Wednesday, June 21, 2017

#theVIPExperience Post #20: Swairah Rehman

My name is Swairah Rehman and I have only been at Crossroad health center for a short amount of time, but I have already started to understand the impact of our job as volunteer interns. When I first started working at  Crossroad, it was at the OTR location, where I was given the opportunity to shadow Dr. Van Milligan. What resonated the most with me was how she always had a smile on her face and attended to her patients with the warmest of greetings. I didn’t understand how she could constantly, patient after patient, keep up with the individual stories of each patient. She congratulated a patient on completing a half marathon and sympathized with another for the loss of a family member. Through these small interactions, she humanized the situations of the patients who entered the room. I was given the chance to see patients on a more intimate level, I was able to see them open up to a doctor.
Many people dread going to the doctor’s office, whether it be for financial reasons or medical realities that they may face. However, at Crossroad the patients were eager to come in and talk to the physicians, they connected with them on a level that is not seen in many physicians’ offices. These patients, who may be juggling two to three jobs or may be taking care of multiple family members, didn’t always have to time to call different hospitals and doctor’s offices to schedule appointments or chase down medical records. However, at Crossroads we worked to help and understand the patients’ situations and accommodate their schedules. The humanity I saw here made me realize I wouldn’t want to be anywhere else as an intern. My job as an intern was making the lives of these patients a little bit easier and I am truly grateful that I have been given this opportunity to make a difference, no matter how small or big.
`           Now, as a second year student at the University of Cincinnati and living in Cincinnati on my own, my eyes have been opened to the conditions of many of the individuals in the area. Being able to understand the stories of those around us is crucial to integrating into the community we live in. My major is in Biological Sciences on a pre-med track, with aspirations of becoming a family care physician. My time at Crossroad, has pushed me towards pursuing a certificate in minority health which is something that I have decided on in order for me to better serve underrepresented populations and give them a voice within healthcare. I want to thank Crossroad for showing me how important family care physicians are and how every community deserves adequate care no matter how impoverished.

-- Swairah Rehman (Sway)

Thursday, June 15, 2017

#theVIPExperience Post #19: Lindsay Weaver

If I could tell a younger Lindsay what to expect from Crossroad, it wouldn't be directly treating an underrepresented population and diving into root causes of the health problems they face. It also wouldn't be solving problems such as gentrification, medical discrimination, and poverty. I would tell young, naïve Lindsay to expect making lots and lots and lots and lots of phone calls.

I jest, of course, but only a little bit. I have become quite good at making phone calls, so I'm adulting really well!
Communication, in fact, is an important tenant of what Crossroad VIP's do. We help bridge the gap that separates our patients and their outside appointments. We help make sure they understand all the details of their appointments so they can get there and be in charge of their health, as well as set up appointments they would otherwise be unable to make. Through active communication, we learn that it's not necessarily laziness or ineptitude that explains why patients no-show; sometimes it's a late bus, or lack of insurance coverage, or a hectic work schedule, or other personal circumstances.
It's also through communication that we help learn our patients' anxieties. I've had a handful of patients thank me for scheduling appointments, and then ask me to pray for them and their families. This is what reminds me of compassion, which literally means "to suffer with". As a practicing Catholic at Xavier, prayer  brings us to communicate all our thoughts to God, and it becomes all the stronger when we invite others to pray with us. But it requires so much vulnerability to ask someone to pray for you. Who wants to open up to a classmate, let alone a perfect stranger, when faced with a challenge in life? It warms my heart when our patients let us into theirs. Suffering is hardly a desirable thing, but to choose to empathize with people unlike you helps us to see beyond the surface, perhaps into the divine.
But that might be a little over-romantic. More often than not, when we call our patients, we get a brief thank you, or a barrage of frantic and unrelated questions, or a filled voicemail inbox. It's still worth it, because I so often imagine that I would be the same way if I were in a similar situation. My next advice to that younger Lindsay would be to shake off the frustrating moments, and learn from them. I have probably learned more from what I have done wrong and had to work to correct than what I have done right the first time. "Suffering with" doesn't mean I get to suffer with others only when it's convenient for me; it means to choose to do what is best for our patients at all times, even when you're frustrated about every little thing.
All that being said, I love being a Crossroad VIP, and a referral team leader this semester. I love the everything our program stands for. I love being able to share my enthusiasm for medicine and social justice to others and to hone new skills I haven't thought to learn. And most of all, I love our Crossroad community.

