For L.A.'s Neediest Patients, the Most Important Person May Not Be A Doctor
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Code Black: Young Doctors Still in Love with Medicine
Bay Area Groups Struggle to Enroll Filipinos in Covered California
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A Health Training Program Everyone Likes But...
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You can hear her work on \u003ca href=\"https://www.npr.org/search?query=Rachael%20Myrow&page=1\">NPR\u003c/a>, \u003ca href=\"https://theworld.org/people/rachael-myrow\">The World\u003c/a>, WBUR's \u003ca href=\"https://www.wbur.org/search?q=Rachael%20Myrow\">\u003ci>Here & Now\u003c/i>\u003c/a> and the BBC. \u003c/i>She also guest hosts for KQED's \u003ci>\u003ca href=\"https://www.kqed.org/forum/tag/rachael-myrow\">Forum\u003c/a>\u003c/i>. Over the years, she's talked with Kamau Bell, David Byrne, Kamala Harris, Tony Kushner, Armistead Maupin, Van Dyke Parks, Arnold Schwarzenegger and Tommie Smith, among others.\r\n\r\nBefore all this, she hosted \u003cem>The California Report\u003c/em> for 7+ years, reporting on topics like \u003ca href=\"https://soundcloud.com/rmyrow/on-a-mission-to-reform-assisted-living\">assisted living facilities\u003c/a>, the \u003ca href=\"https://www.npr.org/sections/alltechconsidered/2014/12/01/367703789/amazon-unleashes-robot-army-to-send-your-holiday-packages-faster\">robot takeover\u003c/a> of Amazon, and \u003ca href=\"https://www.kqed.org/bayareabites/50822/in-search-of-the-chocolate-persimmon\" rel=\"noopener noreferrer\">chocolate persimmons\u003c/a>.\r\n\r\nAwards? Sure: Peabody, Edward R. Murrow, Regional Edward R. Murrow, RTNDA, Northern California RTNDA, SPJ Northern California Chapter, LA Press Club, Golden Mic. Prior to joining KQED, Rachael worked in Los Angeles at KPCC and Marketplace. 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Her medications never seemed to work, and she kept returning to the emergency room in crisis.\u003c/p>\n\u003cp>Walfred Lopez, a Los Angeles County community health worker, was determined to figure out why.\u003c/p>\n\u003caside class=\"pullquote alignright\">“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t.\"\u003cbr>\n\u003ccite>Dr. Clemens Hong, L.A. County Dept. of Health Services\u003c/cite>\u003c/aside>\n\u003cp>Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn’t have immigration papers, she told him, and her children still lived in Mexico.\u003c/p>\n\u003cp>Then she mentioned something she hadn’t told her doctors: She was nearly blind.\u003c/p>\n\u003cp>Pedroza’s doctor, Janina Morrison, was stunned. For years, Morrison said, “people have been changing her medications and changing her insulin doses, not really realizing that she can’t read the bottles.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/231552584\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>Health officials across the country face a vexing quandary – how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether community health workers like Lopez may be one part of the answer.\u003c/p>\n\u003cp>Lopez is among 25 workers employed by the county to do everything possible to remove obstacles standing in the way of patients’ health. That may mean coaching them about their diseases, ensuring they take their medications or scheduling medical appointments. Their help can extend beyond the clinic walls, too, to such things as finding housing or getting food stamps.\u003c/p>\n\u003cfigure id=\"attachment_98363\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\">\u003cimg class=\"size-full wp-image-98363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\" alt=\"(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \" width=\"1024\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-400x132.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-800x263.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-960x316.jpg 960w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Breaking Down Barriers\u003c/strong>\u003c/p>\n\u003cp>The workers don’t necessarily have a medical background. They get several months of county-sponsored training, which includes instruction on different diseases and medications, as well as tips on how to help patients change behavior. They are chosen for their ability to relate to both patients and providers. Many have been doing this job for friends and family for years – just without pay.\u003c/p>\n\u003cp>“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t,” said Dr. Clemens Hong, who is heading the program for the county. “That helps break down barriers.”\u003c/p>\n\u003cp>For now, they work with about 150 patients, many of whom have mental health issues, substance abuse problems and multiple chronic diseases. The patients haven’t always had the best experience with the county’s massive health care system.\u003c/p>\n\u003cp>“They tell us, ‘I am just a number on this list,’” Lopez said. “When you call them by name and when you know them one-on-one … they receive that message that I care for you. You are not a number.”\u003c/p>\n\u003cp>By spring, Hong said he hopes to have hundreds more patients in the program.\u003c/p>\n\u003cp>Community health workers have been used for decades in the U.S. and even longer in other countries. But now officials in various counties and states — including Massachusetts, Pennsylvania and Oregon — are relying on them more as pressure grows to improve health outcomes and reduce Medicaid and other public costs, experts said.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The hardest part is the system. Trying to navigate it is sometimes even hard for us.”\u003cbr>\n\u003ccite>Walfred Lopez, community health worker\u003c/cite>\u003c/aside>\n\u003cp>“They are finding a resurgence because of the Affordable Care Act and because health care providers are being held financially accountable for factors that occur outside the clinical walls,” said Dr. Shreya Kangovi, assistant professor of medicine at the University of Pennsylvania and director of the Penn Center for Community Health Workers.\u003c/p>\n\u003cp>Kangovi said community health worker programs, however, are likely to fail if they don’t hire the right people, focus too narrowly on certain diseases or operate outside of the medical system. They also need to be guided by the best scientific evidence on what works.\u003c/p>\n\u003cp>“A lot of people think… they can sort of make it up as they go along, but the reality is that it is really hard,” she said.\u003c/p>\n\u003cp>Hong, who designed the program based on lessons learned from other models, said Los Angeles County is taking a rigorous approach. It is conducting a study comparing the costs and outcomes of patients in the program against similar patients without assigned workers.\u003c/p>\n\u003cp>The patients are chosen based on their illnesses, how often they end up in the hospital and whether doctors believe they would benefit.\u003c/p>\n\u003cp>To Lopez, 43, the work is personal. A former accountant from Guatemala, Lopez has a genetic condition that led to a kidney transplant. Like some of his patients, including Pedroza, he is now on dialysis.\u003c/p>\n\u003cp>He tries to use his experience and education to get what patients need. But even he runs into snags, he said. One time, he had to argue with a clerk who turned away his patient at an appointment because she didn’t have identification.\u003c/p>\n\u003cp>“The hardest part is the system,” Lopez said. “Trying to navigate it is sometimes even hard for us.”\u003c/p>\n\u003cp>Lopez and his fellow community health worker, Jessie Cho, sit in small cubicles in the clinic at Los Angeles County-USC Medical Center, the county’s biggest and busiest public hospital. Throughout the day, they accompany patients to visits and meet with them before and after the doctor does. They also visit patients at home and in the hospital, and give out their cell phone numbers so patients can reach them quickly.\u003c/p>\n\u003cp>Cho said the patients often can’t believe that somebody is willing to listen to them. “Nobody else on the medical team has it as their job to provide empathy and compassion,” she said.\u003c/p>\n\u003cp>Morrison, the clinic physician, said both workers have become an essential part of the health team.\u003c/p>\n\u003cp>“There is just a limited amount I can accomplish in 15 or 20 minutes,” Morrison said. “There are all these mysteries of my patients’ lives that I know are getting in the way of taking care of their chronic medical problems. I either don’t have time to get to the bottom of it or they are never going to really feel that comfortable talking to me about it.”\u003c/p>\n\u003cp>Natalia Pedroza, who wears a colorful scarf around her head and speaks only Spanish, is a perfect example. Morrison said before Lopez came on board, “I wasn’t getting anywhere with her.”\u003c/p>\n\u003cp>Initially, Lopez had a hard time helping her understand her health conditions and overcoming her distrust of the system. When they first met, Pedroza believed the dialysis that kept her kidneys functioning was the cause of her health problems. And she didn’t get why Lopez was always around.\u003c/p>\n\u003cp>But he helped her — by getting her appointments, for instance, and helping arrange for Pedroza to get pre-packaged medications so she wouldn’t have to read the directions. Now Pedroza thinks Lopez is helping her to get better.\u003c/p>\n\u003cp>On a recent afternoon, Lopez sat down with Pedroza before her medical appointment.\u003c/p>\n\u003cp>“How are you feeling?” he asked in Spanish.\u003c/p>\n\u003cp>Pedroza responded that her hair was still falling out and that she still felt sick. She also said she hadn’t been checking her blood sugar because she didn’t know how to use the machine. Lopez calmly demonstrated how the machine worked, and then the two spent several minutes chatting about her job and her neighborhood.\u003c/p>\n\u003cp>Lopez said he believes he has a made a difference for other patients as well. On a recent Sunday, a 43-year-old patient with chronic pain who initially refused his help texted that he planned to go to the emergency room because of a headache. Lopez reached Morrison, who agreed to squeeze him into the schedule a few days later. And the patient didn’t go to the ER.\u003c/p>\n\u003cp>Lopez persuaded another patient, a 56-year-old woman, to take her blood pressure medication before her appointments so that when she arrived, the doctors wouldn’t get worried about her numbers and send her to the hospital.\u003c/p>\n\u003cp>In one case, his ability to bond with a patient almost undermined his goal of getting the man the help he needed. The patient, who was depressed, said he didn’t want to go see a mental health counselor because he was more comfortable talking to Lopez.\u003c/p>\n\u003cp>“It was touching,” Lopez said. “I was about to cry.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Anna Gorman is a reporter with \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"L.A. County is hiring and training health workers who can help needy patients navigate care -- and even connect them with housing or food stamps.","status":"publish","parent":0,"modified":1446662852,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":40,"wordCount":1599},"headData":{"title":"For L.A.'s Neediest Patients, the Most Important Person May Not Be A Doctor | KQED","description":"L.A. County is hiring and training health workers who can help needy patients navigate care -- and even connect them with housing or food stamps.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"For L.A.'s Neediest Patients, the Most Important Person May Not Be A Doctor","datePublished":"2015-10-27T07:07:30.000Z","dateModified":"2015-11-04T18:47:32.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"98360 http://ww2.kqed.org/stateofhealth/?p=98360","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/10/27/for-los-angeles-neediest-patients-the-most-important-person-may-not-be-a-doctor/","disqusTitle":"For L.A.'s Neediest Patients, the Most Important Person May Not Be A Doctor","source":"Kaiser Health News","sourceUrl":"http://khn.org/news/in-l-a-community-health-workers-are-part-of-the-medical-team/","nprByline":"Anna Gorman","path":"/stateofhealth/98360/for-los-angeles-neediest-patients-the-most-important-person-may-not-be-a-doctor","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Month after month, Natalia Pedroza showed up at the doctor’s office with uncontrolled diabetes and high blood pressure. Her medications never seemed to work, and she kept returning to the emergency room in crisis.\u003c/p>\n\u003cp>Walfred Lopez, a Los Angeles County community health worker, was determined to figure out why.\u003c/p>\n\u003caside class=\"pullquote alignright\">“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t.\"\u003cbr>\n\u003ccite>Dr. Clemens Hong, L.A. County Dept. of Health Services\u003c/cite>\u003c/aside>\n\u003cp>Lopez spoke to her in her native Spanish and, little by little, gained her trust. Pedroza, a street vendor living in downtown Los Angeles, shared with him that she was depressed. She didn’t have immigration papers, she told him, and her children still lived in Mexico.\u003c/p>\n\u003cp>Then she mentioned something she hadn’t told her doctors: She was nearly blind.\u003c/p>\n\u003cp>Pedroza’s doctor, Janina Morrison, was stunned. For years, Morrison said, “people have been changing her medications and changing her insulin doses, not really realizing that she can’t read the bottles.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/231552584&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/231552584'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Health officials across the country face a vexing quandary – how do you help the sickest and neediest patients get healthier and prevent their costly visits to emergency rooms? Los Angeles County is testing whether community health workers like Lopez may be one part of the answer.