New Orleans Musicians' Clinic

The New Orleans Musicians' Clinic was established in 1998. The Assistance Foundation emerged after Hurricane Katrina in 2005 to expand the clinic's mission to keep New Orleans culture ALIVE by providing social services and outreach

The New Orleans Musicians' Clinic (NOMC) is a comprehensive healthcare clinic dedicated to sustaining New Orleans’ musicians and tradition bearers by providing access to affordable medical services, regardless of the individual's ability to pay. Founded by several cultural community organizations in 1998, the NOMC has developed a unique access point to primary occupational health care for a population of artists who are insured, under insured or uninsured. After Hurricane Katrina devastated the city in 2005, the New Orleans Musicians' Assistance Foundation evolved to expand the mission of the clinic and provide social services which assisted musicians and culture bearers in returning to the city. The programs at NOMC&AF are primarily donor driven and stress prevention, advocacy, and economic empowerment. Today the clinic engages many partners, providers and funders at the federal, state and local levels to serve the increasing demand of their more than 2,500 patients.

Background and Mission

As the birthplace of jazz, New Orleans has remained a cultural mecca for centuries. Local musicians are a vital resource to New Orleans in terms of its economic viability and vibrant cultural identity. In 2012, performers entertained more than 9 million visitors to the city. Yet even before Hurricane Katrina devastated the city in 2005 many musicians already suffered perpetual economic hardship and poor health as a result of limited access to affordable health care and lifestyle. In fact, the story of New Orleans musicians has too often been one of tragic death from preventable causes (take for example Buddy Bolden and James Booker). This illustrates problems that many US musicians face: poor health-seeking behaviors and a lack of access to high quality, affordable medical care. With few exceptions, New Orleans musicians are independent contractors working in a cash-based economy. Musicians rarely benefit from employee benefits (in particular health insurance) and at the time of current writing the Occupational Safety and Health Administration does not regular their working environment. They were, quite simply, a class excluded from the American health care delivery system.^[1]

NOMC became a local response to the challenging reality that many New Orleans musicians existed outside of the healthcare system. By evolving a small community clinic to provide culturally competent medical services to a unique group of New Orleans entertainers and performers, the goal of the NOMC was also to evolve their patient base from a group unaccustomed to receiving routine medical care to a group who engages in preventative health. The New Orleans Musicians' Clinic keeps New Orleans music culture alive by sustaining musicians, entertainers and tradition bearers in body, mind and spirit,^[1][2] by developing access to primary care, preventative health services, occupational and social services regardless of the ability to pay for such services.

The Assistance Foundation (NOMAF) emerged in 2005 to support the primary care provided by the NOMC while expanding its mission to take on cultural issues, such as creating economic opportunities for musicians through its NOMAF Gig Fund, raising awareness for noise-induced hearing loss during practice, onstage, at festivals and in local venues through the NOMAF Safe Sounds Program, providing a one-time benevolent payment for musicians facing extreme hardship through The NOMAF Emergency Fund and hosting community wellness events in and around New Orleans.

History and Leadership

It was a chance meeting in Hilton Head, SC in the summer of 1996 between the renowned US physician and jazz enthusiast, Dr. Jack McConnell ^[3] as he performed “Bill Bailey” with the highly successful rock band Phish, and the then-New Orleans Mayor's mother that provided the catalyst for changing the health care delivery system for musicians in New Orleans. A connection with Dr. Mervin Trail, who oversaw both the Louisiana State University Medical School and the Charity Hospital System was next established. Dr. Trail readily acknowledged that musicians were at the soul of the city's #1 industry, tourism, and embraced the opportunity for the LSU Medical School to establish a center for those in the performing arts.

McConnell met with a team of health advocates for the working poor in Louisiana and musicians’ advocates to come up with a medical safety net for New Orleans’ musicians. Louisiana has had universal health care since the 1930s, when Louisiana Governor Huey P. Long (1928–1932) pushed a number of bills through the 1929 session of the Louisiana State Legislature to fulfill campaign promises including an unprecedented universal health program for hospitals and universal “charity” care.^[4] In 1995, McConnell set out to design a comprehensive health care system to treat musicians. Pre hurricane Katrina, more than 3500 musicians working in New Orleans suffered from health problems related to working late hours, long separations from family while on the road, and uncertain financial futures. Even before the floods of August 2005, New Orleanians endured an epidemic of poverty and health care outcomes rivaling most Third World nations. While the city’s tradition-bearers are celebrated the world over, at home many live hand-to-mouth, outside mainstream social and economic systems. These same musicians have prided themselves in existing in a cash-only economy, never having a bank account, and never paying taxes. Needless to say, many icons died young from preventable and treatable conditions.

The coalition of interested parties quickly grew to include other New Orleans-based entities: the Union of New Orleans Musicians AFM Local 174-496, the Tulane School of Medicine, and one of the USA's largest music festivals: The New Orleans Jazz and Heritage Festival. Trail recognized the need for assembling a resourceful team to serve as Planning Committee for the NOMC: the Dean of the LSU Medical School, Dr. Robert Marier, led the medical team and E. Johann Bultman, then chairman of the board of the New Orleans Jazz & Heritage Foundation (NOJHF), agreed to serve as co-chair of this committee. Under Bultman’s leadership, the Planning Committee grew to include physicians and administrators from the LSU Medical School and LSU Medical Center, faculty from the LSU School of Nursing and Dental School, city representatives, and the music and arts community.