-- Lindsay Weaver

Wednesday, June 7, 2017

#theVIPExperience Post #18: "Understanding Population Health" by Bailey Windell

Unlike many of the other interns who are a part of the VIP program, I do not wish to enter the medical field. I am a student at Xavier University studying Health Services Administration with minors in Business and Criminal Justice. Through my undergrad experience I have found that being in a health care setting is not for me, however I continue to find value in the experience of this internship.  Being someone who has grown up very privileged, it has been difficult for me to understand the barriers in many of our patient’s ways that I did not have to face.  
Population health is a hot topic I health care right now. It is, “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” Basically, it is how healthy people are based on the factors of life including race, location, socio-economic status; ext. Medical care actually plays a small role in the health outcomes of individuals, excluding acute cases. By working at Crossroads I have been able to see first hand many of these discrepancies. Especially when working in the OTR office, I was able to see patients who did not understand the way the medical system worked. Frequently, I would get frustrated with the referral process, as I want to teach the patients to do the referrals, rather than do it for them. The flaw in this scheme is that many of them don’t want to put the time, money, or energy into their own health. One way I think we can combat this is through education. By teaching people the reasons behind the actions that they take, may help them to become more likely to do them themselves.
Understanding population health is important for everyone, not just those going into medicine, because our health affects everything we do. If there is a group of people who are automatically less likely to be healthy, how does that affect their quality of life? In a time where health care, especially insurance, is a heated debate, it is important to remember the individuals that we have all met. It is important to hear their stories and understand why they are in the position they are in. It is important to be empathetic and step into their shoes. Most importantly, to treat them as you would want to be treated. Crossroads is an organization that works hard to value to “whole person” who walking into the clinic, and not just their ailment. 
-- Bailey Windell

Friday, May 26, 2017

#theVIPExperience Post #17: Emily Kim

According to the Kaiser Family Foundation, 1 in 12 Americans, which adds up to 24.3 million people, sought care at federally qualified health centers, similar to Crossroad Health Center, in 2015. Nearly 6 in 10 of these patients were women, and hundreds of thousands of veterans sought care as well. Crossroad Health Center alone serves a population of 11,000 people, most of whom live at or below the poverty line and are racial or ethnic minorities. These numbers are powerful and convey the important role that Crossroad plays in serving Cincinnati residents, but stories are arguably even more powerful. What I have received from being a VIP at Crossroad is stories, and for that I am truly grateful.
             Being a VIP means that you give just as much as you receive. Volunteering at Crossroad has been one of the only volunteer experiences I’ve had that has ignited me, where I want to stay six hours, not four, to finish scheduling referrals and overcoming insurance barriers. However, I also want to stay to take in as much as possible. I’ve learned so much from providers, staff, and patients that I would have never learned otherwise. Many of these often frustrating stories that I’ve collected are associated with insurance barriers. Even though the Affordable Care Act has helped to increase the number of patients with health insurance at FQHCs, one in four health center patients remain uninsured. An issue that’s also been presented to me as a VIP is the problem of underinsurance, where patients nominally have insurance, but their deductibles are so high that their insurance is mostly catastrophic—it can only kick in if they get into a car accident or need emergency surgery.
However, the most frustrating insurance barrier that I’ve experienced concerns dental insurance. Many insurance plans do not provide dental insurance at all, as if dental care was any less important than general health care. I would argue, in fact, that dental insurance is even more important than health care in cases of seeking employment. Your teeth are the first thing someone sees when they look at your face, and having poor dental health is one of the greatest barriers to employment, along with obesity, for people of low socioeconomic status. One of the patients for whom I needed to schedule a referral needed to see an oral surgeon for their health needs. However, with no dental insurance and little to no income, the patient would not have his procedure covered nor could he pay for it himself. I called every single oral surgeon in Cincinnati, and none of them would provide care at a reduced cost or even provide care to Medicaid patients in the first place. The patient would have to travel to UC Medical Center to fill out financial aid paperwork, but having no car, this was also difficult. As the patient’s designated VIP, I felt responsible for ultimately being unable to get them the care they needed. From my experience, I learned just how important insurance and reduced cost care is to millions of Americans. From my experience with this patient and at Crossroad, I recently contacted Senators Rob Portman and Sherrod Brown to encourage them to vote against the American Health Care Act, as this would reverse many of the gains that the Affordable Care Act put in place in terms of insurance access and utility.
To VIPs starting your first rotation, to people contemplating applying to volunteer at Crossroad, and to people who haven’t even heard of Crossroad Health Center: I highly encourage you to apply to become a VIP. Being able to immerse myself in an environment of giving has been an igniting blessing to my college and life experiences. I hope that other people can find the same drive in them to give and learn from others as I have.