\u003c/p>\n\u003cp>Lopez is among 25 workers employed by the county to do everything possible to remove obstacles standing in the way of patients’ health. That may mean coaching them about their diseases, ensuring they take their medications or scheduling medical appointments. Their help can extend beyond the clinic walls, too, to such things as finding housing or getting food stamps.\u003c/p>\n\u003cfigure id=\"attachment_98363\" class=\"wp-caption aligncenter\" style=\"max-width: 1024px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\">\u003cimg class=\"size-full wp-image-98363\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/10/community-worker-8-2.jpg\" alt=\"(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \" width=\"1024\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2.jpg 1024w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-400x132.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-800x263.jpg 800w, https://ww2.kqed.org/app/uploads/sites/27/2015/10/community-worker-8-2-960x316.jpg 960w\" sizes=\"(max-width: 1024px) 100vw, 1024px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(L) The Los Angeles County-USC Medical Center is the county’s biggest and busiest public hospital. (R) Walfred Lopez, a community health worker at the center, looks over a patient’s health record \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>Breaking Down Barriers\u003c/strong>\u003c/p>\n\u003cp>The workers don’t necessarily have a medical background. They get several months of county-sponsored training, which includes instruction on different diseases and medications, as well as tips on how to help patients change behavior. They are chosen for their ability to relate to both patients and providers. Many have been doing this job for friends and family for years – just without pay.\u003c/p>\n\u003cp>“By being from the community, by speaking their language, by having these shared life experiences, they are able to break through and engage patients in ways that we as providers often can’t,” said Dr. Clemens Hong, who is heading the program for the county. “That helps break down barriers.”\u003c/p>\n\u003cp>For now, they work with about 150 patients, many of whom have mental health issues, substance abuse problems and multiple chronic diseases. The patients haven’t always had the best experience with the county’s massive health care system.\u003c/p>\n\u003cp>“They tell us, ‘I am just a number on this list,’” Lopez said. “When you call them by name and when you know them one-on-one … they receive that message that I care for you. You are not a number.”\u003c/p>\n\u003cp>By spring, Hong said he hopes to have hundreds more patients in the program.\u003c/p>\n\u003cp>Community health workers have been used for decades in the U.S. and even longer in other countries. But now officials in various counties and states — including Massachusetts, Pennsylvania and Oregon — are relying on them more as pressure grows to improve health outcomes and reduce Medicaid and other public costs, experts said.\u003c/p>\n\u003caside class=\"pullquote alignright\">“The hardest part is the system. Trying to navigate it is sometimes even hard for us.”\u003cbr>\n\u003ccite>Walfred Lopez, community health worker\u003c/cite>\u003c/aside>\n\u003cp>“They are finding a resurgence because of the Affordable Care Act and because health care providers are being held financially accountable for factors that occur outside the clinical walls,” said Dr. Shreya Kangovi, assistant professor of medicine at the University of Pennsylvania and director of the Penn Center for Community Health Workers.\u003c/p>\n\u003cp>Kangovi said community health worker programs, however, are likely to fail if they don’t hire the right people, focus too narrowly on certain diseases or operate outside of the medical system. They also need to be guided by the best scientific evidence on what works.\u003c/p>\n\u003cp>“A lot of people think… they can sort of make it up as they go along, but the reality is that it is really hard,” she said.\u003c/p>\n\u003cp>Hong, who designed the program based on lessons learned from other models, said Los Angeles County is taking a rigorous approach. It is conducting a study comparing the costs and outcomes of patients in the program against similar patients without assigned workers.\u003c/p>\n\u003cp>The patients are chosen based on their illnesses, how often they end up in the hospital and whether doctors believe they would benefit.\u003c/p>\n\u003cp>To Lopez, 43, the work is personal. A former accountant from Guatemala, Lopez has a genetic condition that led to a kidney transplant. Like some of his patients, including Pedroza, he is now on dialysis.\u003c/p>\n\u003cp>He tries to use his experience and education to get what patients need. But even he runs into snags, he said. One time, he had to argue with a clerk who turned away his patient at an appointment because she didn’t have identification.\u003c/p>\n\u003cp>“The hardest part is the system,” Lopez said. “Trying to navigate it is sometimes even hard for us.”\u003c/p>\n\u003cp>Lopez and his fellow community health worker, Jessie Cho, sit in small cubicles in the clinic at Los Angeles County-USC Medical Center, the county’s biggest and busiest public hospital. Throughout the day, they accompany patients to visits and meet with them before and after the doctor does. They also visit patients at home and in the hospital, and give out their cell phone numbers so patients can reach them quickly.\u003c/p>\n\u003cp>Cho said the patients often can’t believe that somebody is willing to listen to them. “Nobody else on the medical team has it as their job to provide empathy and compassion,” she said.\u003c/p>\n\u003cp>Morrison, the clinic physician, said both workers have become an essential part of the health team.\u003c/p>\n\u003cp>“There is just a limited amount I can accomplish in 15 or 20 minutes,” Morrison said. “There are all these mysteries of my patients’ lives that I know are getting in the way of taking care of their chronic medical problems. I either don’t have time to get to the bottom of it or they are never going to really feel that comfortable talking to me about it.”\u003c/p>\n\u003cp>Natalia Pedroza, who wears a colorful scarf around her head and speaks only Spanish, is a perfect example. Morrison said before Lopez came on board, “I wasn’t getting anywhere with her.”\u003c/p>\n\u003cp>Initially, Lopez had a hard time helping her understand her health conditions and overcoming her distrust of the system. When they first met, Pedroza believed the dialysis that kept her kidneys functioning was the cause of her health problems. And she didn’t get why Lopez was always around.\u003c/p>\n\u003cp>But he helped her — by getting her appointments, for instance, and helping arrange for Pedroza to get pre-packaged medications so she wouldn’t have to read the directions. Now Pedroza thinks Lopez is helping her to get better.\u003c/p>\n\u003cp>On a recent afternoon, Lopez sat down with Pedroza before her medical appointment.\u003c/p>\n\u003cp>“How are you feeling?” he asked in Spanish.\u003c/p>\n\u003cp>Pedroza responded that her hair was still falling out and that she still felt sick. She also said she hadn’t been checking her blood sugar because she didn’t know how to use the machine. Lopez calmly demonstrated how the machine worked, and then the two spent several minutes chatting about her job and her neighborhood.\u003c/p>\n\u003cp>Lopez said he believes he has a made a difference for other patients as well. On a recent Sunday, a 43-year-old patient with chronic pain who initially refused his help texted that he planned to go to the emergency room because of a headache. Lopez reached Morrison, who agreed to squeeze him into the schedule a few days later. And the patient didn’t go to the ER.\u003c/p>\n\u003cp>Lopez persuaded another patient, a 56-year-old woman, to take her blood pressure medication before her appointments so that when she arrived, the doctors wouldn’t get worried about her numbers and send her to the hospital.\u003c/p>\n\u003cp>In one case, his ability to bond with a patient almost undermined his goal of getting the man the help he needed. The patient, who was depressed, said he didn’t want to go see a mental health counselor because he was more comfortable talking to Lopez.\u003c/p>\n\u003cp>“It was touching,” Lopez said. “I was about to cry.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Anna Gorman is a reporter with \u003c/em>\u003ca href=\"http://khn.org\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>, a nonprofit news organization covering health care policy and politics. It is an editorially independent program of the \u003c/em>\u003ca href=\"http://www.kff.org/\">\u003cstrong>\u003cem>Kaiser Family Foundation\u003c/em>\u003c/strong>\u003c/a>\u003cem>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/98360/for-los-angeles-neediest-patients-the-most-important-person-may-not-be-a-doctor","authors":["byline_stateofhealth_98360"],"categories":["stateofhealth_11"],"tags":["stateofhealth_2519","stateofhealth_335"],"featImg":"stateofhealth_98362","label":"source_stateofhealth_98360"},"stateofhealth_32898":{"type":"posts","id":"stateofhealth_32898","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"32898","score":null,"sort":[1433315534000]},"guestAuthors":[],"slug":"in-the-inland-empire-bringing-doctors-to-patients-who-need-them-most","title":"In the Inland Empire, Bringing Doctors to Patients Who Need Them Most","publishDate":1433315534,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>MORENO VALLEY, Calif. -- Jennifer Vargas’ path toward becoming a doctor took her from Westwood to Guadalajara before it ultimately led back home, to California’s vast Inland Empire east of Los Angeles.\u003c/p>\n\u003cp>When the Chino Hills, Calif. native graduated from medical school in Mexico, her first choice for residency training was Riverside County’s public medical center, which serves among the fastest growing and most medically deprived parts of California.\u003c/p>\n\u003cp>It was just what she wanted: To serve a vulnerable patient population facing high barriers to care, particularly immigrant patients from Mexico who would benefit from a Spanish-speaking physician.\u003c/p>\n\u003cp>“It offered the best fit for me,” said Vargas, 32, a second-year resident in family medicine at Riverside County Regional Medical Center.\u003c/p>\n\u003cp>The Inland Empire – a region roughly the size of Maine, including both Riverside and San Bernardino counties -- needs hundreds more like her. Officials have launched a muscular effort to educate physicians locally and entice doctors from the outside to settle in Southern California’s interior, miles from the famously alluring coast.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>They’re trying to do more than fix a doctor shortage. They’re attempting to train and attract the right kind of physicians -- mainly primary care providers who relate to disadvantaged patients and want to treat them in their communities, before they become critically or chronically ill.\u003c/p>\n\u003cp>Some see it as an experiment with lessons for other underserved regions of the country – a way to spread out and diversify the next generation of doctors.\u003c/p>\n\u003cp>“Today, our country is largely training the sons and daughters of wealthy people to be physicians,\" said G. Richard Olds, dean of the University of California, Riverside, School of Medicine. “You wonder why we have a problem with people not serving in underserved communities; it’s because they don’t know what an underserved community looks like.”\u003c/p>\n\u003cp>He’s looking for students who grew up in the Inland Empire and want to stay. He also wants people who speak English as a second language, or who were the first in their families to attend college.\u003c/p>\n\u003cp>The Inland Empire has for decades been short of physicians as newcomers poured in. Its population swelled from 1.6 million in 1980 to 4.4 million today. In 2011, it had 43 primary care physicians per 100,000 population, a supply roughly half the level recommended by experts, according to a study published last year by the California Healthcare Foundation.\u003c/p>\n\u003cp>Now, with the expansion of health insurance and Medi-Cal through the Affordable Care Act, many more new patients have spilled into the system.\u003c/p>\n\u003cp>The flow of patients seeking primary care services at the 12 family care clinics run by Riverside County rose 8 percent to 161,000 during the year ended last June 30, said Dr. Geoffrey Leung, the system’s chief of family medicine.\u003c/p>\n\u003cp>Volume has continued to rise since then and now is only limited by the system’s capacity.\u003c/p>\n\u003cp>“If we had more providers, we would have more patients,” Leung said.\u003cbr>\n\u003cstrong>\u003cbr>\nA Bagful Of Drugs, A Long List of Ailments \u003c/strong>\u003c/p>\n\u003cp>On a recent Friday morning, Maria Avelino Ibarra arrived at Riverside County main campus in Moreno Valley after an hour-long bus ride.\u003c/p>\n\u003cp>Ibarra, a 50-year-old Corona resident with diabetes, had come to renew her insulin prescription and get treatment for pain in her right knee, which she injured in a fall last year.\u003c/p>\n\u003cp>But as Dr. Bakr Khalifa Al Omrani, a second-year medical resident, quizzed her about her recent medical history, she added more ailments to the list, including chronic headaches, stomach problems and high cholesterol.\u003c/p>\n\u003cp>As she spoke, Ibarra pulled out a square-foot size zip-lock bag with 15 medication bottles and set them on a small counter in the exam room.\u003c/p>\n\u003cp>“Okay, I will not be able to deal with all of the problems today,” Khalifa told her through a Spanish translator listening in by phone. “Is your knee the most urgent problem?”