Three years ago, Oregon native Ali Chisti, MPH ’13, was on course to become a private practice neurosurgeon, studying medicine at Oregon Health and Science University in Portland. During the summers he worked as a caddie at a golf course in Bandon, along Oregon’s rural southern coast, to help pay for school. But in the summer of 2010 he learned about a fellow caddie’s health care troubles. Chisti’s friend had broken his wrist playing basketball. He went to the emergency room at a local hospital. But he didn’t have health insurance—and $12,000 in hospital bills later, he was forced to file for bankruptcy.

It got Chisti thinking long and hard about health care access and inequities—and led him to take a break from medical school to study health policy and management at Harvard School of Public Health (HSPH).

Chisti’s friend could have gone instead to the Bandon area’s safety-net health center—the Waterfall Clinic, which offers reduced rates based on financial need—but the friend didn’t know about it because it had no website and the phone line frequently gave a busy signal. Chisti later learned that the clinic was also critically short on providers and had no system in place for referring uninsured patients to outside doctors or specialists.

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