Thursday, October 16, 2014

A Patient-Centered Medical Home

“Crossroad is the only place I go that has doctors who actually care about how I’m doing.”

This was a direct quote from one of the patients I talked to during my last shift. After volunteering with the Health Center for over six months now, I can honestly say that his statement is a perfect depiction of Crossroad Health Center. Crossroad Health Center is a Patient-Centered Medical Home, but what does that really mean? 

In my opinion, the patient was spot on. Crossroad Health Center is a place where the doctors and staff have the patient’s overall health and wellbeing in mind. Every week when I go in to work, I find out about a different service that Crossroad offers their patients. From regular, yearly doctor visits to visits with the diabetic specialist or one of the psychiatrists, there is someone on staff who can handle whatever issue a patient is dealing with and who wants to take the time to make sure the patient leaves feeling better about whatever it is. As interested as I am in seeing the different illnesses or problems that patients are facing, I am equally as amazed by how Crossroad always has a service to deal with the problems. This hands on, holistic approach to patient care has certainly affected me as a volunteer. 

Crossroad has instilled in me a desire to see to it that patients are taken care of beyond just getting in and out of their exam room. Few other doctor’s offices will call patients’ homes to ensure that they were able to schedule appointments for the referrals that were made for them at their last appointment. It was through making these referral calls and working in the Pre-Visit Planning Room that I have learned how to interact with patients one on one. For all of the amazing medical practices I have seen and all of the new medical illnesses and procedures I have been introduced to, I have gained just as much knowledge about how to treat people that come in to the doctor’s office. 

Crossroad serves as a constant reminder to me of why I want to go into the medical field. I have seen numerous patients come in to the office who have completely given up on their health. But just because they have, it does not mean the providers or the staff has. Not a week has gone by that I have not been impressed by Crossroad’s dedication to their patients. I know how cliché it is to say that a person becomes a doctor “to help people”, but that is exactly what Crossroad Health Center does. People are getting the medical attention they need and they are seeing changes in their health because of this place. It is rare that someone gets the opportunity to be a part of a place so amazing. I am so grateful that I have been able to return to Crossroad every week and continue to learn more and more about the inner workings of a true Patient-Centered Medical Home.

-Katie Woebkenberg

Wednesday, October 8, 2014

The Importance of Listening

One of the major lessons I have taken away from my time at Crossroads is the importance of listening. The staff at Crossroads always seems to make time to really listen to their patients even when they are very busy. When I talk to patients on the phone, I come across many patients who are angry and frustrated because they feel like they aren’t being listened to. I think a big part of this perception is that patients and doctors often have different priorities when it comes to a patient’s health.

Many of the patients at Crossroad have multiple chronic conditions and medication lists that are multiple pages long. The providers only have so much time to spend with a patient and have to pick and choose what issues are the most important to talk about at each visit. This can be made difficult when the patients bring an equally long list of their own concerns. The physicians I have shadowed have done an excellent job of balancing their time with the patients so they can address what they need to, but also address their patients’ concerns. This allows patients to leave Crossroad feeling taken care of.

I think another reason patients can feel like they aren’t being listened to is when they don’t fully understand why a physician is focused on a certain aspect of their health. If a patient doesn’t entirely understand a condition it can seem less troublesome than one they do understand and they may feel like the physician is focusing on the wrong thing. The providers at Crossroad not only take the time to listen, but to explain. I hear a lot “I am worried about this because…” and then watch the doctor get the patient on the same page. Understanding their conditions not only allows patients to understand why doctors focus on what they do but it also empowers patients to take control of their health.

One thing I enjoy about being an intern is that I have more time to spend with a patient on the phone if needed. Sometimes patients need to talk for a while just to feel heard, and then there is a simple fix to the problem. It is satisfying when I can help a patient with one of these problems and they realize that I am on their side. I have been inspired by the physicians at Crossroads to always make sure I take the time to listen to my patients and make them feel cared for in my future as a physician.

-Katie Copp

Friday, September 26, 2014

Considering The Whole Person

On my first day as an intern, I met a patient who has stuck in my memory ever since. He was a middle-aged man in torn up jeans and a windbreaker stuffed with grocery bags, unsuitable clothing for the frigid January weather. While sifting through an overflowing bag that held the man’s prescriptions, the doctor explained that the man was illiterate and needed help managing all his medications. From my very first day at the clinic, I have been surprised to find that severe social and health disparities not only exist, but also that they have always been so close. I have learned many lessons in compassion and understanding through direct interaction with the underserved members of my community, but I have also learned a great deal about the process of administering health care. This process has become very apparent to me through my participation with the Tobacco Treatment Group.

I have learned a great deal from being an active member of the group, but perhaps the most important thing I have learned is that a patient’s health is dependent on every aspect of their life. For the majority of patients, quitting smoking is not the only challenge that they are facing. Patients grapple with depression, drug and alcohol abuse, family issues, financial issues, and many others. All these struggles accumulate to affect the patients’ health. I have learned that all the challenges these patients face must be identified and addressed in order to move the patient toward better health.