\u003c/p>\n\u003cp>It was. Khalifa tried to flex her knee, which bent only to about 90 degrees before causing sharp pain.\u003c/p>\n\u003cp>The appointment lasted 35 minutes, about twice as long as primary care visits usually do. It’s a common problem: Because patients have gone without care so long, doctors have to spend more time sorting out their problems. That, in turn, lengthens wait times for other patients seeking appointments.\u003c/p>\n\u003cp>\u003cstrong>Thinking Creatively\u003c/strong>\u003c/p>\n\u003cp>The shortage of doctors, and the pent-up demand for care, is a problem with deep roots.\u003c/p>\n\u003cp>Historically, the region has not cultivated young physicians. The Inland Empire is below the state average in producing high school graduates who go to college. And until the UC Riverside program was founded in 2013, the region had only one medical school, at Loma Linda University.\u003c/p>\n\u003cp>To top it off, Olds said, there aren’t enough slots to train medical residents in the region.\u003c/p>\n\u003cfigure id=\"attachment_33167\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-1-e1433354732551.jpg\">\u003cimg class=\"size-thumbnail wp-image-33167\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-1-400x267.jpg\" alt=\"The Riverside County Regional Medical Center is a public teaching hospital in Moreno Valley. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Riverside County Regional Medical Center is a public teaching hospital in Moreno Valley. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>All of these obstacles narrow the pipeline of available doctors. “Where you come from is about 40 percent of the decision” of where to practice, the dean said. “And another 40 percent is where you completed residency.”\u003c/p>\n\u003cp>In addition, the Inland Empire has hardly been an attractive destination for doctors from the outside.\u003c/p>\n\u003cp>Reimbursement from public and private payers isn’t as high as in coastal areas, said Leigh Hutchins, CEO of North American Medical Management California Inc., an Ontario-based firm that develops and manages provider networks and helps physicians coordinate care and conduct business. .\u003c/p>\n\u003cp>Even existing doctor groups have trouble covering the start-up costs of bringing on a new doctor, whose practice may take three years to become self-sustaining.\u003c/p>\n\u003cp>“It’s a good $250,000 to $300,000 a year to support a new doctor, by the time you do salary and benefits and other payments,” Hutchins said.\u003c/p>\n\u003cp>The doctor shortage has hit hard at the Inland Empire Health Plan (IEHP), the Medi-Cal managed care organization serving the two counties. Membership passed 1 million in February, up 60 percent from the 623,000 it had in December 2013, according to state figures.\u003c/p>\n\u003cp>“We’ve had to think creatively about how to get more doctors in our plan,” said Dr. Bradley Gilbert, the nonprofit’s CEO.\u003c/p>\n\u003cp>One way is to provide grants -- to private physician groups, hospitals and even the county health systems to defray new doctors’ startup costs.\u003c/p>\n\u003cp>In September, the plan set aside $8 million from its reserves for that purpose, $5 million for primary care doctors and $3 million for specialists.\u003c/p>\n\u003cp>IEHP received applications for some 199 doctors for the grants, which will cover up to $100,000 of a primary physician’s annual costs and up to $150,000 of a specialist’s. As of last month, the health plan had approved grants for 123 physicians, 71 of them in primary care. Hiring has already begun.\u003c/p>\n\u003cp>To boost the long-term supply, UC Riverside is recruiting medical students through “mission-based scholarships.” These cover the entire cost of medical school if students commit to practicing in a needed primary care discipline in the region for five years after residency.\u003c/p>\n\u003cp>“There’s a growing movement,” Leung said. “Young physicians are looking for work that feels meaningful and purposeful.”\u003c/p>\n\u003cp>\u003cstrong>‘I Need You A Lot’\u003c/strong>\u003c/p>\n\u003cp>Vargas knew from age 7 that she wanted to be a doctor.\u003c/p>\n\u003cfigure id=\"attachment_33169\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-5-e1433354869110.jpg\">\u003cimg class=\"size-thumbnail wp-image-33169\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-5-400x267.jpg\" alt=\"Patient Maria Sanchez, 54, shares a light moment with her doctor, second year resident, Jennifer Vargas. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Maria Sanchez, 54, shares a light moment with her doctor, second year resident, Jennifer Vargas. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of four children of Mexican immigrant parents, she volunteered at a cancer hospital near her home when she was in high school and continued to volunteer at local hospitals while studying biology and Spanish literature at UCLA. Later, while in Mexico, she and fellow medical students made house calls in small cities and villages.\u003c/p>\n\u003cp>Today, her connection with her patients is obvious.\u003c/p>\n\u003cp>Maria Sanchez, 54, will see only Dr. Vargas.\u003c/p>\n\u003cp>“I understand English, but it’s better when I can express myself in Spanish,” Sanchez said. “It’s easier to understand the advice they give you.”\u003c/p>\n\u003cp>Sanchez, a permanent U.S. resident originally from Nayarit, Mexico, has diabetes, high blood pressure and high cholesterol. After 30 years of working in various factories packing oranges and avocados, the mother of three also suffers from lower back pain and sore feet.\u003c/p>\n\u003cp>But on this day she is seeing Vargas for chest pains, numbness in her right arm and an itchy bump on her cheek.\u003c/p>\n\u003cp>“I’m a junker,” she jokingly tells Vargas.\u003c/p>\n\u003cp>It can be a hassle to get an appointment, said Sanchez. “Sometimes I can be on hold for as long as 30 minutes, only to get disconnected and have to call again.”\u003c/p>\n\u003cp>On this day, the appointment takes 30 minutes. Vargas orders an electrocardiogram, prescribes ointment for her cheek and medication for her chest pain.\u003c/p>\n\u003cp>“Thanks for worrying about me,” Sanchez says in Spanish as she leaves.\u003c/p>\n\u003cp>“Always,” replies Vargas.\u003c/p>\n\u003cp>“Take care of yourself,” Sanchez adds. “I need you a lot.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a> is an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/p>\n\n","blocks":[],"excerpt":"Officials have launched a muscular effort to educate physicians locally and entice doctors from elsewhere.","status":"publish","parent":0,"modified":1433355471,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":54,"wordCount":1588},"headData":{"title":"In the Inland Empire, Bringing Doctors to Patients Who Need Them Most | KQED","description":"Officials have launched a muscular effort to educate physicians locally and entice doctors from elsewhere.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"In the Inland Empire, Bringing Doctors to Patients Who Need Them Most","datePublished":"2015-06-03T07:12:14.000Z","dateModified":"2015-06-03T18:17:51.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"32898 http://ww2.kqed.org/stateofhealth/?p=32898","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/06/03/in-the-inland-empire-bringing-doctors-to-patients-who-need-them-most/","disqusTitle":"In the Inland Empire, Bringing Doctors to Patients Who Need Them Most","nprByline":"Andrew Wang and Heidi de Marco, Kaiser Health News","path":"/stateofhealth/32898/in-the-inland-empire-bringing-doctors-to-patients-who-need-them-most","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>MORENO VALLEY, Calif. -- Jennifer Vargas’ path toward becoming a doctor took her from Westwood to Guadalajara before it ultimately led back home, to California’s vast Inland Empire east of Los Angeles.\u003c/p>\n\u003cp>When the Chino Hills, Calif. native graduated from medical school in Mexico, her first choice for residency training was Riverside County’s public medical center, which serves among the fastest growing and most medically deprived parts of California.\u003c/p>\n\u003cp>It was just what she wanted: To serve a vulnerable patient population facing high barriers to care, particularly immigrant patients from Mexico who would benefit from a Spanish-speaking physician.\u003c/p>\n\u003cp>“It offered the best fit for me,” said Vargas, 32, a second-year resident in family medicine at Riverside County Regional Medical Center.\u003c/p>\n\u003cp>The Inland Empire – a region roughly the size of Maine, including both Riverside and San Bernardino counties -- needs hundreds more like her. Officials have launched a muscular effort to educate physicians locally and entice doctors from the outside to settle in Southern California’s interior, miles from the famously alluring coast.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>They’re trying to do more than fix a doctor shortage. They’re attempting to train and attract the right kind of physicians -- mainly primary care providers who relate to disadvantaged patients and want to treat them in their communities, before they become critically or chronically ill.\u003c/p>\n\u003cp>Some see it as an experiment with lessons for other underserved regions of the country – a way to spread out and diversify the next generation of doctors.\u003c/p>\n\u003cp>“Today, our country is largely training the sons and daughters of wealthy people to be physicians,\" said G. Richard Olds, dean of the University of California, Riverside, School of Medicine. “You wonder why we have a problem with people not serving in underserved communities; it’s because they don’t know what an underserved community looks like.”\u003c/p>\n\u003cp>He’s looking for students who grew up in the Inland Empire and want to stay. He also wants people who speak English as a second language, or who were the first in their families to attend college.\u003c/p>\n\u003cp>The Inland Empire has for decades been short of physicians as newcomers poured in. Its population swelled from 1.6 million in 1980 to 4.4 million today. In 2011, it had 43 primary care physicians per 100,000 population, a supply roughly half the level recommended by experts, according to a study published last year by the California Healthcare Foundation.\u003c/p>\n\u003cp>Now, with the expansion of health insurance and Medi-Cal through the Affordable Care Act, many more new patients have spilled into the system.\u003c/p>\n\u003cp>The flow of patients seeking primary care services at the 12 family care clinics run by Riverside County rose 8 percent to 161,000 during the year ended last June 30, said Dr. Geoffrey Leung, the system’s chief of family medicine.\u003c/p>\n\u003cp>Volume has continued to rise since then and now is only limited by the system’s capacity.\u003c/p>\n\u003cp>“If we had more providers, we would have more patients,” Leung said.\u003cbr>\n\u003cstrong>\u003cbr>\nA Bagful Of Drugs, A Long List of Ailments \u003c/strong>\u003c/p>\n\u003cp>On a recent Friday morning, Maria Avelino Ibarra arrived at Riverside County main campus in Moreno Valley after an hour-long bus ride.\u003c/p>\n\u003cp>Ibarra, a 50-year-old Corona resident with diabetes, had come to renew her insulin prescription and get treatment for pain in her right knee, which she injured in a fall last year.\u003c/p>\n\u003cp>But as Dr. Bakr Khalifa Al Omrani, a second-year medical resident, quizzed her about her recent medical history, she added more ailments to the list, including chronic headaches, stomach problems and high cholesterol.\u003c/p>\n\u003cp>As she spoke, Ibarra pulled out a square-foot size zip-lock bag with 15 medication bottles and set them on a small counter in the exam room.\u003c/p>\n\u003cp>“Okay, I will not be able to deal with all of the problems today,” Khalifa told her through a Spanish translator listening in by phone. “Is your knee the most urgent problem?”\u003c/p>\n\u003cp>It was. Khalifa tried to flex her knee, which bent only to about 90 degrees before causing sharp pain.\u003c/p>\n\u003cp>The appointment lasted 35 minutes, about twice as long as primary care visits usually do. It’s a common problem: Because patients have gone without care so long, doctors have to spend more time sorting out their problems. That, in turn, lengthens wait times for other patients seeking appointments.\u003c/p>\n\u003cp>\u003cstrong>Thinking Creatively\u003c/strong>\u003c/p>\n\u003cp>The shortage of doctors, and the pent-up demand for care, is a problem with deep roots.\u003c/p>\n\u003cp>Historically, the region has not cultivated young physicians. The Inland Empire is below the state average in producing high school graduates who go to college. And until the UC Riverside program was founded in 2013, the region had only one medical school, at Loma Linda University.\u003c/p>\n\u003cp>To top it off, Olds said, there aren’t enough slots to train medical residents in the region.\u003c/p>\n\u003cfigure id=\"attachment_33167\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-1-e1433354732551.jpg\">\u003cimg class=\"size-thumbnail wp-image-33167\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-1-400x267.jpg\" alt=\"The Riverside County Regional Medical Center is a public teaching hospital in Moreno Valley. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The Riverside County Regional Medical Center is a public teaching hospital in Moreno Valley. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>All of these obstacles narrow the pipeline of available doctors. “Where you come from is about 40 percent of the decision” of where to practice, the dean said. “And another 40 percent is where you completed residency.”\u003c/p>\n\u003cp>In addition, the Inland Empire has hardly been an attractive destination for doctors from the outside.\u003c/p>\n\u003cp>Reimbursement from public and private payers isn’t as high as in coastal areas, said Leigh Hutchins, CEO of North American Medical Management California Inc., an Ontario-based firm that develops and manages provider networks and helps physicians coordinate care and conduct business. .