Sunday, July 23, 2017

#theVIPExperience Post #23: Erica Geers

The first time I visited Crossroad, my first inclination was to turn around in the opposite direction. I grew up in small town Indiana. Everyone is white, middle class, and knows one another. When I entered OTR, I was propelled into a new world, one with an underserved population. I have always wanted to be a doctor and have done the usual preparations: advanced science classes, research, job shadowing, etc. However, my few short months at Crossroad has helped me discover a whole new side of healthcare: patients’ struggles.

My first couple of weeks included job shadowing, where I was paired with Dr. O’Dea. This was unlike any shadowing experience I have had before. Dr. O’Dea was really engaged with me. She was sure to give me each patient’s background before we entered the room and after each visit, answered the barrage of questions I had about each appointment. She was also the PCP that got the Spanish-speaking patients. Having studied the language in Chile three years prior, it was a lot of fun testing my skills with these patients and even learning some new vocabulary.

One thing that hit me the most while shadowing was when a patient did not show up to the appointment (of which there were plenty), Dr. O’Dea was not angry or discouraged. Other providers I have shadowed in the past would become irritated when a patient was a “no-show” and would view it as a sign of disrespect. However, Dr. O’Dea informed that many of the patients are so busy that a doctor’s appointment is the last thing on their minds. Many work multiple jobs or jobs that have long or irregular shift hours. Some cannot get childcare or transportation. She explained that this does not anger her, but saddens her that these people’s lives are so crazy busy that they have to put their own health on the backburner. It was at that moment I realized healthcare was not as simple as I thought it to be.

Working as a CVIP has shown me that patients need support as well. This job isn’t easy. I can make dozens of phone calls a day and get nothing but voicemails, disconnected numbers, or disgruntled patients. It can be hard keeping up with the multiple cases we are assigned. It can be frustrating communicating with some patients. It is certainly disheartening when you cannot schedule an urgent appointment for a patient just because of insurance or limited availability. However, there is obviously good that comes from it. The satisfaction of finally making the appointment, the humility learned from listening to the patients’ stories, and the gracious smile and “thank you Ms. Erica” that a patient gives after you help them. I certainly recommend becoming a CVIP. It is an eye-opening, inspiring, and gratifying experience that you cannot get at just any hospital. I am grateful to every provider, fellow VIP, and patient that has made this experience so worth it. 

       -- Erica Geers

Thursday, July 13, 2017

#theVIPExperience Post #22: Julia Harrison

My name is Julia Harrison and I am in my second rotation as a VIP at Crossroad. When I first applied to the program, I honestly did not know what to expect. I only heard that I would be doing something at a desk in a health care setting and since I plan to study medicine, I thought it would be good to participate in. I had no idea what a valuable experience it would become. Not only do I feel that I have gotten a “sneak-peek” into the health care professions, but my eyes have been opened to the struggles of patients of the underserved population of Over-The-Rhine.
Having grown up in a privileged community, I had never known how easy it was for underprivileged patients to get lost in the system or how hard it is for them to get the treatments that they need. It amazes me that as a VIP, someone who is trained to schedule referral appointments and arrange transportation, I still face difficulties. For someone who does not have the resources that the VIPs have, like unlimited phone minutes, access to internet, or time to sit on hold, scheduling referral appointments can seem nearly impossible. As a result, it may take patients a long time to schedule their appointments or they may forget or decide it is not worth the trouble. Because of my experience as a VIP, I have come to understand how essential the program is to the community it serves.
In addition to getting to work as a VIP, I also had the opportunity to shadow one of the primary care providers at Crossroad. Because I am considering becoming a doctor, I found it very valuable to watch a doctor who serves underserved patients. It is a sacrifice of their time and their compensation, which I found to be so admirable. Overall, my experiences at Crossroad, from shadowing the providers to interacting with the patients, have opened my eyes to career possibilities other than what I had previously considered. Because of my participation in the VIP Program, I am considering a career which provides underserved populations with more accessible health care. For anyone who is considering applying to be a VIP, I would definitely recommend this program to anyone who is looking to learn more about health care or underserved populations.

     -- Julia Harrison

Monday, July 3, 2017

#theVIPExperience Post #21: Lily Marrero

Unlike some of my fellow VIPs, my first encounter with Crossroad Health Center took place not in college, but high school. Clark Montessori is a public high school right here in Cincinnati, and during our senior year, each student finds a “job shadow” in a field of their choice, and I was searching for a Certified Pediatric Nurse Practitioner. Fortunately, I found Brook Gumm, CPNP. Those two weeks shadowing her, seeing patients and watching her day-to-day activities, were what solidified my resolve to pursue a career in nursing, and eventually my own CPNP certification. After those two weeks, I wanted nothing more than to return to Crossroad someday. 

After one semester at the University of Cincinnati, in the Honors program, I got my chance. Several of my fellow Honors Scholars have participated in the VIP program, and presented on it during one of my classes. Realizing that I would have the opportunity to return to the place I had so loved, I applied as soon as the Spring Rotation was available. For the first three weeks of my rotation, I shadowed none other than the amazing Ms. Brook. Those first weeks reminded me of exactly why I had enjoyed myself so much the first time around: not only was I fascinated by the medicine (I always have been), but I was so touched by the stories that the patients trusted us with. They revealed to Ms. Brook their biggest worries, their most frightening obstacles, and instead of dismissing them, she supported these people, these families, with suggestions and careful listening ears. 

It is with this same spirit and consideration that I approach my duties as a VIP. I was given the honor this rotation of becoming the Referral Team Leader for the Over-the-Rhine Pediatrics team, and I’ve never been busier or felt more fulfilled. As I’ve seen in some other posts, it is true: a lot of what we do is make phone calls. And sometimes, those phone calls are met with less than pleasant answers or voicemails, and sometimes nothing at all. It can be frustrating, it’s true. Even more irritating and discouraging can be those referrals which are, for whatever reason, incredibly difficult to schedule; complicated referral documents, requests for records, slow faxes, miscommunications, and many other factors can stall or even stop the process of scheduling completely. This leads to frustrated volunteers, staff, and of course, patients. However, those frustrations are minute compared to the joy when a complicated referral finally gets scheduled. I have heard such gratitude expressed; patients and their families so often thank us for taking the responsibility, and time spent on the phone, off their plates. I often think of how these four hours out of my week can help families get their children to crucial appointments; they just don’t have the half hour or hour, or two, to spend on the phone, researching and communicating. But I do, I have the time to donate, and I give it more than willingly. 
   -- Lily Marrero

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