As I walk thirty minutes from Clifton to Over-the-Rhine in Cincinnati, Ohio each morning, I smell urine and see trash and a dead squirrel that no one has cleaned for two months. I found the cheapest sublease, and my room was full of spider webs and dust. I came to Cincinnati, Ohio based on a single email from Father James Foster about how I will be serving an underserved patient population, and quite frankly the first sentence from Not All of Us Are Saints lingered in my head – “This is absurd!”
I am working as a care coordinator at Crossroad Health Center, a Federally Qualified Health Center. Caroline Hensley founded Crossroad Internship Program as well as the Care Coordination Team with ideas from “Realigning Health with Care” from Stanford Social Innovation Review at heart. Rebecca Onie, Paul Farmer, and Heidi Behforouz emphasize in “Realigning Health with Care” that “expanding the scope of health care, the place where it is delivered, and the workforce that provides it” can dramatically improve health outcomes. Acknowledging that nontraditional medical workers, including students and not just licensed clinicians, can help health systems by performing at the top of their abilities is critical. Over ninety percent of our patients fall below two-hundred percent of the federal poverty line, and providers cannot address all of patients’ social needs such as “hunger, poor-housing, and indebtedness.” Crossroad Internship Program consists of undergraduates who are willing to work as a case manager in order to help make appointments and referral processes smoother on behalf of our patients. Patients who are uneducated, illiterate, or disabled benefit from these workers. The Care Coordination Team consists of graduate students and young professionals mainly addressing chronic conditions such as diabetes, hypertension, asthma, and cancer. We focus on preventing chronic diseases as well as disease management, cutting down potential cost of healthcare costs.
The Care Coordination Team is currently a small group of twelve people. Most students are graduate students and medical students. Prestige or status do not come into play when it comes to working for the poor. Everyone has humbled themself and worked together to produce results in areas that have a distinct need. There are teams for diabetes, hypertension, asthma, and colon cancer within the care coordination team. I am a part of the asthma team and produced an extensive protocol for patients with asthma. I have worked with the executive director of Crossroad Health Center as well as Dr. De Laat to make sure that my team is promoting a procedure that can efficiently check up on patients with a chronic condition. I was also responsible for knowing general protocols for other teams to make sure that I am ready to answer any questions to incoming calls from patients. Our team regularly makes calls to foster a close relationship between the patient and the provider and educate and ensure adherence to medication to better patients’ chronic conditions while addressing their barriers as well as social needs.
Most patients at Crossroad Health Center rely on insurance such as Medicaid and Medicare, and some have no insurance. We take in patients without insurance and encourage them to pay using a sliding scale application where patients can do a fifteen-dollar copayment or less. We strive to serve patients regardless of ability to pay. We deal with minority and vulnerable populations who are at high-risk. We make sure to follow-up with patients and especially reach out to patients with diabetes, hypertension, asthma, and cancer. We stand in solidarity with the poor to bridge the gap between self-management and clinical management, advocating for the patient. Many patients here at Crossroad Health Center have comorbidities or multiple chronic diseases. Needless to say, our patients suffer from substantial nonmedical needs too. We prevent patients from falling through the crack by regularly calling them. There has been a plethora of cases where patients were having spontaneous suicidal thoughts, and clinicians and non-clinicians were able to save their lives just by regularly checking up on them. Even though we are not their family or a significant other, it is indisputable that we can still be a part of their support system.
While I indirectly listened to patients about their conditions and personal lives, I know very little about experiencing the inescapable cycle of poverty that most of our patients do. I have felt entitled to live in a nicer house and felt ashamed of myself when I walked around Over-the-Rhine in Cincinnati, full of homeless people. I learned to look beyond mere clinical care but to consider and listen to an individual as a whole. University of Notre Dame emphasizes students’ responsibility to service and justice, and working as a care coordinator at Crossroad Health Center has let me embrace my responsibility not only to service but also to acceptance and compassion.
Eric Sah is a part of the class of 2019 and is an Applied and Computational Mathematics and Statistics major in the College of Science. He plans to apply to medical school after graduation.
0 comments:
Post a Comment