\u003c/p>\n\u003cp>Even existing doctor groups have trouble covering the start-up costs of bringing on a new doctor, whose practice may take three years to become self-sustaining.\u003c/p>\n\u003cp>“It’s a good $250,000 to $300,000 a year to support a new doctor, by the time you do salary and benefits and other payments,” Hutchins said.\u003c/p>\n\u003cp>The doctor shortage has hit hard at the Inland Empire Health Plan (IEHP), the Medi-Cal managed care organization serving the two counties. Membership passed 1 million in February, up 60 percent from the 623,000 it had in December 2013, according to state figures.\u003c/p>\n\u003cp>“We’ve had to think creatively about how to get more doctors in our plan,” said Dr. Bradley Gilbert, the nonprofit’s CEO.\u003c/p>\n\u003cp>One way is to provide grants -- to private physician groups, hospitals and even the county health systems to defray new doctors’ startup costs.\u003c/p>\n\u003cp>In September, the plan set aside $8 million from its reserves for that purpose, $5 million for primary care doctors and $3 million for specialists.\u003c/p>\n\u003cp>IEHP received applications for some 199 doctors for the grants, which will cover up to $100,000 of a primary physician’s annual costs and up to $150,000 of a specialist’s. As of last month, the health plan had approved grants for 123 physicians, 71 of them in primary care. Hiring has already begun.\u003c/p>\n\u003cp>To boost the long-term supply, UC Riverside is recruiting medical students through “mission-based scholarships.” These cover the entire cost of medical school if students commit to practicing in a needed primary care discipline in the region for five years after residency.\u003c/p>\n\u003cp>“There’s a growing movement,” Leung said. “Young physicians are looking for work that feels meaningful and purposeful.”\u003c/p>\n\u003cp>\u003cstrong>‘I Need You A Lot’\u003c/strong>\u003c/p>\n\u003cp>Vargas knew from age 7 that she wanted to be a doctor.\u003c/p>\n\u003cfigure id=\"attachment_33169\" class=\"wp-caption alignright\" style=\"max-width: 400px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-5-e1433354869110.jpg\">\u003cimg class=\"size-thumbnail wp-image-33169\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/06/riverside-5-400x267.jpg\" alt=\"Patient Maria Sanchez, 54, shares a light moment with her doctor, second year resident, Jennifer Vargas. \" width=\"400\" height=\"267\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient Maria Sanchez, 54, shares a light moment with her doctor, second year resident, Jennifer Vargas. \u003ccite>(Heidi de Marco/KHN)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of four children of Mexican immigrant parents, she volunteered at a cancer hospital near her home when she was in high school and continued to volunteer at local hospitals while studying biology and Spanish literature at UCLA. Later, while in Mexico, she and fellow medical students made house calls in small cities and villages.\u003c/p>\n\u003cp>Today, her connection with her patients is obvious.\u003c/p>\n\u003cp>Maria Sanchez, 54, will see only Dr. Vargas.\u003c/p>\n\u003cp>“I understand English, but it’s better when I can express myself in Spanish,” Sanchez said. “It’s easier to understand the advice they give you.”\u003c/p>\n\u003cp>Sanchez, a permanent U.S. resident originally from Nayarit, Mexico, has diabetes, high blood pressure and high cholesterol. After 30 years of working in various factories packing oranges and avocados, the mother of three also suffers from lower back pain and sore feet.\u003c/p>\n\u003cp>But on this day she is seeing Vargas for chest pains, numbness in her right arm and an itchy bump on her cheek.\u003c/p>\n\u003cp>“I’m a junker,” she jokingly tells Vargas.\u003c/p>\n\u003cp>It can be a hassle to get an appointment, said Sanchez. “Sometimes I can be on hold for as long as 30 minutes, only to get disconnected and have to call again.”\u003c/p>\n\u003cp>On this day, the appointment takes 30 minutes. Vargas orders an electrocardiogram, prescribes ointment for her cheek and medication for her chest pain.\u003c/p>\n\u003cp>“Thanks for worrying about me,” Sanchez says in Spanish as she leaves.\u003c/p>\n\u003cp>“Always,” replies Vargas.\u003c/p>\n\u003cp>“Take care of yourself,” Sanchez adds. “I need you a lot.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://kaiserhealthnews.org\" target=\"_blank\">Kaiser Health News\u003c/a> is an editorially independent program of the \u003ca href=\"http://kff.org\" target=\"_blank\">Kaiser Family Foundation.\u003c/a>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/32898/in-the-inland-empire-bringing-doctors-to-patients-who-need-them-most","authors":["byline_stateofhealth_32898"],"categories":["stateofhealth_11"],"tags":["stateofhealth_335"],"featImg":"stateofhealth_32916","label":"stateofhealth"},"stateofhealth_23125":{"type":"posts","id":"stateofhealth_23125","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"23125","score":null,"sort":[1419362384000]},"guestAuthors":[],"slug":"challenges-to-mainstream-health-care-in-oaklands-underserved-communities","title":"Challenges to Mainstream Health Care in Oakland’s Underserved Communities","publishDate":1419362384,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_23127\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS13416_IMG_0618-2.jpg\">\u003cimg class=\"wp-image-23127 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS13416_IMG_0618-2-640x365.jpg\" alt=\"Sownai Saetern and Jan Tracie check blood pressures as Kimberly Nichole waits in line at the EOLA Health Fair in Oakland. (Adizah Eghan/KQED)\" width=\"640\" height=\"365\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sownai Saetern and Jan Tracie check blood pressures as Kimberly Nichole waits in line at a health fair in Oakland, put on by nursing students at Samuel Merritt University. (Adizah Eghan/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Adizah Eghan\u003c/strong>\u003c/p>\n\u003cp>It's not your normal health care setting: Reggaeton is thumping from a space where people are doing Zumba. Food is available – for free.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He’s a white doctor, he just wouldn’t understand,\" one woman's grandmother told her.\u003c/aside>\n\u003cp>It's the annual health fair held at the East Oakland Leadership Academy, a charter school serving inner-city K-8 students. The health fair is organized by nursing students at Samuel Merritt University, and it serves a dual purpose: serving the Oakland community and recruiting people of color to SMU's nursing programs. The federal government classifies East Oakland as a medically underserved area.\u003c/p>\n\u003cp>Foot traffic is low, but the fair is filled with liveliness. For the past 11 years, EOLA has provided food and health care to the community through events like this fair.\u003c/p>\n\u003cp>“Health is always a concern for us\" says Laura Armstrong, EOLA's founder and executive director. \"Getting the information out to everybody and providing a local place close in the neighborhood for them to come is just something that we do. It’s all about the community.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>People curiously stroll through the school enjoying the free goodies and asking plenty of questions about their blood pressure, body mass index and sugar intake. The SMU students answer questions as they hand out pamphlets. The Samuel Merritt booth is placed right in front of the entryway so that any interested EOLA kids can start thinking about nursing school and connect with the university now.\u003c/p>\n\u003cp>Raychole Javius, 31, is from East Oakland. She stands outside EOLA munching on a free sandwich she got inside. Javius has Medi-Cal, but it’s been 15 years since she saw a doctor.. She says she’s afraid to go, “It makes me nervous, actually. It makes me very, very nervous about the results or what they can tell me or I don’t know.”\u003c/p>\n\u003cp>\u003cstrong>Need for Greater Cultural Understanding\u003c/strong>\u003c/p>\n\u003cp>Javius says it’s the way she was raised. Her parents hardly went to the doctor and did not like to take medications. “When I’m dying and I can’t breathe, then I’ll call 911 or get my butt to the hospital,” she laughs.\u003c/p>\n\u003cp>Javius says she stays healthy by exercising daily and avoiding takeout foods. But she knows that she’s due for a visit to the doctor’s office, “I will go because that’s the right thing to do. But I’m scared, that’s all, I’m scared.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Recognizing a need for nurses that reflect the population of the Bay Area. \u003c/aside>\n\u003cp>None of Javius's attitudes surprise Dr. Winston F. Wong. He's director of disparities and quality initiatives at Kaiser Permanente, “There is an issue with regards to how safe individuals feel with their care provider,\" he says, \"and how much that care provider has credibility with regards to understanding their family situation, their community and their cultural context.”\u003c/p>\n\u003cp>Some of the nursing students also have personal experience with this issue of comfort and safety.\u003c/p>\n\u003cp>Dale Wong is one of three nursing students greeting people as they enter a small classroom to get their blood pressure checked. He talks about the risk of hypertension and stroke with ease to a woman whose blood pressure is on the higher side.\u003c/p>\n\u003cp>According to Wong, each community has different needs. “Health fairs bring awareness especially if you have them in different communities in Oakland, like West Oakland, Chinatown and the Fruitvale area.”\u003c/p>\n\u003cp>“Looking at my culture, we just don’t talk about it sometimes,” he says. I’m Chinese, and my grandparents were very secretive about their health problems. They didn’t want to burden their families. When they did go to the doctor’s office, they didn’t want any procedures done, for anything.”\u003c/p>\n\u003cp>Health fairs are a great initial step to get people out and receiving care. But Kaiser’s Dr. Wong warns about the false sense of security they create. “One blood pressure taken in a busy playground or gym is not necessarily the way that we think care [is] best provided to people.”\u003c/p>\n\u003cp>“I think that health fairs maybe have a role, but they’re certainly not the solution per se with regards to providing access for underserved populations,” he said.\u003c/p>\n\u003cp>\u003cstrong>Recruiting Students of Color to Health Professions\u003c/strong>\u003c/p>\n\u003cp>Shanda Williams, 31, is a senior at Samuel Merritt. Williams decided to become a nurse after she accompanied her grandmother on a doctor's visit. Her grandmother has a history of hypertension, heart attack, and stroke and knows it's important to visit the doctor to get the medication she needs.\u003c/p>\n\u003cp>“When the doctor asked her if she was eating healthy and exercising she would lie,” Williams said.\u003c/p>\n\u003cp>When Williams confronted her grandmother about lying to the doctor she told her, “He’s a white doctor, he just wouldn’t understand the way that we eat.”\u003c/p>\n\u003cp>The things that are hardest to explain often run along cultural and racial lines. “I realized that I needed — our community needed — more nurses that looked and were reflective of the population (of the) Bay Area,” Williams said, which is the reason she is pursuing a career in nursing, here in her own neighborhood.\u003c/p>\n\u003cp>“I want to be able to say 'Hey, I come from the same neighborhood you come from, I grew up with the same kind of customs and rituals that you had and yes, we can do this together, you can be honest with me because if you’re not honest with me, I can’t treat you properly,'” she says.\u003c/p>\n\u003caside class=\"pullquote alignright\">“I want to be able to say 'Hey, I come from the same neighborhood you come from.'\" \u003c/aside>\n\u003cp>Samuel Merritt puts effort into recruiting students of color and engaging existing students in the community. They provide scholarship money, support for mothers and nursing success seminars. However additional support is needed to build up the diversity of California’s future workforce.\u003c/p>\n\u003cp>A UCSF report states, “Low high school and college graduation rates for underrepresented minority youth make it difficult to increase diversity at medical and nursing schools in particular. The allied health professions continue to be more reflective of the state’s population. The community colleges that offer allied health programs attract a diverse student population, but attrition rates are high and programs have difficulty finding the resources to expand to meet growing numbers of applicants.”\u003c/p>\n\u003cp>Another way to gradually break down the cultural barrier is to employ more community health workers or promotoras, as they’re known in Spanish, to help people self-manage their conditions and chronic diseases.\u003c/p>\n\u003cp>Kaiser's Dr. Wong says these workers have credibility as peer educators and peer supporters. Their work extends the reach of physicians and medical offices and they are linguistically and culturally relevant to their respective communities\u003c/p>\n\u003cp>An additional option is the use of mobile medical units. These units bring the high quality professional infrastructure of a medical facility to patients so that individuals don’t have to worry about transportation to their doctor’s office.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>It’s unclear how many generations it will take for those in underserved communities to comfortably experience care. But it is evident that as the population in California continues to grow, more unconventional models of care will need to be paired with active recruitment of a more culturally adequate workforce.