How appropriate and timely for my last blog to highlight what I think is one of the most fascinating parts about the acronym CHC. The word “Community” in Community Health Center. Without it, we would be just another Health Center.

Community does not mean that we alone serve the community, that’s a tall order for a Health Center. But Community means that we work within and share our labor with our neighbors. Those neighbors include our local government, community organizations, businesses, civic leaders and the like.

I enjoy working with the community to help give our Daily Planet patients the best care available. Today The Daily Planet partnered with Virginia Commonwealth University School of Nursing, Department of Health Education and the Department of Genetics. I feel it is important to expose young learners of all disciplines to public health. I also believe it is important to stay involved with research and the institutions of medicine, so that our patients are afforded the same level of cutting edge care that is offered to the general public. VCU is our neighbor and we work closely together to take care of our community.

Last week at the Daily Planet we held an orientation for the VCU School of Nursing and Department of Health Education students. These students will be working with us on a HRSA grant that we were awarded to improve how we obtain family histories. We know that if we explore the family history of our patients it will give us useful information to predict their personal health risk and implement a plan for prevention. Not only are we teaching cultural competence, but these students are helping us to take better care of our patients.

We are a “Community” Health Center in the true sense, in that we involve the Community, to take care of the Community, because we are the Community!

I hope that during my month of blogs, you have noted that practicing Community Health has all of the excitement, adventure, and variety of specialty care medicine or third world mission work.

It is truly what you make it, and it is all available to you in many different shapes, sizes, and locations.

Dare to explore and enjoy! Thanks to all for allowing me to share!

Hitting The Pavement

It was an unusually slow day at one of our outreach sites. Could have something to do with the long-awaited break in the heat wave, for today’s temperature is running a cool 90 degrees. Whatever the case the census is low and we have been advised that most of our patients have headed to the park.

So my nurse and I decided to take a detour before heading back to the office, so we dropped by Monroe Park. This is a common gathering place for the homeless of Richmond. As expected, the benches were full of many of our patients and a few that have been long lost to follow up.

We were welcomed with open arms. Many were shocked, saying “Dr. Stevens, you will come anywhere to find us!” My nurse and I went from bench to bench, checking blood pressures, encouraging them to take their medications, stop smoking, and to keep their follow up appointments. In fact three walked back with us over to the clinic, one for a Tuberculosis test reading, another for treatment of high blood pressure, and another who we discovered was just released from the hospital but living under a bridge.

As I was sitting on the bench and looking up at the fountain, I thought, “What a wonderful view- I couldn’t ask for better office space”. Granted not all Community Health Centers operate out of a City Park (and this is not routine for me). However, I can say that meeting patients where they are and participating in outreach is a very important aspect of community health.

I enjoy the public health tract that my career has taken; every day is something new, something different, and something worthwhile. When I woke up this morning I knew I had a job to do, but had no idea I was going to “Hit the Pavement”, but I’m so glad I did.

Each One Teach One

On the first Friday of the month we do a significant outreach campaign at The Conrad Center. It has become so popular that we have named it “First Fridays” at Conrad.

At 745am, The Daily Planet staff cheerfully starts invading the center. Their doors have long opened prior to our arrival, because they serve meals (including a belly warming breakfast) to the homeless daily.

The facility also houses several agencies that provide various services to the homeless. One of the key roles is a central point of entry to the shelters for the city.

Each Friday, The Daily Planet goes there to provide Tuberculosis and Blood Pressure screening, as well as acute care assessments. However, on the first Friday of each month we have a “Health Fair” that also includes Vaccinations, Educational Sessions, and Special Theme Services- such as Prostate Cancer Screening, Skin Cancer Awareness Day, or Family Medical History Celebrations. Other agencies join us such as The Fan Free Clinic (conducting on-site HIV testing) and Alcoholics Anonymous. We give out snacks, prizes, bus tickets, and just try to bond with participants.

My favorite part of the event is that we have a great crew of graduate health professional students from Virginia Commonwealth University who come to gain experience, practice their skills, and learn about public health. We have representation from all schools including pharmacy, nursing, medical, public health, and research departments. They join forces and work together to make “First Fridays” a huge success.

I enjoy teaching, because I will forever be a student of medicine.

My patients keep me humble and appreciative, my students keep me abreast and fine tuned. I need them both to practice my craft. And to both I am forever indebted.