Today the NOMC&AF is directed by Bethany Ewald Bultman, E. Johann Bultman, Dr. Cathi Fontenot, and LSU Health Network. Mac Rebennak (a.k.a. Dr. John), Big Chief Bo Dollis, Kermit Ruffins, Trombone Shorty, JoJo Herman, Harry Shearer, Judith Owen, Bonnie Raitt, and other top names in the music industry and New Orleans cultural community support the clinic.

Sphere of Support: Medical, Emotional, Financial, and Social

The NOMC has become an essential medical service due to the lack of a system of care for those people without insurance. The few volunteer-staffed clinics in the area are overwhelmed with patients. The majority of these other clinics lack access to affordable prescription medications, relying on samples or costly retail pharmacies. While ER and Trauma care are available, outpatient services and sick care are not available in New Orleans. There remain access issues with the public hospitals in surrounding communities. For many musicians, the NOMC is their only source of support - whether it be medical, emotional, financial, or social.^[1]

The impact of Hurricane Katrina on the psyche of New Orleans musicians has been immense, and their needs are increasing rather than diminishing. Since Hurricane Katrina, NOMC have broadened their mission to address the new challenges faced by New Orleans musicians. Displaced family members, housing problems, financial difficulties, mental stress created by grief and loss – all negatively impact the health of New Orleans musicians. The capacity of the city and state services to meet these challenges has been greatly reduced. It will take many years to rebuild.^[1]

The NOMC’s expanded social services include the registration of patients in pharmaceutical assistance programs, crisis and case management, electronic medical records, identifying musician-patients, referral to and follow-up with appropriate agencies, and involvement in regular meetings with partnering organizations to provide outreach to patients in non-clinical settings.^[1]

Partnerships

The NOMC works with neighborhood groups like the Musicians’ Protective Union. In the Tremé neighborhood (the historic birthplace of Jazz), NOMC collaborated to create the St. Anna’s Episcopal Church Musicians’ Mission, a lively jam session held weekly, which includes a free meal and a “resource hall”, providing multiple services such as 5 point anti-stress acupuncture, legal advice, housing assistance, and medical and mental health screenings, and social service referrals.^[1]

New Orleans Musicians Assistance Foundation

The New Orleans Musicians Assistance Foundation (NOMAF) evolved from the NOMC following Hurricane Katrina in 2005, sharing the mission and promise to keep New Orleans music alive. NOMAF encompasses the Musicians’ Clinic as well as the NOMAF Gig Fund, which provides occupational opportunities for our musicians, the Emergency Fund, the Prevent Death by Lifestyle Program to engage our patients in their own wellness strategies, the Herman Ernest Memorial Health Screening Initiative which provides head and neck cancer screenings in conjunction with the Interfaith community and the Tulane University School of Medicine.

Herman "Roscoe" Ernest III

Herman Ernest Memorial Screening Initiative for Head, Neck and Throat Cancer

The Herman Ernest Memorial Screening Initiative is a component of NOMAF's partnership with Healing Hands Across the Divide (HHAD), a public outreach program of the Department of Otolaryngology at Tulane University School of Medicine. This program honors the life of Herman "Roscoe" Ernest III and was formed in March 2011, shortly after he lost his brave battle to oral cancer. Before his tragically early death, Roscoe challenged his medical support staff at NOMAF and his doctors at Tulane to promote head and neck cancer awareness, prevention, and early detection throughout his community. African Americans have twice the mortality rate of their non-African American counterparts,^[5] and this is in part due to African Americans presenting with a late stage of cancer at the time of diagnosis.^[6] Early detection of such cancers is key to improving survival rates. Since March 2011, HHAD has partnered with several local churches and community events to spread awareness about head and neck cancers and conduct cancer screenings . This project is important for all members of the community but especially musicians due to their increased occupational exposure to tobaccos and alcohol, both risk factors for developing head and neck cancer.

Expanding the Field of Arts and Health

The NOMC provides a model of experience-based practice for the expanding field of arts and health. The history and lessons learned from the NOMC may prove to demonstrate that the medical needs of any underserved, hart-to-reach populations can be met - if the model for healthcare delivery is creative, adaptable and in adherence to an organizational culture in which administrators strive for long-term, successful patient outcomes. Operating a health clinic designed for unconventional, specific population—patients who are performing work in fields which they consider "a calling" - requires a mission-driven staff. Using the NOMC model as a response to the unique needs of a vulnerable patient population, the methods which established the clinic may be adapted to treat other unique populations - whether it be farmers, teachers, first-responders, service industry workers, or non-profit employees, a model for health care delivery must be led by providers committed to patient-centric mission and use creativity and compassion to respond to the needs of patients.

In 2012, Clinic Co-Founder Bethany Bultman became the Chair of the International Performing Arts Medicine Association's (PAMA) annual conference in Aspen. NOMC continues to work with Athletes in the Arts, a subset of PAMA, to develop a stronger link between athletes and performing artists in health care delivery.

References

External links

• New Orleans Musicians' Clinic
• New Orleans Musicians' Assistance Foundation