed. So does it slow it down? Is it a smaller number of people? Absolutely, but the need is still out there. On the vision side, it’s similar but different you’ve spread out, patients waiting, there are cleared guards on all of the instruments used for vision exams and the same thing with dispensing where people pick out their frames, they now pick them out of course the frames are put back and disinfected before they’re put out again. So it’s slowed it down but the need has not changed one bit. 

Whitney: 

And I guess you’ve been guided by CDC recommendations and epidemiologists around us. And now that some of that guidance is changing. The CDC recently said that vaccinated people can remove their masks. Do you see your operations changing in the coming weeks or months? 

Jeff Eastman: 

We’re actually having a meeting with our dental committee coming up as far as that. We’re fortunate enough to have the former under secretary of health and human services, Dr. Gerar on our board. So I’m sure if we move forward, we will ensure that it’s the very best for our patients and for our volunteers and staff throughout the clinics. 

Whitney: 

You mentioned earlier that this job for you is fun even, but I also hear in some of your responses here, that the need is great and that feels tragic and difficult and challenging, the fact that people can’t get insured the way they need to be insured, or they can’t access healthcare the way they need to access it. So what about this process and this operation brings you joy, even in the midst of the challenge? 

Jeff Eastman: 

It’s probably the best putting the words to some of the volunteers, just was up in a Rural Retreat this weekend and spend time with a dentist, Neil. And he’s a long-time volunteer, is he frustrated because he’s comes year after year and it never ends? Absolutely. However, I spoke with him at the end of the day and he was so excited that he was able to treat the number of people he did, that we had done all the heavy lifting, we had done the logistics, the organization and the fundraising. 

Jeff Eastman: 

And when you talk with our volunteers, they’re so excited that they’re heading chance to give back and make a difference and you swing back around to the patients there’s never been a clinic I’ve been to where on Sunday afternoon when we got to load up, because they’re all pop-up clinics and there’ll be a patient there that we treated over the weekend that wants to give back. So I believe that people inherently want to give back and you’ve just got to make it easy for them and create that process as no matter who you are, everybody I believe wants to give back and make a difference in the lives of others. 

Whitney: 

You also mentioned earlier, the name Stan Brock, and for those out there who don’t know who Stan is. I wonder if you could tell us a little bit about him? 

Jeff Eastman: 

Sure, absolutely. Stan was an amazing individual back in the 1950s, he was a young man and started adventure on himself and a British guy at the time, out on a cattle ranch in the Brazil Guyanese borders, the largest cattle ranch in the Western hemisphere. Like all young men, we always know what’s best for us and we’re in charge. Well, he wanted to be a cowboy called Vaqueros. He found himself with this ranch and he showed up and said I want to be able Vaquero, I’m sure that the Vaqueros snickered and said, “Oh, sure Stan.” They said, “Just ride this horse over there.” So they put him on a horse named Cain at which is Wapashawna, the local language for the devil. This particular horse had already killed two individuals. They put Stan on it. 

Jeff Eastman: 

The outcome was obvious, bring him off, put him down on the bottom of the Corral. And as he laid there looking up, he asked them, “Where’s the doctor?” And they pointed down outside the Corral, well, 26 days down that trail. Well, Stan had an epiphany right then that he wanted to bring healthcare closer to the individuals, in his time in Guyana, he read books, delivered rudimentary medicine to individuals, learned how to fly, flew medicines from Georgetown out to the interior there on the Brazil Guyanese border. He went off to a career where the Mutual of Omaha’s Wild Kingdom, where he was the guy that Marlin Perkins, the host sent out to the alligators and the snakes. Then he did a movie career, flew aircraft all over the Western hemisphere. At the age of 49 with, I don’t know about your family Whitney, but at 49 I was thinking about retiring, what does that look like? 

Jeff Eastman: 

He started Remote Area Medical and he gave everything to it. All of his life savings, 24 hours a day, seven days a week. We initially started out in old rundown school, we ran it for a dollar a year in Knoxville. He slept in the building on the floor, on a grass mat, showered with a garden hose out back, never drew a salary, actually donated his social security to the organization. We moved to our newer buildings so we could expand and treat more people, he still slept on the floor in the back and on a grass mat and gave everything he had to the organization. He was probably the most philanthropic individual I’ve ever met because he gave it all. 

Whitney: 

And when did he pass away? 

Jeff Eastman: 

He passed away three years this August. 

Whitney: 

Yeah. Well, that’s emblematic of what you were speaking about earlier of this desire we all have to give back and he gave back in space and I’m so glad RAM is still in operation. I wondered if we could talk for a minute about vaccines and you mentioned that RAM is offering the COVID-19 vaccinations and I wonder what you’ve experienced in terms of people coming in and either asking for them or saying, “No, I don’t want them.” What are those conversations like? 