\u003c/p>\n\n","blocks":[],"excerpt":"“He’s a white doctor, he just wouldn’t understand,\" one woman's grandmother told her.","status":"publish","parent":0,"modified":1419368243,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1325},"headData":{"title":"Challenges to Mainstream Health Care in Oakland’s Underserved Communities | KQED","description":"“He’s a white doctor, he just wouldn’t understand," one woman's grandmother told her.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Challenges to Mainstream Health Care in Oakland’s Underserved Communities","datePublished":"2014-12-23T19:19:44.000Z","dateModified":"2014-12-23T20:57:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"23125 http://blogs.kqed.org/stateofhealth/?p=23125","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/12/23/challenges-to-mainstream-health-care-in-oaklands-underserved-communities/","disqusTitle":"Challenges to Mainstream Health Care in Oakland’s Underserved Communities","path":"/stateofhealth/23125/challenges-to-mainstream-health-care-in-oaklands-underserved-communities","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23127\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS13416_IMG_0618-2.jpg\">\u003cimg class=\"wp-image-23127 size-large\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/12/RS13416_IMG_0618-2-640x365.jpg\" alt=\"Sownai Saetern and Jan Tracie check blood pressures as Kimberly Nichole waits in line at the EOLA Health Fair in Oakland. (Adizah Eghan/KQED)\" width=\"640\" height=\"365\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Sownai Saetern and Jan Tracie check blood pressures as Kimberly Nichole waits in line at a health fair in Oakland, put on by nursing students at Samuel Merritt University. (Adizah Eghan/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Adizah Eghan\u003c/strong>\u003c/p>\n\u003cp>It's not your normal health care setting: Reggaeton is thumping from a space where people are doing Zumba. Food is available – for free.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“He’s a white doctor, he just wouldn’t understand,\" one woman's grandmother told her.\u003c/aside>\n\u003cp>It's the annual health fair held at the East Oakland Leadership Academy, a charter school serving inner-city K-8 students. The health fair is organized by nursing students at Samuel Merritt University, and it serves a dual purpose: serving the Oakland community and recruiting people of color to SMU's nursing programs. The federal government classifies East Oakland as a medically underserved area.\u003c/p>\n\u003cp>Foot traffic is low, but the fair is filled with liveliness. For the past 11 years, EOLA has provided food and health care to the community through events like this fair.\u003c/p>\n\u003cp>“Health is always a concern for us\" says Laura Armstrong, EOLA's founder and executive director. \"Getting the information out to everybody and providing a local place close in the neighborhood for them to come is just something that we do. It’s all about the community.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>People curiously stroll through the school enjoying the free goodies and asking plenty of questions about their blood pressure, body mass index and sugar intake. The SMU students answer questions as they hand out pamphlets. The Samuel Merritt booth is placed right in front of the entryway so that any interested EOLA kids can start thinking about nursing school and connect with the university now.\u003c/p>\n\u003cp>Raychole Javius, 31, is from East Oakland. She stands outside EOLA munching on a free sandwich she got inside. Javius has Medi-Cal, but it’s been 15 years since she saw a doctor.. She says she’s afraid to go, “It makes me nervous, actually. It makes me very, very nervous about the results or what they can tell me or I don’t know.”\u003c/p>\n\u003cp>\u003cstrong>Need for Greater Cultural Understanding\u003c/strong>\u003c/p>\n\u003cp>Javius says it’s the way she was raised. Her parents hardly went to the doctor and did not like to take medications. “When I’m dying and I can’t breathe, then I’ll call 911 or get my butt to the hospital,” she laughs.\u003c/p>\n\u003cp>Javius says she stays healthy by exercising daily and avoiding takeout foods. But she knows that she’s due for a visit to the doctor’s office, “I will go because that’s the right thing to do. But I’m scared, that’s all, I’m scared.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Recognizing a need for nurses that reflect the population of the Bay Area. \u003c/aside>\n\u003cp>None of Javius's attitudes surprise Dr. Winston F. Wong. He's director of disparities and quality initiatives at Kaiser Permanente, “There is an issue with regards to how safe individuals feel with their care provider,\" he says, \"and how much that care provider has credibility with regards to understanding their family situation, their community and their cultural context.”\u003c/p>\n\u003cp>Some of the nursing students also have personal experience with this issue of comfort and safety.\u003c/p>\n\u003cp>Dale Wong is one of three nursing students greeting people as they enter a small classroom to get their blood pressure checked. He talks about the risk of hypertension and stroke with ease to a woman whose blood pressure is on the higher side.\u003c/p>\n\u003cp>According to Wong, each community has different needs. “Health fairs bring awareness especially if you have them in different communities in Oakland, like West Oakland, Chinatown and the Fruitvale area.”\u003c/p>\n\u003cp>“Looking at my culture, we just don’t talk about it sometimes,” he says. I’m Chinese, and my grandparents were very secretive about their health problems. They didn’t want to burden their families. When they did go to the doctor’s office, they didn’t want any procedures done, for anything.”\u003c/p>\n\u003cp>Health fairs are a great initial step to get people out and receiving care. But Kaiser’s Dr. Wong warns about the false sense of security they create. “One blood pressure taken in a busy playground or gym is not necessarily the way that we think care [is] best provided to people.”\u003c/p>\n\u003cp>“I think that health fairs maybe have a role, but they’re certainly not the solution per se with regards to providing access for underserved populations,” he said.\u003c/p>\n\u003cp>\u003cstrong>Recruiting Students of Color to Health Professions\u003c/strong>\u003c/p>\n\u003cp>Shanda Williams, 31, is a senior at Samuel Merritt. Williams decided to become a nurse after she accompanied her grandmother on a doctor's visit. Her grandmother has a history of hypertension, heart attack, and stroke and knows it's important to visit the doctor to get the medication she needs.\u003c/p>\n\u003cp>“When the doctor asked her if she was eating healthy and exercising she would lie,” Williams said.\u003c/p>\n\u003cp>When Williams confronted her grandmother about lying to the doctor she told her, “He’s a white doctor, he just wouldn’t understand the way that we eat.”\u003c/p>\n\u003cp>The things that are hardest to explain often run along cultural and racial lines. “I realized that I needed — our community needed — more nurses that looked and were reflective of the population (of the) Bay Area,” Williams said, which is the reason she is pursuing a career in nursing, here in her own neighborhood.\u003c/p>\n\u003cp>“I want to be able to say 'Hey, I come from the same neighborhood you come from, I grew up with the same kind of customs and rituals that you had and yes, we can do this together, you can be honest with me because if you’re not honest with me, I can’t treat you properly,'” she says.\u003c/p>\n\u003caside class=\"pullquote alignright\">“I want to be able to say 'Hey, I come from the same neighborhood you come from.'\" \u003c/aside>\n\u003cp>Samuel Merritt puts effort into recruiting students of color and engaging existing students in the community. They provide scholarship money, support for mothers and nursing success seminars. However additional support is needed to build up the diversity of California’s future workforce.\u003c/p>\n\u003cp>A UCSF report states, “Low high school and college graduation rates for underrepresented minority youth make it difficult to increase diversity at medical and nursing schools in particular. The allied health professions continue to be more reflective of the state’s population. The community colleges that offer allied health programs attract a diverse student population, but attrition rates are high and programs have difficulty finding the resources to expand to meet growing numbers of applicants.”\u003c/p>\n\u003cp>Another way to gradually break down the cultural barrier is to employ more community health workers or promotoras, as they’re known in Spanish, to help people self-manage their conditions and chronic diseases.\u003c/p>\n\u003cp>Kaiser's Dr. Wong says these workers have credibility as peer educators and peer supporters. Their work extends the reach of physicians and medical offices and they are linguistically and culturally relevant to their respective communities\u003c/p>\n\u003cp>An additional option is the use of mobile medical units. These units bring the high quality professional infrastructure of a medical facility to patients so that individuals don’t have to worry about transportation to their doctor’s office.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s unclear how many generations it will take for those in underserved communities to comfortably experience care. But it is evident that as the population in California continues to grow, more unconventional models of care will need to be paired with active recruitment of a more culturally adequate workforce.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/23125/challenges-to-mainstream-health-care-in-oaklands-underserved-communities","authors":["8344"],"categories":["stateofhealth_11"],"tags":["stateofhealth_335"],"featImg":"stateofhealth_23127","label":"stateofhealth"},"stateofhealth_20001":{"type":"posts","id":"stateofhealth_20001","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"20001","score":null,"sort":[1404405907000]},"guestAuthors":[],"slug":"code-black-young-doctors-still-in-love-with-medicine","title":"Code Black: Young Doctors Still in Love with Medicine","publishDate":1404405907,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_20002\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4-Jamie-Eng-M.D.-with-patient-in-CODE-BLACK-a-Long-Shot-release-2014.jpg\">\u003cimg class=\"size-large wp-image-20002\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4-Jamie-Eng-M.D.-with-patient-in-CODE-BLACK-a-Long-Shot-release-2014-640x360.jpg\" alt='Dr. Jamie Eng with patient in the documentary \"Code Black.\"' width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Jamie Eng with patient in the documentary \"Code Black.\"\u003c/figcaption>\u003c/figure>\n\u003cp>Don't eat a sandwich before you sit down to watch the documentary \"\u003ca href=\"http://codeblackmovie.com\" target=\"_blank\">Code Black\u003c/a>.\" In one of the first scenes, we watch a team of doctors and nurses cut into a patient. It's a bloody business, and the camera doesn't turn away. That's because this film is about the brilliant chaos of emergency care, and the people drawn to this work.\u003c/p>\n\u003cp>For all the debate over health care in America, it's relatively rare to hear from doctors on the front lines, and even more rare to hear from young doctors about a field they've recently chosen to devote their lives to. “Code Black,” a documentary by a doctor when he was a resident at LA County's USC Medical Center, delivers that perspective with punch and passion. It promises a look into \"America's busiest ER.\"\u003c!--more-->\u003c/p>\n\u003cp>Ryan McGarry is now an assistant professor and physician at The Weill Medical College of Cornell University. Possibly, his penchant for storytelling has something to do with his bachelor's degree in English at Pennsylvania State University. His decision to become a doctor was inspired in part by his experience as a Stage IV cancer patient while an undergraduate. Even though he switched gears professionally, he finds poetry in his new field.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/157165060&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>His training ground for emergency medicine is “C-Booth”, a now-closed but legendary trauma bay, where “more people have died and more people have been saved than in any other square footage in the United States,” McGarry tells us in his voice over.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The film is a first-person reflection of McGarry's personal choices: of his respect for the students and teachers around him, of how jazzed he is to be doing emergency medicine, of how anxious he is about the primacy of money and politics over human values in medicine today.\u003c/p>\n\u003cp>We also hear from McGarry's fellow interns, like Jamie Eng, speaking with an almost dreamy calm about what motivates her to charge into a scene that would send most people running. \"When I rotated here as a medical student, I saw how the seniors just commanded the place. And I thought, 'I want to be that person. I want to be that calm. That cool. That collected. That knowledgeable. That confident.'”\u003c/p>\n\u003cfigure id=\"attachment_20004\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/3-Danny-Cheng-M.D.-Dave-Pomeranz-M.D.-Ryan-McGarry-M.D.-Billy-Mallon-M.D.-at-bedside-in-CODE-BLACK-a-Long-Shot-Factory-release-2014.jpg\">\u003cimg class=\"size-medium wp-image-20004\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/3-Danny-Cheng-M.D.-Dave-Pomeranz-M.D.-Ryan-McGarry-M.D.-Billy-Mallon-M.D.-at-bedside-in-CODE-BLACK-a-Long-Shot-Factory-release-2014-300x169.jpg\" alt='From L to R: Danny Cheng, M.D., Dave Pomeranz, M.D., Ryan McGarry, M.D., Billy Mallon, M.D. at bedside in C-Booth in the documentary \"Code Black.