Helping Patients, One Referral at a Time

Like many of the other interns, I wanted to become an intern at Crossroad Health Center to help people beyond what I was previously able to do in my other community service experiences. One of the main tasks of a Crossroad Interns is “referral tracking”. This entails going through a list of patients who were referred to doctors other than their primary care physician such as an ophthalmologist, dermatologist, gastroenterologist etc. For many, the importance of patients going to their referrals may not be apparently obvious. But, consider a patient who has diabetes, and is at high risk for infection and blindness. Making sure a patient with this disease is able to go their ophthalmology appointment could be the difference between them being able to see and losing their sight. Because of the potential high risk nature of many of the patients who receive care at Crossroad, I am able to “help” patients by assisting them in finding the correct contact information for these specialists and make appointments.

A question that came to mind while doing referrals is how much am I actually helping? I think the answer to this question, for me, differs patient to patient. A couple of weeks ago, a fellow intern and I were able to schedule three different appointments at three different doctor’s office for one single patient. Additionally, we were able to look up the bus routes from the patient’s house to these different locations and included the times in which he needed to arrive at each bus stop location in order to make his appointments on time. We sent this information to the patient in the form of a voicemail as well as a letter. Besides having many health complications, this patient was also cognitively disabled. And not to discount his best efforts, but scheduling on his own would have been almost impossible. I called this patient back this week, and he confirmed he was able to make all of his appointment.

Conversely, there are patients who have the means to call and make their appointments, but still, we call them anyways and ask if they have been able to schedule an appointment, and if not, if they need us to assist them. Weeks later, we call back to see if they went to their appointment, and if not, the cycle of making an appointment begins again. To be frank, I believe by making the appointments for the patients who are capable is enabling them to not take the proper accountability for their health. Aside from just helping them with referrals, and by that, I mean clarifying which kind of doctor they need to go to, and providing  them with the number to call, we can help them take responsibility for their health by not simply doing things for them, but giving them the proper resources to make the appointments on their own.

I urge my fellow interns and future interns to evaluate their methods in which they handle referrals and ask yourself: “what can I do to help this person, but not enable them to not take responsibility?” Once again, I think evaluating each patient individually and accessing their capability to make an appointment or what information they will need in order to make an appointment on their own will be of more help to them in the long run. The resilience of many of our patients would probably surprise us all. Our desire to help shouldn’t outweigh the patient’s own responsibility to their health.

--Calyn Crawford

Bridging The Gaps In Healthcare

As I reflect on my experience as a volunteer intern at Crossroad Health Center I realize that my experiences there will impact not only my career as a physician, but more importantly my life as a whole. I started at Crossroad ignorant to how the healthcare system worked, and unaware of the healthcare gaps that exist in our healthcare system. Fortunately there are places such as Crossroad Health Center who make it their mission to decrease these gaps in the healthcare system.

Crossroad has taught me that medicine is a team effort. Before I was an intern I thought of medicine as doctors and nurses but it is so much more than that. From myself as a volunteer intern to the physicians, everyone plays a crucial role at Crossroad to ensure quality care for the patients. The respect among the employees there is special, it makes everyone feel like what they are doing is important, and this leads to better care for the patients. Whenever a Crossroad employee is giving a tour to someone looking to join the team they always mention the VIP’s dressed in blue and how important they are to the clinic.

This feeling of importance among every person at Crossroad is crucial in order to provide the best care possible to the patients, because they truly are in need of it. I will never forget my first day shadowing I saw a patient on over thirty medications who was had diabetes, blindness, hepatitis B, kidney disease, and countless other chronic conditions. I was ignorant to the health issues that poverty and the health care gap can cause. I will never forget my experiences shadowing and hearing patients tell the physician they cannot afford a medication that would cost them less than ten dollars. Crossroad has taught me that some people may try to improve their health but their life situations make it extremely difficult. For this reason in the future I will look at patients and their whole situation rather then just their symptoms, which is one of the most important things I have learned at Crossroad.  

--Ellis Green

Dedication to the Community

As a CVIP intern, I have gained insightful and invaluable perspective about the healthcare challenges that underserved communities can face. Crossroad Health Center truly fits the designation of patient-centered medical home, with a large and encompassing list of services. From childhood services, to mental health and addiction counseling, to the pharmacy located on its first floor, CHC helps patients manage their health in a community that faces sizable economic and social challenges.  Shadowing the selfless providers at OTR has allowed me to reflect and gain perspective about the unique and seemingly insurmountable situations that patients can face.

One of the most important principles I learned during my rotation is that medicine cannot be contained to the health center. To impact communities in the most meaningful manner, health care must go beyond the exam room, through education and community outreach. One of the ways I participated in this was by volunteering for a Crossroad event at its West location, during National Health Center Week. Although the day I volunteered on was not as busy as previous days of the weeklong event, I still enjoyed interacting with the children and parents that did come to play and learn, respectively.

Some of the situations that patients have to face seemed unreal. One patient that left an impression on me was a woman who had come in for intense back-pain. After a lengthy wait for the provider on a very busy day, she was lying on the exam-room table when I entered. The pain had been triggered while lifting her arm, and she did not know what medications she was taking, perhaps due to continuity of care issues. However, her history of back pain was what struck me most; it had started when she was stabbed in the back, literally, by her ex-husband in the past. The pain had been exacerbated after being involved in an auto accident half a year prior to the visit. She was forced to deal with the pain at her work, for fear of losing her job, for which she was on her feet all day. Finally, just weeks before, the patient had been struck by a vehicle which knocked her down and ran over her foot, while walking to the bus stop from her chiropractor’s. All of this had been poured out to Dr. Rahner between gasps of pain, and I could not help but empathize as she described feeling mad, angry, and disgusted.

The experience made me reflect on the profound impact, and unique relationship that providers at CHC have with their patients. Perhaps the most notable aspect of this relationship is the amount of trust, and respect that patients have for their provider. Through shadowing and service in the community, I have learned much from both staff and patients at Crossroad. It is a safe and hopeful place in a community that faces challenges that reach beyond health care, and the dedication to service and well-being in the community is what makes me most proud about being an intern at Crossroad Health Center.

--Irwin Mahajan