Jeff Eastman: 

We’ve had vaccines, I believe four different clinics and what’s interesting, just even within our clinics, as far as access, I mean, two of the clinics, those people stayed in the parking lot and got parked, we made sure it’s sort of like an extra little verbiage. “Hey, we’ve got vaccines for you.” Besides when they came in and that conversation with the nurse, we’ve had two clinics where in my view, they weren’t in a positioning where people could see vaccines and knew they there was less than optimal. So in my mind, it’s making people aware that there’s vaccines out there. We’ve looked at, I got a screenshot from a mass retailer yesterday from a volunteer that said, “COVID vaccines available now at no cost.” Well, if you think about it, you and I both know they’re free, but what’s that percentage of individuals out that don’t know they’re free. 

Jeff Eastman: 

Or if you look at my mom, who’s in her nineties, my mother-in-law who is 82, they drive from their house to the Save A Lot to a Dollar General, so they don’t see that big sign and get your COVID vaccination here. So I think accessibility is a huge amount, same as the regular challenges are for all healthcare in rural areas. It’s, how do I get it as accessible? See, I don’t have broadband, I don’t use the internet. I’ve still got my flip phone. So how do I access it? 

Whitney: 

There’s national media seems to suggest that vaccine hesitancy is higher in rural places. And we do know that fewer rural residents have gotten the vaccination then our urban counterparts, but you and I had this conversation a couple of weeks ago, just about, why that hesitancy and what we can do to bridge the gap. And I just wonder if you could share a little bit of your wisdom on that score? 

Jeff Eastman: 

I think as a society, we can do a better job partnering with different entities to make it accessible. I mean, if you think about the reason people come to RAM clinic it’s on the weekend, they don’t have to take time off from during the week. They know when they come to ours, we advertise free. I’ve yet to see any COVID-19 signage, get your vaccine here that says it’s free. It’s kind of like a flu shot, a flu shot is free at your major pharmacies, if you have insurance. Okay. So is there a miscommunication, as far as that we’ve got some organization and retailers that are nationwide in scope and are focused on delivering retail goods and services to the rural communities, what does that look like partnering with them and providing vaccinations outside that eight to five o’clock hour, in those evenings and weekends. So how do we increase that accessibility to vaccines, I think would make a huge impact. 

Whitney: 

I remember too, you said in our conversation a few weeks ago, finding out what people need to in order to say, yes, what are the support mechanisms that need to be in place, do we just need a conversation? And also leaving the politics at the door is a big piece of it as well. 

Jeff Eastman: 

Yeah, you actually touched that on transportation. When you get outside of major metropolitan areas, getting to clinics is a big thing and getting to medical services. When we have individuals at our clinics, unfortunately, a friend brings them on a Friday afternoon and leaves them in the parking lot with a tent and will pick them back up on Saturday after noon. 

Whitney: 

Before I let you go. I’m wondering, do you envision a world ever where we won’t need necessarily a RAM model, where everyone will have access to quality and affordable healthcare? Is that something you’re you feel like you’re working toward? 

Jeff Eastman: 

Well, what’s interesting is that’s how we were founded in 1985. Our first seven years were spent delivering healthcare outside of the United States, Central America, and around the world. In 92, we got that phone call from Sneedville Tennessee, the hospital closed and they needed health care, sound familiar maybe. Rural health care hospitals closing, should we ever get to the point that RAM’s free health care is not maybe needed here in the US, I’ve got a team ready, willing, and able to jump in a plane and head down to anywhere in South America, Central America, the Caribbean, anywhere to help make a difference. 

Whitney: 

One last question. I always ask folks on this show is what are you reading or listening to right now that is inspiring you or something that you’d want to share with the public? 

Jeff Eastman: 

That’s interesting, I find myself going back and reading older literary works. Sinclair’s the Jungle, some things never change, I didn’t know that we realized that we actually rented furniture to people back in the early 19 hundreds. So I found myself going back and saying, history repeats itself. Read on the pandemic and I know it was very dynamic back then just like now, things change week to week. So it’s a very similar outcome on that, but we’d like to add that anybody who would like to join the journey, volunteering, please go to ramusa.org and click on volunteer. It’s an amazing journey, you do not have to be a medical person, I’m not. The huge number of our individuals are general volunteers to help with everything. If you can’t come join the journey that way, just click on the donate button and make a difference. 

Whitney: 

Thank you so much, Jeff. I hope to see you out and about around Athens here soon. 

Jeff Eastman: 

Absolutely, thank you Whitney.