\"' width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From L to R: Danny Cheng, M.D., Dave Pomeranz, M.D., Ryan McGarry, M.D., Billy Mallon, M.D. at bedside in C-Booth in the documentary \"Code Black.\"\u003c/figcaption>\u003c/figure>\n\u003cp>That's everything you want to believe about doctors: that smart, soulful, driven people will be doing their darndest to keep you or your loved one alive in that critical moment of need. Whether you can pay or not.\u003c/p>\n\u003cp>LA County/USC is a public hospital, and it's cheering to see how much the interns care for their patients, no matter how poor. But time marches on. A new hospital was built. It’s clean. It’s quiet. It meets modern codes for earthquake safety. Still, whatever rules the old hospital could be exempted from because it was so old and so small, the doctors have to follow modern rules in the new hospital. Perhaps predictably, they hate them, particularly the bureaucratic documentation required for every last, little thing that happens in the ER.\u003c/p>\n\u003cp>Eng laments, \"I just had a patient with the simplest of complaints. It took me about two minutes to see her. I saw her standing right here in the hallway. I don’t even need a room for her. Basically, it took me four times as long to document as it took me to talk to her and do the exam at the same time.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've worked on both coasts now,\" McGarry says, \"and whether it be a primary care office or a busy emergency department, the thing that physicians and other providers are talking the most right now is the disconnection from us and patients.\" How did it come to be, he wonders, \"that insurance companies and administrators and everybody else who isn't as invested, arguably, is sort of running that experience?\"\u003c/p>\n\n","blocks":[],"excerpt":"Documentary by a doctor when he was a resident at LA's USC Medical Center offers rare look from the front lines.","status":"publish","parent":0,"modified":1404783269,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":true,"iframeSrcs":["https://w.soundcloud.com/player/"],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":702},"headData":{"title":"Code Black: Young Doctors Still in Love with Medicine | KQED","description":"Documentary by a doctor when he was a resident at LA's USC Medical Center offers rare look from the front lines.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Code Black: Young Doctors Still in Love with Medicine","datePublished":"2014-07-03T16:45:07.000Z","dateModified":"2014-07-08T01:34:29.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"20001 http://blogs.kqed.org/stateofhealth/?p=20001","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/07/03/code-black-young-doctors-still-in-love-with-medicine/","disqusTitle":"Code Black: Young Doctors Still in Love with Medicine","path":"/stateofhealth/20001/code-black-young-doctors-still-in-love-with-medicine","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_20002\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4-Jamie-Eng-M.D.-with-patient-in-CODE-BLACK-a-Long-Shot-release-2014.jpg\">\u003cimg class=\"size-large wp-image-20002\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/4-Jamie-Eng-M.D.-with-patient-in-CODE-BLACK-a-Long-Shot-release-2014-640x360.jpg\" alt='Dr. Jamie Eng with patient in the documentary \"Code Black.\"' width=\"640\" height=\"360\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Jamie Eng with patient in the documentary \"Code Black.\"\u003c/figcaption>\u003c/figure>\n\u003cp>Don't eat a sandwich before you sit down to watch the documentary \"\u003ca href=\"http://codeblackmovie.com\" target=\"_blank\">Code Black\u003c/a>.\" In one of the first scenes, we watch a team of doctors and nurses cut into a patient. It's a bloody business, and the camera doesn't turn away. That's because this film is about the brilliant chaos of emergency care, and the people drawn to this work.\u003c/p>\n\u003cp>For all the debate over health care in America, it's relatively rare to hear from doctors on the front lines, and even more rare to hear from young doctors about a field they've recently chosen to devote their lives to. “Code Black,” a documentary by a doctor when he was a resident at LA County's USC Medical Center, delivers that perspective with punch and passion. It promises a look into \"America's busiest ER.\"\u003c!--more-->\u003c/p>\n\u003cp>Ryan McGarry is now an assistant professor and physician at The Weill Medical College of Cornell University. Possibly, his penchant for storytelling has something to do with his bachelor's degree in English at Pennsylvania State University. His decision to become a doctor was inspired in part by his experience as a Stage IV cancer patient while an undergraduate. Even though he switched gears professionally, he finds poetry in his new field.\u003c/p>\n\u003cp>\u003ciframe src=\"https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/157165060&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" frameborder=\"no\" scrolling=\"no\">\u003c/iframe>\u003c/p>\n\u003cp>His training ground for emergency medicine is “C-Booth”, a now-closed but legendary trauma bay, where “more people have died and more people have been saved than in any other square footage in the United States,” McGarry tells us in his voice over.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The film is a first-person reflection of McGarry's personal choices: of his respect for the students and teachers around him, of how jazzed he is to be doing emergency medicine, of how anxious he is about the primacy of money and politics over human values in medicine today.\u003c/p>\n\u003cp>We also hear from McGarry's fellow interns, like Jamie Eng, speaking with an almost dreamy calm about what motivates her to charge into a scene that would send most people running. \"When I rotated here as a medical student, I saw how the seniors just commanded the place. And I thought, 'I want to be that person. I want to be that calm. That cool. That collected. That knowledgeable. That confident.'”\u003c/p>\n\u003cfigure id=\"attachment_20004\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/3-Danny-Cheng-M.D.-Dave-Pomeranz-M.D.-Ryan-McGarry-M.D.-Billy-Mallon-M.D.-at-bedside-in-CODE-BLACK-a-Long-Shot-Factory-release-2014.jpg\">\u003cimg class=\"size-medium wp-image-20004\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/07/3-Danny-Cheng-M.D.-Dave-Pomeranz-M.D.-Ryan-McGarry-M.D.-Billy-Mallon-M.D.-at-bedside-in-CODE-BLACK-a-Long-Shot-Factory-release-2014-300x169.jpg\" alt='From L to R: Danny Cheng, M.D., Dave Pomeranz, M.D., Ryan McGarry, M.D., Billy Mallon, M.D. at bedside in C-Booth in the documentary \"Code Black.\"' width=\"300\" height=\"169\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">From L to R: Danny Cheng, M.D., Dave Pomeranz, M.D., Ryan McGarry, M.D., Billy Mallon, M.D. at bedside in C-Booth in the documentary \"Code Black.\"\u003c/figcaption>\u003c/figure>\n\u003cp>That's everything you want to believe about doctors: that smart, soulful, driven people will be doing their darndest to keep you or your loved one alive in that critical moment of need. Whether you can pay or not.\u003c/p>\n\u003cp>LA County/USC is a public hospital, and it's cheering to see how much the interns care for their patients, no matter how poor. But time marches on. A new hospital was built. It’s clean. It’s quiet. It meets modern codes for earthquake safety. Still, whatever rules the old hospital could be exempted from because it was so old and so small, the doctors have to follow modern rules in the new hospital. Perhaps predictably, they hate them, particularly the bureaucratic documentation required for every last, little thing that happens in the ER.\u003c/p>\n\u003cp>Eng laments, \"I just had a patient with the simplest of complaints. It took me about two minutes to see her. I saw her standing right here in the hallway. I don’t even need a room for her. Basically, it took me four times as long to document as it took me to talk to her and do the exam at the same time.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"I've worked on both coasts now,\" McGarry says, \"and whether it be a primary care office or a busy emergency department, the thing that physicians and other providers are talking the most right now is the disconnection from us and patients.\" How did it come to be, he wonders, \"that insurance companies and administrators and everybody else who isn't as invested, arguably, is sort of running that experience?\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/20001/code-black-young-doctors-still-in-love-with-medicine","authors":["251"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_791","stateofhealth_335"],"featImg":"stateofhealth_20002","label":"stateofhealth"},"stateofhealth_16172":{"type":"posts","id":"stateofhealth_16172","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16172","score":null,"sort":[1384285181000]},"guestAuthors":[],"slug":"bay-area-groups-struggle-to-enroll-filipinos-in-covered-california-obamacare-milpitas","title":"Bay Area Groups Struggle to Enroll Filipinos in Covered California","publishDate":1384285181,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_16180\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-e1384284709202.jpg\">\u003cimg class=\"size-large wp-image-16180\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-640x359.jpg\" alt=\"Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press) \" width=\"640\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vanessa Ochavillo,\u003c/strong> \u003ca href=\"http://peninsulapress.com/2013/11/06/covered-california-enrollment-filipino-community/\" target=\"_blank\">Peninsula Press\u003c/a>\u003c/p>\n\u003cp>Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\u003c/p>\n\u003cp>The rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/aside>\n\u003cp>But a lack of adequate funding and manpower has made it difficult to educate eligible, uninsured Filipinos about \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange.\u003c/p>\n\u003cp>The problems in the Filipino community — the largest Asian minority in California — come as uninsured Americans across the country struggle to enroll in a plan because of widespread technical problems with the federally-run \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov website\u003c/a>. California residents can sign up for a plan via a separate website run by Covered California which has encountered some glitches but not on the scale that the federal website has seen.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The Filipino Youth Coalition, the community organization leading Filipino outreach in the Bay Area, started out as a youth service provider for Filipino-American high school students. But since open enrollment for Covered California began, the organization has had to remake itself into a health insurance education resource for all ages.\u003c/p>\n\u003cp>“There’s a lot of work to be done,” said Sarah Gonzalez, executive director of the coalition. “We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/p>\n\u003cp>Gonzalez has recently resorted to paying out-of-pocket for transportation to and from presentations, as well as for refreshments, which -- although not mandatory -- are customary at Filipino gatherings.\u003c/p>\n\u003cp>Open enrollment will continue until March 31, 2014. But outreach workers are working under the pressure of the Dec. 15 deadline, which is the last day to enroll in order to receive coverage beginning Jan. 1. After that, uninsured individuals may incur a federal penalty.\u003c/p>\n\u003cp>Through its partnership with Asian Americans Advancing Justice, the only Asian and Pacific Islander community organization to receive a grant from Covered California, the Filipino Youth Coalition secured a small grant, which advocates said would be inadequate to fund the entire effort over the next five months.\u003c/p>\n\u003cp>But for outreach specialists like Gonzalez, delivering presentations and setting up information tables at events is worth the extra work. “At every presentation, the response is awesome,” she said. “It’s just, ‘Tell us what to do. Tell us where to sign.’”\u003c/p>\n\u003cp>By going through these familiar sources of information, including community centers, clinics, and churches, Covered California hopes to overcome the language barrier that had been identified as a major deterrent in applying for insurance in the past, said Iyanrick John, senior policy analyst at Asian and Pacific Islander American Health Forum, an advocacy group that closely studies health care in the Asian and Pacific Islander community.\u003c/p>\n\u003cp>As part of this “culturally sensitive” strategy, Covered California has pushed vigorously for resources to be delivered in native languages. Fact sheets and call lines are available in Tagalog, the primary Filipino dialect, as well as 11 other non-English languages.\u003c/p>\n\u003cp>“One of the aspects of the Affordable Care Act is that everybody must have equal access to get health insurance through the marketplace,” John said. “Covered California has done a pretty good job at that.”\u003c/p>\n\u003cp>Despite increased language access, both educators and enrollees struggle with the program’s criteria for qualifying for benefits. Certified outreach workers said those benefits were not thoroughly covered -- if at all -- in their three-day training conducted before the Oct. 1 launch. And educators found that they could not answer all enrollees’ questions like: Are children of undocumented immigrant parents covered but the parents not? Or, how are subsidies classified?\u003c/p>\n\u003cp>To better prepare for upcoming events, educators are regularly tuning in to informational webinars hosted by Covered California.\u003c/p>\n\u003cp>Recognizing the difficulties in signing up minority communities since the Oct. 1 launch, Covered California is ramping up its outreach.