Consequently, many states in this region manage HSPA populations numbering in the millions. Cultural barriers also prevent underserved populations from accessing medical care. Latino individuals often avoid visiting the doctor altogether because they cannot communicate effectively in English, according to the American Academy of Family Physicians AAFP.
Immigration status is also a concern for this specific group, as some Hispanic or Latino patients are undocumented. Trends within the health care industry drive up the number of medically underserved populations, as well. Interest in primary care practice among medical students has waned and, in turn, reduced care access in some areas, according to the National Conference of State Legislatures.
The U. This number is expected to grow to between 15, and 35, by , as more specialists rise through the ranks, retirements increase and demand increases, analysts for the Association of American Medical College found.
These variables continue to catalyze the expansion of underserved populations and, therefore, give way to less than ideal care outcomes. According to the AAFP, infant mortality rates are high in these communities, and the number of cancer, diabetes and heart disease diagnoses continue to grow.
There is really only one option for addressing medically underserved populations: entering neglected communities and providing customized care. Many health care organizations are answering the call. The National Association of Free and Charitable Clinics periodically opens outposts in areas that host large underserved populations.
The organization not only sets up temporary facilities and provides mobile clinical services but also works with city governments to establish permanent clinics, such as the Free Clinic of Culpeper in Culpeper, Virginia. Nurses are often at the center of these programs, using their interpersonal and medical skills to make connections and solve health problems. In some cases, these health care professionals do far more than staff wards. There, she offers services in a county that includes 46 federally designated HPSAs.
Nurses like Gerrity, although reliant on their medical knowledge, possess special skill sets that allow them to function effectively in facilities designed to treat underserved populations. Advanced communication skills are essential in many situations, according to the American Medical Association Journal of Ethics.
Nurses caring for underserved populations often encounter patients who cannot converse in English. This situation necessitates fluency in another commonly spoken language such as Spanish. Additionally, nurses working with patients from underserved populations must learn how to deftly read nonverbal cues, as many patients balk at expressing their needs openly. But beyond the seemingly cold atmosphere of the waiting room, the overall ambiance of the clinic was warm, and patients and those I worked with were joyful.
It was at that CHC that I witnessed firsthand the barriers to health that many Americans face every day. I became determined to dedicate my medical career to tackling these barriers head-on, so I joined a CHC after I graduated from residency. I love the work I do. In fact, while many of my peers working in other settings struggle with burnout, I find great professional and personal joy in my own career. My hope is that more medical students, residents and family doctors already in practice will be drawn to this satisfying work.
CHCs come in different shapes and sizes, ranging from rural practices with only a handful of physicians to multispecialty offices with multiple sites in urban areas, but they are all rooted in the s civil rights movement and War on Poverty, and they share a common aim: to serve the underserved populations of our country.
Many aspiring medical students express a desire to serve the underserved in admission essays and interviews, yet that honorable goal is often lost in the mix of training and medical school debt. Health centers are an ideal place to serve the underserved, but research shows that almost 70 percent of all CHCs are in need of more family doctors.
This is unfortunate not just for the health centers but for patients who arguably have some of the greatest needs in health care. There are many reasons why some family doctors might not be interested in working in a CHC, but I find they can be distilled down to two: The pay might not be as lucrative as other settings, and the patients can be challenging. I recently spoke with some of my colleagues who also work in CHCs and also contribute to this blog, and I would like to share with you the main reasons we love working in CHCs and why the pay and the challenge shouldn't deter you from working in this model.
My organization's primary mission is "providing quality, compassionate primary medical and dental care and social services to those who need it most. My co-workers fully embrace this mission, and in doing so, we are united behind a singular purpose of improving the health of our community. Lalita Abhyankar, M. We value working with the underserved and find our particular site to be a place for continued learning.
Kimberly Becher, M. My office is filled with people who go out of their way to help patients get the care they need, whether that means physical help getting through the front door or emotional support with difficult family dynamics or contributing their own time and money for incentive programs for colon and breast cancer screening.
I never know what is going to walk through my door, but isn't that part of the excitement of medicine? I recently saw a year-old woman who has never had a period. She had never undergone a full workup for reasons that can be summed up in one word: poverty. Another patient had several months of abdominal pain that was unexplained -- that is, until a CT scan showed multiple hepatic abscesses consistent with amoebiasis.
He had traveled to his home country in South America several months earlier and brought back a few "friends. Needless to say, I have been challenged in a good way, and my differential steps outside what may be seen in a typical family medicine office. Chris Baumert, M. I get to provide prenatal care, including first trimester ultrasounds, do well-child care, perform procedures and counsel on end-of-life decision-making -- a real broad scope of practice.
Becher said she doesn't see much racial or ethnic diversity in rural West Virginia, but she has a huge variability in patient complexity and health literacy.
Because we're motivated by our mission to improve the health of a population that faces many challenges, we've had to think outside the box to deliver the best care we can.
Every CHC innovates differently based on patient needs. Academic medicine is taking the lead in helping individuals who have limited access to healthy, nutritious food with innovative yet practical programs to address food insecurity. Food insecurity, which is defined as limited or uncertain access to adequate food, affects more than Researchers have found that adults who are food insecure are at increased risk of developing chronic diseases, while children are at risk for developmental issues.
Health care providers recognized that for some patients struggling with chronic illnesses like diabetes, kidney disease, and heart disease, a lack of financial resources or living in a so-called food desert — an area where it is difficult to buy affordable or good-quality fresh food — can compromise their ability to stay healthy. To address food insecurity, Geisinger Health Fresh Food Farmacy in Pennsylvania screens patients for uncontrolled diabetes and then provides a "prescription" for its Fresh Food Farmacy.
Patients who enroll in the program receive care management, coaching, and education. They also receive a weekly supply of food to prepare healthy meals. With healthy food and continual education, some participants have been able to reduce or even eliminate their diabetes medications. Since food insecurity is also documented as a key factor in hospital readmissions, teaching hospitals work to help patients before they leave the hospital. Eskenazi Health in Indiana partnered with Meals on Wheels to offer medically tailored meals to seniors being discharged from the hospital and link patients to food pantries within walking distance to their homes.
The program now feeds 7, to 8, patients and their families each month. Health care providers also found that while food insecurity was a major issue for some patients, others had difficulty getting to and from medical facilities, and some were physically unable to leave their homes to seek care. In addition, roughly 3. Typically, these individuals on average are female, poor, older, have less education, and are more likely to be a member of a minority group.
In a review of 25 studies published in the Journal of Community Health , researchers found transportation was an obstacle to access to medical services for many low-income patients.
To address the problem, a few initiatives have been supported by medical schools and teaching hospitals, including:. Coupled with food insecurity and lack of transportation, inadequate housing ranks among the most challenging barriers to good health for many individuals.
People who are homeless tend to suffer from multiple chronic illnesses or periodic acute illnesses that result in them being seen frequently in emergency departments or admitted to the hospital.
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