For Immediate Release
July 21, 2014
Contacts:
Lisa Rutledge
Western Wayne Family Health Centers
734-941-4991×227 or 313-204-8001
lrutledge@wwfhc.org
Dennis Archambault
Detroit Wayne County Health Authority
313-871-3751
darchambault@dwcha.org
The future of medical training is in the community, where people live, work, and recreate. Community health centers like Western Wayne Family Health Centers, together with the Detroit Wayne County Health Authority and its academic partner Michigan State University, are providing new training experiences for new doctors. The Health Authority sponsors the Authority Health teaching health center program.
With community health centers located in Inkster, Taylor, and most recently River Rouge, Western Wayne Family Health Center is focused on meeting the health needs of the medically underserved areas of the county. It’s also where Cassie Rice, D.O. and Alex Yu, D.O., M.P.H., are realizing their goals of learning community-centered practice.
They will spend their three-year community-based training at Western Wayne. “Within the first three weeks here, there’s been so much that has walked in the door that I was not expecting,” says Dr. Rice, a pediatrician. “You look on your schedule and see sports physicals and well-visits. The patients’ conditions are much more complicated than well-visits or sports medicine visits. The demographics of the area, the social environment that the kids are coming from presents a much more difficult patient. It exposes a resident to much more than you initial think when the patient enters the room. The patients are difficult, but that’s good because within one room you’re getting hit with a lot of situations that I haven’t been exposed to much at all until I came here.”
“I was attracted to this program because it provides experience in different types of hospitals, so I get a broad sense of the industry as a whole; serving the underserved is also something I have been doing since college and the mission of the program fits me,” said Dr. Yu, an internal medicine resident. In addition to his residency training, Dr. Yu has joined the Health Authority’s Population Health Council, a regional coalition of public health stakeholders focused on broad health policy issues. While providing medical care for individual patients, Dr. Yu also has a public health view of circumstances that influence the health status of his patients. “Vulnerable populations are an interest, but not necessarily my career goal,” he says. “I plan on going into primary care because the need is greatest there. I had a concentration in health system and policy so I’d love to restart that interest in the future.”
The Authority Health teaching health center program places medical residents in community health centers as much as possible, while providing them with the necessary hospital-based experiences as well. The health center environment is better for primary care physicians than hospitals because of “the relationships that are established between physician and the family,” says Dr. Rice. “I have been pleasantly surprised because many families have been making re-check visits and follow-ups for their kids. In a hospital it’s wham-bam and they’re gone. Here, it’s nice…following up on their labs, following up on how the kids are doing.”
Like traditional hospital training programs, faculty physicians often learn from their residents as the residents learn from them. “They are all new, so they come across so many new things in medicine and the way medicine is changing,” explains Harjit K. Kholi, M.D. “They’re more well-versed in the use of electronic data systems. They learn from us, from our experience over so many years.” Having residents working with her creates a learning partnership, Dr. Kholi says. “I’m always open to learning with the younger generation, if they are here to learn from me. And whatever I have learned from my mentors, I want to pass it on. There are certain things that are not written in books that come from your experience. That’s what I want to pass on. Books you can read any time. How to deal with a patient, bedside manners, how to interact with the family, with police, and co-workers… that’s something to be learned through experience and mentorship.”
As a “seasoned” physician, Jonathan Levi, M.D., feels he has a responsibility “to both the next generation of physicians and the patients of Western Wayne Family Health Centers to be part of ongoing education and training opportunities. The goal for preceptors is to continuously learn and teach to strive for excellence in how care is delivered. The longstanding tradition of experienced doctors teaching new doctors is a natural component of learning how to practice medicine.
“I learned how to practice medicine in a time before many of the diagnostic tests we have today were available. We had to rely heavily on taking good medical histories and physical examinations. Passing along those skills to new doctors is vital in teaching them and will be valuable to them as they practice. This is especially true in a community health center setting, where we often see uninsured patients and must practice medicine without the benefit of many tests that are often not accessible to them.”
In addition to advances in science, there are “tricks of the trade” you need to learn from experienced doctors, adds Dr. Rice. “There’s a lot going on — there’s often a lot of children in one room: brothers and sisters, moms… you have to learn how to stay focused on one patient. You can get things mixed up easily when there are four children screaming, mom’s yelling. Dr. Kholi has been able to pass on some tips on how to calm yourself in this situation, keep organized. Also, having a parent aid in physical exams is not something I was taught in medical school, but I’ve picked up. Whenever I see my own patients I’ll have mom hold the head, hold the arms, hold this and that… the exam goes much smoother. It’s also a better physical exam. You get more details from that.”
Dr. Kholi, she says, leaves an impression “that you remember throughout your life.”
The Authority Health teaching health center program is funded through the federal government to train primary care physicians and dentists in medically underserved areas. Typically, residents train in hospitals and hospital ambulatory facilities. Studies show that residents training in teaching health center programs remain in the area, or find another medically underserved area to practice. Authority Health is a division of the Detroit Wayne County Health Authority, a public body which coordinates safety net resources in Wayne County. For information, call 313-871-3751 or go to www.healthaccess1.org.
Western Wayne Family Health Centers offers health care to all, with primary care services for all ages, including internal medicine, family practice, pediatrics, obstetrics and gynecology, general dentistry, and integrated behavioral health with locations in Inkster, Taylor, and Lincoln Park. Western Wayne is a locally-governed, non-profit community health center funded through the National Health Center program and located in areas which are medically underserved. It’s newest facility in Lincoln Park, which opened in February, is funded through the Affordable Care Act and awarded by the U.S. Department of Health and Human Services in November 2013. Western Wayne provided care for 10,000 people, with over 32,000 visits. For information, call 313-383-1897 or go to www.wwfhc.org.
Photo 1: L to R: Alex Yu, DO, MPH; Jonathon Levi MD
Photo 2: L to R: Harjit Kohli MD; Cassie Rice DO