By Harika Dabbara
This summer I am working at HealthPoint through the Jaharis Primary Care Pre-Medical Internship. HealthPoint is a non-profit community health center geared towards providing healthcare to all members of the community with an emphasis on providing care to underserved communities in the area. As a pre-med student interested in community health, and having learned about various social determinants of health in my classes at Haverford, I wanted to spend the summer gaining firsthand experience of how these factors affect patients in a medical setting. I was particularly interested in working at HealthPoint because of their emphasis on providing holistic care. Their approach to health care goes beyond addressing biomedical factors affecting a patients’ health, but also addresses the unique social, cultural and behavioral factors that play a role in health outcomes. Patients are encouraged to work with providers outside of their primary care provider to help address arrive at a diagnosis. Visits often involve a nutritionist and behavioral health specialist in addition to the primary care provider, to help patients create a care plan considering the various factors that affect their health. In addition to providing holistic care to their patients, HealthPoint strives to make care accessible to the community by helping patients cover their medical costs through obtaining the proper health insurance as well as enrolling in various public and private aid programs. I think that these measures are critical to providing proper care to all patients and was really excited to become a part of an organization that values supporting patients on beyond the biomedical factors affecting them.
On a day to day basis, I work with the quality improvement coordinator whose responsibilities span across multiple disciplines of the organization. As a community health center, HealthPoint has measures which reflect the health of the community. These measures include Combo-10 vaccinations, diabetes A1C levels, hypertension medication adherence, depression medication adherence, asthma medication adherence, and annual wellness visits to name a few. My daily responsibility has been working with patients to help them understand their diagnosis and set up proper health care plans. I do a lot of outreach to high-risk patients in need of care and work with them to set up a way to obtain the necessary care. This includes helping the patient understand the importance of addressing their diagnosis, explaining what will take place during their visit and helping them schedule their appointments. Throughout this experience, I have learned how different patients or groups of patients react to certain experiences due to cultural beliefs, social stigmas and previous experiences in the health care system. For example, as part of the diabetes care plan, patients are scheduled to see their primary care provider as well as a behavioral health specialist and nutritionist that work together to help them create a plan for a lifestyle that fits their diagnosis. Often times, patients are reluctant to see the behavioral health specialist due to stigmas around mental and behavioral health. This helped me learn the importance of word choice and how adjusting the way I explain what will happen at the appointment helps the patient be more comfortable with their diagnosis. Instead of saying that the patient will see the three providers listed above, I explain to the patient how it is important to address diabetes on a holistic level, which is unique to each patient’s lifestyle. I let them know that during their appointment they will work with the three providers to set personal goals and create a plan that will help them figure out a way to control their diabetes. Overall, this has helped me learn how to interact with patients of varying cultural and socioeconomic backgrounds, as well as the importance of health care professionals being sensitive to these varying backgrounds.
In addition to the work described above, I have gotten to attend conferences with the quality improvement coordinator, Mayfanna. These conferences have been very important in helping me understand the varying social determinants of health. One of the biggest barriers to accessing health care for the patients that the clinic serves is the ability to get insurance or pay for their health care. The first conference I attended focused on parsing the insurance options available to patients and optimizing their use for the benefit of the patient. I learned how complicated accessing government-issued forms of health insurance is. The issue that was addressed in this conference was that different programs and organizations cover various aspects of a patient’s care so that enrolling in just one program may not cover all the care a patient needs. This makes it so that the patient has to pull from many sources when receiving care; a process that is oftentimes so complicated that the patient is unable to obtain the support they need. The goal of this conference was to provide quality improvement coordinators with information regarding these programs and how to help their patients access it. This was applicable to my patient outreach since I was more aware of the barriers that certain patients may face when scheduling their visits. This helped me find ways of placing patients with certain providers that will reduce the cost of their visit based on the programs they are enrolled in. Helping reduce this cost always makes it more likely that the patient will address their diagnosis.
Lastly, I have also had the opportunity to shadow doctors during their visits. This part has been important to helping me see how physicians address many of the same concerns I address in my interactions with patients, as well as to gain an understanding of the typical day of a primary care provider.
So far, my experience this summer at HealthPoint has been critical to enforcing the importance and power of holistic health care. Thank you to Haverford, Dr. Jaharis and the staff at HealthPoint for making this opportunity possible.