-- Emily Kim

Monday, May 15, 2017

#theVIPExperience Post #16: Haley Beavers

My journey as a VIP has spanned over half my Xavier career, the half that has been arguably the most transformative two years of my life. I first learned about the internship program during my sophomore year when Drs. Schubert came to speak on “global health in our backyard” at Xavier University. That year, I was a Winter-Brueggeman Fellow and thick in the weeds of year-long research project centered on universal healthcare. A few weeks before I was to head off to Costa Rica to complete the international capstone of the fellowship, I saw that the Pre-Med Society was sponsoring this talk that pertained not only to the focus of my fellowship, but also struck a chord in my heart. I still remember feeling so excited when I heard this incredible clinic offered an internship opportunity for students. There haven’t been many moments in my life where I felt absolutely sure about something, but I knew during that presentation that I was going to apply for this internship.

After I applied and well into my first rotation, I was also fortunate enough to be involved in a program through Xavier’s Dorothy Day Center for Faith and Justice called Dorothy Day Immersions (DDI). People who know me well enough will chuckle when they read this, as it probably seems like, when given an inch, I’ll take a mile and talk about DDI. However, I will argue that I cannot isolate the two experiences and the impact they have had on me over the past two years. Through DDI, we explore the intersection of faith and justice and spend a week of winter break on trips diving deeper into justice-related issues across the country. DDI took me to New York City in 2016 and New Orleans in 2017. On both trips, we learned about amazing community organizations that work with the marginalized in order to promote peace and justice within their own communities and in the world at-large. My heart always beamed with joy and purpose when I thought about the mission and vision of Crossroad and our internship program during my two trips. While working with incredible community activists and organizers in NYC and NOLA, I knew that I would return home to Crossroad Health Center, even more on fire to work for and with our patients. Whether or not VIPs realize it, by participating in the program and engaging with the patient population at Crossroad, they build in themselves a desire and drive to seek justice and work for the marginalized. These are the building blocks of a better future.  
Looking back on my past five rotations as a VIP, I cannot begin to describe the amount of growth I have experienced as a result of this program. Not all of it has been easy, and, in fact, I would say that it has been immensely difficult most of the time. I’ve experienced my fair share of failed attempts to schedule a referral, painful encounters with patients who, through the pain, continually inspire me with their courage and vulnerability, and general hiccups along the way. Working with the patients of this clinic, Crossroad staff, and my fellow VIPs has been an absolute honor and a privilege, and my goodbye to this program will not be an easy one for me to say. 

-- Haley Beavers

Monday, May 1, 2017

#theVIPExperience Post #15: "How Crossroad Changed My Life" by Gabby Truitt

Crossroads Health Center has literally changed my life. 

I know this sounds cliche but stick with me here. If you’ve read the previous CVIP blog posts then you understand what our job entails. You also understand the population we work with. So, I won’t go into those details. What I will share with you, however, is how these two things have impacted my future.

I’ve known I wanted to be a doctor since (about) freshmen year of high school. Science has always been my favorite subject and I enjoy helping others. The idea of working with underserved populations, however, never crossed my mind. That is, until I started shadowing in the University of Cincinnati Emergency Department.