Another essential aspect to this process is the patient-provider relationship. In my shadowing experiences, I have learned that in order to provide the most comprehensive health care, the providers must work very hard to build a relationship with their patients. This has led me to conclude the most efficient delivery of health care occurs when the patients can trust their provider and when the provider knows enough about the patient to be able to consider all the aspects of the patients’ lives that contribute to their mental and physical well-being. My work at the clinic has exposed me to the many social barriers to health that exist for the members of Over-The-Rhine. It has also taught me a great deal about the best ways to overcome these barriers. I am very grateful to have the opportunity to contribute to Crossroad’s important mission.


-James Kelly

Friday, September 5, 2014

Health and Happiness

When I say that Crossroad Health Center (Crossroad) is filled with the most hard-working, selfless, and caring doctors I have ever met, I am not exaggerating. Everyone who works at Crossroad is there purely to help people; being paid is not the purpose. I first applied to the Crossroad Volunteer Internship Program (CVIP) because I dream of opening my own clinic in another country one day. I thought that working at a clinic that helps the underserved in my own community would be a great way to see and experience what it would be like. I correctly assumed that I would gain an immense amount of knowledge, but I had no idea that I would have the opportunity to actually help people as only a college student.

At Crossroad, I make referral calls, shadow and assist doctors, and work in a pre-visit planning room. However, my main focus and passion at Crossroad is facilitating a tobacco treatment support group. Every Monday at 3:30, a group of people from all walks of life gather on the second floor of the clinic with one shared goal: to quit smoking. Many of the patients I meet in the group have been through so much in their lives – violence, incarceration, prostitution, alcoholism, drug addictions. They have worked tirelessly to free themselves of those chains and they come to the support group to fix one last thing in their lives. Quitting smoking is no easy feat. Nicotine is more addictive than crack, and several ex-crack users in the group can attest to that. It is so inspiring to even be in the presence of these people who have overcame so much, let alone have the opportunity to help them better their lives further.

Up until working with the Tobacco Treatment Group, I knew that smoking was not good, but I had no idea of the extent it can hinder life. Just looking around the circle, one can observe the terrible effects it can have on a man or a woman. The heavier smokers are out of breath from just talking, their voices are raspy, one is missing limbs because of amputations due to lack of circulation, younger patients look twenty years older, and almost all are poor and their addiction forces them to fork over six dollars whenever they need a new pack.

As the facilitator, I have become a cheerleader, a shoulder to cry on, a resource, and even a friend to many of the regular group members. It is heartbreaking to witness the frustration and despair that frequents our discussions, due to inability to quit. The doctor that comes to the group and I share methods to quit, stress management strategies, craving management, medications, tips, tools, and hope. Working at Crossroad has been the single most rewarding experience I have had in Cincinnati because I have actually been able to make a difference, all the while learning so much about health, life, and dedication. Group members that have quit since I began facilitating the group have already reported how much better they feel and how much their quality of life has improved. Health and happiness are the top two things that I want to spread in the world, and CVIP has given me the opportunity to do just that.

-Sami Nandyal

Friday, June 6, 2014

Treating the Soul and Body, One Smile at a Time

I realized the true power of Crossroad Health Center when one patient told me, "This is the happiest I have been in months!" This patient I shadowed with Dr. VanMilligan was elderly and suffered from depression. However, like any proud grandparent, the patient showed me pictures of her grandchildren and became more lively and silly as she talked to me more. The patient told me that this was the happiest she had been in months, after being able to talk and laugh with others who cared about her. She made me realize the impact that I could play in someone's life just by talking to them and really listening to them. I think this is one side of medicine that is not addressed as often. Mental health and social health needs to be included with physical health. For a doctor to treat a patient, they need to not just help treat the body but the mind as well. I think it would be interesting to see how this could play a part in public health and my medical career in the future.

I began volunteering at Crossroad Health Center in September 2013. Ever since then, I have worked on projects ranging from diabetic patient follow-ups, referral tracking calls, tobacco treatment calls, and pre-visit planning room work. My volunteer work at Crossroad has taught me the complexity of the medical field. Being a doctor is more than seeing a patient and prescribing medicines. During my Success in Health Professions course my freshman year at the University of Cincinnati, I learned about how treating a patient requires the cooperative and interdisciplinary work of nurses, doctors, medical assistants, administrative staff, allied health professionals, volunteers, and the so on. Crossroad Health Center has this unique community focus and is able to effectively work collaboratively to help their patients as a patient centered medical home.
        
The providers at Crossroad have showed me how to treat not just the body, but the soul as well. Dr. O'Dea knows many of her patients on an individual basis and the visit is not just focused on the person as a patient, but the person as a fellow human being and friend. One of my favorite quotes posted in the exam rooms is by Peggy O'Mara,"The way we talk to our children becomes their inner voice." As a future physician interested in pediatrics, I look up to Nurse Practitioner Brook Gumm and the way she is able to talk to children in a loving, friendly way and talk to parents in an informative and comforting manner.
        
I have realized that the projects that I have worked on have helped the patients and create a community for the patients to feel important. It is nice to have a community at Crossroad who cares about each patient as a person and works to bring a smile to each and every patient's face every single day.

- Mahima Venkatesh