If you are interested in joining the fun at First Fridays, just blog me back. We would love to have you! You may also email me at lstevens@dailyplanetva.org

For more information on the Conrad Center-Freedom House
http://www.freedomhouserichmond.org/html/ConradCenter.htm

Haiti Comes to Dr. Stevens

Today was another collision with destiny. If you have been following my posts, you know that my childhood dream was to become a doctor and go to help the people of Haiti. Well, today destiny was fulfilled. No, I didn’t go to Haiti, Haiti came to me.

I was asked by a Daily Planet employee (Mike Wilson) if I would do an assessment on two Pastors from Haiti who are visiting the States. I gladly agreed.

The great part about working in a Community Health Center, specifically a Federally Qualified Health Center, is that we are able to open our doors to those in need.

Although we all have to be cost conscious and concerned about productivity, that is not our driving force. In Community Health Centers, physicians are still able to tap into that humanitarian spirit of giving and taking care of patients that brought us to our profession.

So today, I had the pleasure of providing healthcare to two wonderful pastors and great men of Haiti. It was exciting and challenging. As we worked through the cultural and the language difference we discovered that we had more in common than we first believed to be true.

Had our meeting actually been in Haiti, I would not have been able to provide them with the level of healthcare that I was able to afford them today. So sometimes our destiny is not about our dreams for ourselves, but what we can do for others.

Check out New Hope Haiti Mission at
http://newhopehaitimission.org/Pages/MEET_US.asp

Colliding With Your Destiny

“When you walk in your purpose, you collide with your destiny”-Dr. Bertice Berry. If quotes were a theme song, that would be mine. For a year now, I’ve been colliding with my destiny and it’s been the “ride” of my life.

I’m one of those annoying people who from the age of seven have always known they’ve wanted to be a doctor. My mother was the Director of Nursing of a community hospital; therefore I spent most of my childhood in the hospital corridors being babysat by the staff and the resident doctors. My dream was to be a doctor and to travel to Haiti to help the poor.

However, like most kids by age nine I also wanted to be a teacher, then a rock star, a news reporter, author, and fashion designer. In college I discovered I could be a doctor scientist and a doctor educator, so I went for it, full speed ahead. Believe it or not, I’ve almost been all of those things, well except the rock star.

I know medicine is my purpose, but I also know that traditional medicine is not for me. Traditional in the sense, of a routine day to day office setting. Remember this is the girl who was going be rock star. Out of residency it was toss between Internal Medicine and Emergency Medicine. I loved the excitement of the ER, but overall wanted the long term relationship building of primary care.

After residency, I went home and started a practice. I was very successful and quickly developed a very large practice. However, I was not fulfilled. It was like walking around constantly with butterflies in your stomach.

Choosing what to do in your career can be just as difficult as choosing a career, especially when you excel in many areas and have a heart for doing good. I am living proof that being good at what you do does not guarantee you that satisfying feeling in your gut when you get dressed in the morning to go to work. And that’s the difference between just walking and walking in your purpose.

To be honest I was very good at what I did , everyone was happy - but me. So I tried to re-event my self. I become the TV doctor, I had a weekly show on NPR- I was good an educating the public. Giving back in a different way felt good, but it didn’t pay the bills.

I became a full time academic physician, teaching again was good, it almost felt right, but there was still something missing. I tried connoisseur medicine, no good. Sports medicine was exciting- I tried becoming a boxing fight doctor, that didn’t last long.

I did physicals for congress. Politics was very interesting, “but Senator, could you please not talk while I’m listening to your heart”. And then one day, I volunteered in a homeless clinic. It was like I was seven years old all over again. I collided with my destiny.

From that point, I begin to work with Unity Health Care for the Homeless in Washington D.C. and completed my Masters in Public Health. Then all roads led to Richmond Virginia and to the Daily Planet Healthcare for the Homeless.

Those butterflies in my stomach have finally settled. Each day is different and exciting. I travel to different locations to break up my routine. And although I am not practicing in Haiti, the needs of my patients are just as great. I don’t regret my journey, those experiences having meaning and have prepared me for my journey ahead.

I encourage you to think about your purpose, dig deep, go way back. Remember those age old questions? “What do I want to be when I grow up?” “What do I what to be remembered for?” “What contribution do I want to make on this earth?”

It’s not your parent’s dream or some obligation to do or be anything other than your purpose. And your purpose is something that only you can determine.

Just remember to walk in your purpose and only then will you will collide with your destiny.

Great books to read,
Jack Canfield, The Success Principles- How to Get from Where You Are to Where You Want to Be.