The difference between this shadowing experience and my Crossroads experience is that, after leaving my shadowing shift in the ER, I felt as though I did not want to work with patients on Medicaid. The patients seemed rude, uncooperative, and often times like they just wanted needed pain medications. What I didn’t take into take into account when processing these encounters, was that these patients were in (what they felt was) an emergency situation (even if it wasn’t always a “true medical emergency). They had the same stressors at home as our patients at Crossroads (I’ll get into those soon) do but they had the added stress of feeling incredibly sick.

Now, let’s fast forward to my time at Crossroads.

During the training process, it was explained very clearly what a day may look like for our patients. Many of them have a family to provide for- which means working at least one (maybe more) job(s). They also may not have reliable transportation or means of communication. Some of our patients don’t even know where their next meal will come from or how they’ll afford their medications. Once I thought about these stressors, I had a new perspective on why these patients in the ER seemed rude and uncooperative. What I realized was that the patients weren’t rude at all but were simply blunt; probably because they didn’t have time to waste- they needed to get better and get home to provide for their families. They also weren’t uncooperative, but instead simply didn’t have the means to take care of themselves the way middle to upper class families do. On top of that, these patients needed pain medications because they really were in pain. When you can’t take care of yourself the way you need to, then your illnesses are managed and when an illness and its symptoms aren’t managed then there is typically pain involved. I was starting to understand that the underserved population of Cincinnati is completely stereotyped and misunderstood.

The thing that truly changed my life, however, was being able to interact with our patients. For people with so many things going on in their life, they are all incredibly kind and grateful individuals. I work on the pediatric referral team at our OTR location and the amount of parents that are on top of their children’s referrals, while still working a job and taking care of the entire family, is astounding to me. As a college student, I barely manage to care for myself, let alone do everything these super parents do.

Now that you understand the transformation I’ve gone through while volunteering at Crossroads, I will explain how it has affected my future. As you can probably guess, I have developed a passion for working with underserved populations (a complete 180, I know). It is because of my time at Crossroads that I have decided to earn a Masters in Bioethics (with a focus in public health) before I attend medical school. Instead of performing research, as I originally planned, I will have the opportunity to observe public health ethical dilemmas in the health field and I will learn how to handle these dilemmas when I am a physician. After medical school I want to work in emergency medicine at a public hospital. It is my goal to ensure each of my patients are treated with the respect and care that they deserve. The CVIP program has put life and humanity into perspective for me, therefore encouraging me to do whatever I can to change the world (no matter how small my role in doing so may seem); I will forever and always be grateful for that.

-- Gabby Truitt

Monday, April 24, 2017

#theVIPExperience Post #14: Tiffany Shi

The time I have spent volunteering with Crossroad so far has been nothing short of amazing and inspiring to me. As a VIP who has done the traditional route of assisting patients with referrals as well as the non-traditional route of being a Tobacco Treatment Group (TTG) VIP has helped me grow in more ways than I could have imagined. 

After moving to Cincinnati in the summer of 2016, I wanted to get integrated and get to know my new community. A colleague suggested I look into volunteering with Crossroad, and it has been a truly eye-opening experience. Crossroad's patient population showed me the disparities in healthcare I have heard talked about, but never seen first-hand. As a referral VIP, I was eager to help patients in any way possible, and was always striven to be as efficient as possible. Through my first rotation, I picked up organizational and communication skills.  

However, it is through my second rotation as a TTG member that makes me feel like I've made an impact on others. The TTG is a group therapy style meeting to discuss tobacco cessation as well as living a healthier lifestyle. Each week we have a check-in with how much the patient smoked in the past week and how their week was, a short lesson on various topics relating to tobacco or health, and then goal-setting to end the session. As someone who is passionate in fitness, nutrition, and well-being, this group seemed like the perfect fit for me. Through the TTG, I learned not only how to communicate with others better, but also how to climb out of my shell and speak up when I have something useful to say. Seeing the patients progress each week as well as knowing that they took in at least a little of the information taught to them each week is what brightens my Mondays. 

Volunteering with Crossroad has been one of the best choices I've made since moving to Cincinnati, and I am so grateful for everything this experience has taught me so far. 

-- Tiffany Shi