\u003c/p>\n\u003cp>Officials posted a series of video advertisements to YouTube on Oct. 17 in different Asian languages, though awareness about them remains low. The Tagalog version received just 145 views after nine days on the web.\u003c/p>\n\u003cp>Not everything can be done online. John explained that older, especially first-generation, immigrants prefer to get information through in-person assistance or via ethnic media, including newspapers or radio.\u003c/p>\n\u003cp>Some popular Asian TV spots and radio stations have already started airing advertisements in multiple languages.\u003c/p>\n\u003cp>Specific to the Filipino community, Tagalog, English and a mix of the two will be the focus languages in Covered California’s print advertisement running in November.\u003c/p>\n\u003cp>“Reaching out to communities with culturally-sensitive information delivered in their languages will be vital to our mission of expanding health care coverage in this state,” said Peter Lee, Covered California executive director, in an Oct. 21 press release announcing the launch of an Asian-language ad campaign.\u003c/p>\n\u003cp>This month, the state will expand advertising to paper mail, billboards, transit signs and other outdoor media, increasing awareness on the streets, where it is lacking.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To effectively distribute the additional resources, the program will continue to certify more educators. As of late last month, more than 4,200 potential enrollment counselors still awaited certification.\u003c/p>\n\n","blocks":[],"excerpt":"Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\r\n\r\nThe rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.","status":"publish","parent":0,"modified":1384413213,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":26,"wordCount":958},"headData":{"title":"Bay Area Groups Struggle to Enroll Filipinos in Covered California | KQED","description":"Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\r\n\r\nThe rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bay Area Groups Struggle to Enroll Filipinos in Covered California","datePublished":"2013-11-12T19:39:41.000Z","dateModified":"2013-11-14T07:13:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"16172 http://blogs.kqed.org/stateofhealth/?p=16172","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/11/12/bay-area-groups-struggle-to-enroll-filipinos-in-covered-california-obamacare-milpitas/","disqusTitle":"Bay Area Groups Struggle to Enroll Filipinos in Covered California","path":"/stateofhealth/16172/bay-area-groups-struggle-to-enroll-filipinos-in-covered-california-obamacare-milpitas","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_16180\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-e1384284709202.jpg\">\u003cimg class=\"size-large wp-image-16180\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/11/Ochavillo-News-Story.PhotoCROP-640x359.jpg\" alt=\"Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press) \" width=\"640\" height=\"359\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Filipino Youth Coalition presents information about Covered California in an event at the Milpitas Library. (Vanessa Ochavillo/Peninsula Press)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Vanessa Ochavillo,\u003c/strong> \u003ca href=\"http://peninsulapress.com/2013/11/06/covered-california-enrollment-filipino-community/\" target=\"_blank\">Peninsula Press\u003c/a>\u003c/p>\n\u003cp>Filipino health advocates in the Bay Area are working overtime to educate the community about the Affordable Care Act and to enroll as many people as possible in California’s health insurance online marketplace before the Dec. 15 deadline.\u003c/p>\n\u003cp>The rollout of the state’s new exchange was accompanied by an ambitious outreach program that awarded grants to community organizations that would use their “trusted relationships” to get target populations enrolled.\u003c/p>\n\u003caside class=\"pullquote alignleft\">“We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/aside>\n\u003cp>But a lack of adequate funding and manpower has made it difficult to educate eligible, uninsured Filipinos about \u003ca href=\"https://www.coveredca.com/\" target=\"_blank\">Covered California\u003c/a>, the state’s health insurance exchange.\u003c/p>\n\u003cp>The problems in the Filipino community — the largest Asian minority in California — come as uninsured Americans across the country struggle to enroll in a plan because of widespread technical problems with the federally-run \u003ca href=\"https://www.healthcare.gov/\" target=\"_blank\">HealthCare.gov website\u003c/a>. California residents can sign up for a plan via a separate website run by Covered California which has encountered some glitches but not on the scale that the federal website has seen.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The Filipino Youth Coalition, the community organization leading Filipino outreach in the Bay Area, started out as a youth service provider for Filipino-American high school students. But since open enrollment for Covered California began, the organization has had to remake itself into a health insurance education resource for all ages.\u003c/p>\n\u003cp>“There’s a lot of work to be done,” said Sarah Gonzalez, executive director of the coalition. “We get so many calls to make presentations, and we can only do so much. The resources are so limited.”\u003c/p>\n\u003cp>Gonzalez has recently resorted to paying out-of-pocket for transportation to and from presentations, as well as for refreshments, which -- although not mandatory -- are customary at Filipino gatherings.\u003c/p>\n\u003cp>Open enrollment will continue until March 31, 2014. But outreach workers are working under the pressure of the Dec. 15 deadline, which is the last day to enroll in order to receive coverage beginning Jan. 1. After that, uninsured individuals may incur a federal penalty.\u003c/p>\n\u003cp>Through its partnership with Asian Americans Advancing Justice, the only Asian and Pacific Islander community organization to receive a grant from Covered California, the Filipino Youth Coalition secured a small grant, which advocates said would be inadequate to fund the entire effort over the next five months.\u003c/p>\n\u003cp>But for outreach specialists like Gonzalez, delivering presentations and setting up information tables at events is worth the extra work. “At every presentation, the response is awesome,” she said. “It’s just, ‘Tell us what to do. Tell us where to sign.’”\u003c/p>\n\u003cp>By going through these familiar sources of information, including community centers, clinics, and churches, Covered California hopes to overcome the language barrier that had been identified as a major deterrent in applying for insurance in the past, said Iyanrick John, senior policy analyst at Asian and Pacific Islander American Health Forum, an advocacy group that closely studies health care in the Asian and Pacific Islander community.\u003c/p>\n\u003cp>As part of this “culturally sensitive” strategy, Covered California has pushed vigorously for resources to be delivered in native languages. Fact sheets and call lines are available in Tagalog, the primary Filipino dialect, as well as 11 other non-English languages.\u003c/p>\n\u003cp>“One of the aspects of the Affordable Care Act is that everybody must have equal access to get health insurance through the marketplace,” John said. “Covered California has done a pretty good job at that.”\u003c/p>\n\u003cp>Despite increased language access, both educators and enrollees struggle with the program’s criteria for qualifying for benefits. Certified outreach workers said those benefits were not thoroughly covered -- if at all -- in their three-day training conducted before the Oct. 1 launch. And educators found that they could not answer all enrollees’ questions like: Are children of undocumented immigrant parents covered but the parents not? Or, how are subsidies classified?\u003c/p>\n\u003cp>To better prepare for upcoming events, educators are regularly tuning in to informational webinars hosted by Covered California.\u003c/p>\n\u003cp>Recognizing the difficulties in signing up minority communities since the Oct. 1 launch, Covered California is ramping up its outreach.\u003c/p>\n\u003cp>Officials posted a series of video advertisements to YouTube on Oct. 17 in different Asian languages, though awareness about them remains low. The Tagalog version received just 145 views after nine days on the web.\u003c/p>\n\u003cp>Not everything can be done online. John explained that older, especially first-generation, immigrants prefer to get information through in-person assistance or via ethnic media, including newspapers or radio.\u003c/p>\n\u003cp>Some popular Asian TV spots and radio stations have already started airing advertisements in multiple languages.\u003c/p>\n\u003cp>Specific to the Filipino community, Tagalog, English and a mix of the two will be the focus languages in Covered California’s print advertisement running in November.\u003c/p>\n\u003cp>“Reaching out to communities with culturally-sensitive information delivered in their languages will be vital to our mission of expanding health care coverage in this state,” said Peter Lee, Covered California executive director, in an Oct. 21 press release announcing the launch of an Asian-language ad campaign.\u003c/p>\n\u003cp>This month, the state will expand advertising to paper mail, billboards, transit signs and other outdoor media, increasing awareness on the streets, where it is lacking.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>To effectively distribute the additional resources, the program will continue to certify more educators. As of late last month, more than 4,200 potential enrollment counselors still awaited certification.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16172/bay-area-groups-struggle-to-enroll-filipinos-in-covered-california-obamacare-milpitas","authors":["8344"],"categories":["stateofhealth_11","stateofhealth_15"],"tags":["stateofhealth_38","stateofhealth_335"],"featImg":"stateofhealth_16180","label":"stateofhealth"},"stateofhealth_15820":{"type":"posts","id":"stateofhealth_15820","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"15820","score":null,"sort":[1382601776000]},"guestAuthors":[],"slug":"low-income-californians-want-to-be-engaged-patients-too-shared-decision-making","title":"Low-Income Californians Want To Be Engaged Patients, Too","publishDate":1382601776,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-large wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new\u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance/building-better-health-care-for-low-income-californians\" target=\"_blank\"> statewide survey\u003c/a> looking at \"opportunities and challenges\" in reaching this underserved population.\u003c/p>\n\u003cp>The report is the latest in \u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance\" target=\"_blank\">a series\u003c/a> from the Blue Shield of California Foundation and provides \"important insights for those working to reshape the system in California and for the rest of the country,\" foundation executive director Peter Long said at a briefing and panel discussion in Washington, D.C., on Wednesday.\u003c/p>\n\u003cp>When asked about their top source of health information, media sources (TV, internet, printed material) nudged out medical professionals, 39 percent to 38 percent. However, reliance on a medical provider for information goes up — by 22 percent — if the patient usually sees the same person.\u003c/p>\n\u003cp>From the report:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Patients are also more apt to reply on their provider for information when they feel someone at their healthcare facility knows them (the definition of connectedness), as well as when providers explain things clearly, invite questions and encourage patients to be involved in their own care.\u003c/p>\u003c/blockquote>\n\u003cp>\"People often dismiss populations of lower income because they're different,\" said Dr. Kavita Patel, managing director of Delivery System Reform at the Brookings Institution, at the briefing on Wednesday. \"This study illustrates that no matter what your income is, patient engagement matters.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The survey is based on phone interviews with 1,018 Californians ages 19-64 with household incomes less than 200 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a> (or about $46,000 for a family of four).\u003c/p>\n\u003cp>The report found that people with the strongest connection to their providers speak English and have insurance — which points to the challenge ahead in a state as diverse as California, as the Affordable Care Act is fully implemented on Jan. 1.\u003c/p>\n\u003cp>Yet the report also pointed to steps providers and health centers can take to engage their patients. In particular, patients who perceive that their provider encourages them to be active in their own care and feel that they have as much say in their health decisions as they want are significantly more likely to feel a \"strong rapport\" with their provider. They also feel \"very informed\" about their health and trust the doctor's information, according to the report.\u003c/p>\n\u003cp>Sara Rosenbaum, professor of health policy at the George Washington University School of Public Health, pointed out that \"it was no surprise to me that poor people should value good health care (as much as) anyone else does.\"\u003c/p>\n\u003cp>\u003cstrong>Digital divide\u003c/strong>\u003c/p>\n\u003cp>Though much has been written of the \u003ca href=\"http://www.pewinternet.org/Topics/Demographics/Digital-Divide.aspx?typeFilter=5\" target=\"_blank\">digital divide\u003c/a>, this new report teased out information that surprised even the panel. Four in 10 low-income Californians lack Internet access, the survey found, but that number spikes to 67 percent of low-income Spanish speakers.