Rick Warren, The Purpose Driven Life, What On Earth Am I Here For?

Hello to Dr. Lisa Stevens Price

Dr. Lisa Price Stevens has known she was going to be a doctor since she was 7 years old. Her mother was a public health nurse and later became a director at a small community hospital, where Lisa spent a lot of time watching her while she was young. “I kind of grew up in medicine.” Idealistically, she wanted to do great things in medicine like “work in Haiti” and “help the poor.” But she fell into the more traditional career path and progression once she completed residency.

After a few years practicing and teaching in private practice and academic hospital environments she felt the call to “find her true north.” She’d had visions of being a Marcus Welby-type physician, but she just didn’t feel like she was doing what she had set out to do in being a doctor. She’d read that “if you walk in your purpose you will collide with your destiny,” so she did some soul searching to re-examine her professional life. She wanted to make a real difference in people’s lives.

Dr. Stevens had always assumed that working in community health meant living in some far off place. After doing some internet research, she discovered that smaller cities and urban areas are underserved too. She could have the best of both worlds – live where she wanted to live (Richmond) and help people in need.

So she reached out to the primary care association in Virginia, Virginia Community Healthcare Association, to see what her options might be. Faced with a child nearing college age and still paying off her own school loans, she was interested in loan repayment as well. She learned there was an opportunity for someone with her skills and experience in her own backyard, and that loan repayment could come with it.

Dr. Diane Reynolds-Cane, the Medical Director at the Daily Planet, had just accepted an appointment by Gov. Bob McDonnell to license and regulate health care providers as the director of the Virginia Department of Health Professions. The Daily Planet needed a new Medical Director. Virginia Community Healthcare Association connected them with Dr. Stevens.

After an extensive interview process, Peter Prizzio, the Daily Planet’s CEO, offered the Medical Director position to Dr. Stevens. She came aboard on July 1.”Working at the Daily Planet just feels right,” says Dr. Stevens. She gets to work with those who need her skills the most, while using her leadership skills and affecting change at a grass roots level.

What’s been the biggest surprise about working in community health? “It’s not been so much a surprise as a reaffirmation,” says Dr. Stevens. The people and community she supports are “truly caring people. They care about their families, they care about the future, and they care about their health. They could be any one of us – we’re all just a financial catastrophe away from where they are.”

The Daily Planet serves a predominantly male population in their forties, mostly African American. They are seeing more women, many of whom are dealing with homelessness or lack of insurance issues. They come from all walks of life – the previously rich who have lost everything, and those who have always been poor or abused.

Despite the challenges that face her, Dr. Stevens finds the working environment and work/life balance very comfortable. She usually sees 15-20 patients a day plus attending to her administrative duties. There is no weekend work and no on-call. The multi-disciplinary team approach used in community health creates a great whole patient-centered atmosphere, attending not just to medical needs but also to vision, behavioral health and pharmacy/medication education needs as well. She manages to keep her schedule within a 40-hour week which allows her to spend time on other leadership and grass roots activities.

One of the best things about working at the Daily Planet is the amount of time she can actually spend with her patients. There are still the quick 15 minute sick visits for many, but she has the latitude to spend 30-45 minutes with a new patient to gather information and really gain an understanding of what is going on with their health and in their lives. The other great thing is there is “no such thing as a typical day.” Every day is different and rewarding.

The biggest hurdle Dr. Stevens faces is lack of access to specialty care for her patients who need it. Since most specialists are not adequately reimbursed for treating the underserved, there is some resistance to providing specialty care to the underinsured and uninsured. That lack of reimbursement is a major issue of health care reform.

Another key component of health care reform is addressing the shortage of primary care physicians. One of the keys to combating the shortage is the National Health Service Corps (NHSC) Loan Repayment Program. Dr. Stevens has taken advantage of this program to address her own medical school debt. She never really knew that loan repayment was an option outside of being in the military or working in a far off place. When she started researching community health as a career opportunity, she found loan repayment was available to her. With most medical school grads facing $200K in student loan debt, Dr. Stevens says “it’s the only way to go,” and has become a proselytizer for the NHSC.

“The application process was not hard. The folks from the NHSC guide you through it, and all the information you need is readily available,” said Dr. Stevens. She feels the application process was fair and not difficult to navigate or terribly time-consuming, especially considering the pay-off. She has been granted a loan repayment award.

Summing up her experience working in community health, Dr. Stevens says it’s “been great.” “It’s been truly a gift,” she says. “It’s the perfect setting.”