\u003c/p>\n\u003cp>Dr. Ron Yee worked for 20 years at United Health Centers, a group of community clinics in the Central Valley.\u003cstrong> \u003c/strong>\"I knew our patients did not have access to the Internet,\" he said at the briefing, \"but I was surprised to see 67 percent of our Spanish speakers did not have access. That's a big number for us to understand.\"\u003c/p>\n\u003cp>Of the people in the survey who use the Internet, three-quarters are interested in access to a health center's Internet patient portal. Of the few who have access, \"virtually all find it useful,\" the report found.\u003c/p>\n\u003cp>A similar disparity was found in email or text messages from providers. While very few low-income Californians have access to the technology, of those who do, 87 percent found email or text messages from the clinic or provider useful.\u003c/p>\n\u003cp>\u003cstrong>Alternative approaches\u003c/strong>\u003c/p>\n\u003cp>While California faces a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/12/the-primary-care-crunch-not-enough-doctors-and-more-patients-coming-engaged-patient/\" target=\"_blank\">shortage of primary care providers\u003c/a> at the moment when access to insurance is expanding, alternative approaches can help with access and communication. For example, team-based care where a patient may see a nurse practitioner or physician assistant or health navigators — people who help patients make their way through a hospital or clinic — can \"enhance, rather than diminish, the critical connection between patients and their providers,\" the report found.\u003c/p>\n\u003cp>\"Patients are ahead of policymakers here,\" Peter Long noted, adding that critics had said that expanding access would lead to greater demands on physicians. But low-income Californians \"are open to team care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We've heard a lot about mandates,\" Patel observed. \"This is the patient mandate. These folks were very clear about their aspirations. ... What they're willing to do if engaged to me is heartening.\"\u003c/p>\n\n","blocks":[],"excerpt":"Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new statewide survey looking at \"opportunities and challenges\" in reaching this underserved population.","status":"publish","parent":0,"modified":1386709735,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":769},"headData":{"title":"Low-Income Californians Want To Be Engaged Patients, Too | KQED","description":"Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new statewide survey looking at "opportunities and challenges" in reaching this underserved population.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Low-Income Californians Want To Be Engaged Patients, Too","datePublished":"2013-10-24T08:02:56.000Z","dateModified":"2013-12-10T21:08:55.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"15820 http://blogs.kqed.org/stateofhealth/?p=15820","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/10/24/low-income-californians-want-to-be-engaged-patients-too-shared-decision-making/","disqusTitle":"Low-Income Californians Want To Be Engaged Patients, Too","path":"/stateofhealth/15820/low-income-californians-want-to-be-engaged-patients-too-shared-decision-making","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_15832\" class=\"wp-caption alignnone\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-e1382588779517.jpg\">\u003cimg class=\"size-large wp-image-15832\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/10/56292361-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Only about one in four low-income Californians say they have easily comprehensible information for health decision-making, and 71 percent say they would like more. That's just one of the findings from a new\u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance/building-better-health-care-for-low-income-californians\" target=\"_blank\"> statewide survey\u003c/a> looking at \"opportunities and challenges\" in reaching this underserved population.\u003c/p>\n\u003cp>The report is the latest in \u003ca href=\"http://www.blueshieldcafoundation.org/programs/sub-program/innovation-and-performance\" target=\"_blank\">a series\u003c/a> from the Blue Shield of California Foundation and provides \"important insights for those working to reshape the system in California and for the rest of the country,\" foundation executive director Peter Long said at a briefing and panel discussion in Washington, D.C., on Wednesday.\u003c/p>\n\u003cp>When asked about their top source of health information, media sources (TV, internet, printed material) nudged out medical professionals, 39 percent to 38 percent. However, reliance on a medical provider for information goes up — by 22 percent — if the patient usually sees the same person.\u003c/p>\n\u003cp>From the report:\u003c!--more-->\u003c/p>\n\u003cblockquote>\u003cp>Patients are also more apt to reply on their provider for information when they feel someone at their healthcare facility knows them (the definition of connectedness), as well as when providers explain things clearly, invite questions and encourage patients to be involved in their own care.\u003c/p>\u003c/blockquote>\n\u003cp>\"People often dismiss populations of lower income because they're different,\" said Dr. Kavita Patel, managing director of Delivery System Reform at the Brookings Institution, at the briefing on Wednesday. \"This study illustrates that no matter what your income is, patient engagement matters.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The survey is based on phone interviews with 1,018 Californians ages 19-64 with household incomes less than 200 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a> (or about $46,000 for a family of four).\u003c/p>\n\u003cp>The report found that people with the strongest connection to their providers speak English and have insurance — which points to the challenge ahead in a state as diverse as California, as the Affordable Care Act is fully implemented on Jan. 1.\u003c/p>\n\u003cp>Yet the report also pointed to steps providers and health centers can take to engage their patients. In particular, patients who perceive that their provider encourages them to be active in their own care and feel that they have as much say in their health decisions as they want are significantly more likely to feel a \"strong rapport\" with their provider. They also feel \"very informed\" about their health and trust the doctor's information, according to the report.\u003c/p>\n\u003cp>Sara Rosenbaum, professor of health policy at the George Washington University School of Public Health, pointed out that \"it was no surprise to me that poor people should value good health care (as much as) anyone else does.\"\u003c/p>\n\u003cp>\u003cstrong>Digital divide\u003c/strong>\u003c/p>\n\u003cp>Though much has been written of the \u003ca href=\"http://www.pewinternet.org/Topics/Demographics/Digital-Divide.aspx?typeFilter=5\" target=\"_blank\">digital divide\u003c/a>, this new report teased out information that surprised even the panel. Four in 10 low-income Californians lack Internet access, the survey found, but that number spikes to 67 percent of low-income Spanish speakers.\u003c/p>\n\u003cp>Dr. Ron Yee worked for 20 years at United Health Centers, a group of community clinics in the Central Valley.\u003cstrong> \u003c/strong>\"I knew our patients did not have access to the Internet,\" he said at the briefing, \"but I was surprised to see 67 percent of our Spanish speakers did not have access. That's a big number for us to understand.\"\u003c/p>\n\u003cp>Of the people in the survey who use the Internet, three-quarters are interested in access to a health center's Internet patient portal. Of the few who have access, \"virtually all find it useful,\" the report found.\u003c/p>\n\u003cp>A similar disparity was found in email or text messages from providers. While very few low-income Californians have access to the technology, of those who do, 87 percent found email or text messages from the clinic or provider useful.\u003c/p>\n\u003cp>\u003cstrong>Alternative approaches\u003c/strong>\u003c/p>\n\u003cp>While California faces a \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/09/12/the-primary-care-crunch-not-enough-doctors-and-more-patients-coming-engaged-patient/\" target=\"_blank\">shortage of primary care providers\u003c/a> at the moment when access to insurance is expanding, alternative approaches can help with access and communication. For example, team-based care where a patient may see a nurse practitioner or physician assistant or health navigators — people who help patients make their way through a hospital or clinic — can \"enhance, rather than diminish, the critical connection between patients and their providers,\" the report found.\u003c/p>\n\u003cp>\"Patients are ahead of policymakers here,\" Peter Long noted, adding that critics had said that expanding access would lead to greater demands on physicians. But low-income Californians \"are open to team care.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>We've heard a lot about mandates,\" Patel observed. \"This is the patient mandate. These folks were very clear about their aspirations. ... What they're willing to do if engaged to me is heartening.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/15820/low-income-californians-want-to-be-engaged-patients-too-shared-decision-making","authors":["240"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_38","stateofhealth_236","stateofhealth_335"],"featImg":"stateofhealth_15832","label":"stateofhealth"},"stateofhealth_7835":{"type":"posts","id":"stateofhealth_7835","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"7835","score":null,"sort":[1344016844000]},"guestAuthors":[],"slug":"a-health-training-program-everyone-likes-but","title":"A Health Training Program Everyone Likes But...","publishDate":1344016844,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/health-training-program-everybody-likes-but…950\" href=\"http://centerforhealthreporting.org/blog/health-training-program-everybody-likes-but%E2%80%A6950\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_7841\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/ToddlerExamined_Flickr_AlecCouros_08032012.jpg\">\u003cimg class=\"size-medium wp-image-7841\" title=\"(Flickr: Alec Couros)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/ToddlerExamined_Flickr_AlecCouros_08032012-300x234.jpg\" alt=\"(Flickr: Alec Couros)\" width=\"300\" height=\"234\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Flickr: Alec Couros)\u003c/figcaption>\u003c/figure>\n\u003cp>The past couple years, we’ve witnessed a seeming contradiction in state health policy.\u003c/p>\n\u003cp>On the one hand, we’ve had an unending march of state health programs to the budgetary cutting block, victims of California’s impoverished financial condition; on the other, that same state government has busily prepared for the \u003ca title=\"http://www.healthcare.gov\" href=\"http://www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a>, set to hit ground in January 2014.\u003c/p>\n\u003cp>While glancing at data on the website of the\u003ca title=\"http://www.oshpd.ca.gov\" href=\"http://www.oshpd.ca.gov\" target=\"_blank\"> Office of Statewide Health Planning and Development\u003c/a> (better known as OSHPD), I thought I’d found a program that was another example of California preparing for reform and decided to dig deeper.\u003c/p>\n\u003cp>Its moniker, \u003ca href=\"http://www.oshpd.ca.gov/hwdd/cal-search/\" target=\"_blank\">Cal-SEARCH\u003c/a>, stands for Student/Resident Experiences and Rotations in Community Health. Its description reads like a perfect fit for this health-reform, getting-health-providers-to-underserved-communities world we’ve entered.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Cal-SEARCH, its literature says, “will provide funded training opportunities for health professional students and residents statewide\" who are enrolled in one of 15 programs ranging from primary care residencies to clinical psychology to clinical social work. Those who qualify “will serve a 4-8 week, 80-hour minimum, clinical rotation in CCHCs (community clinics and health centers) and complete a community project.”\u003c!--more-->\u003c/p>\n\u003cp>If students successfully complete their stints, they get “a modest stipend” of $700. The program provides no money for housing or food or transportation. That’s all on the student.\u003c/p>\n\u003cp>And speaking of modest, I found that Cal-SEARCH is part of a national SEARCH program, funded by the U.S. Department of Health and Human Services, that since its inception three years ago has cost the government a paltry $579,000. That’s right, a little more than half a million for three years, less than the cost of one moderately priced home in California. Since the program operates in a number of states, it’s a safe bet that the budget for California’s version is a modest part of that modest amount.\u003c/p>\n\u003cp>It sure sounds like an unusually cost-effective way to open the world of medically underserved California to medical students, to acquaint them with the challenges, opportunities and rewards that working in such an environment can offer.\u003c/p>\n\u003cp>And again, the state uses \u003cem>federal\u003c/em> monies, not its own, to get a leg up on a major challenge facing California -- getting medical professionals to underserved areas and populations.\u003c/p>\n\u003cp>So, using exclusively federal dollars to solve a California problem? Too good to be true, eh?\u003c/p>\n\u003cp>Well, it is.\u003c/p>\n\u003cp>Money for the program has run out, and there are no federal dollars to keep Cal-SEARCH alive, said Donna Scheerer-Treleven, senior program coordinator with the California Primary Care Association. The \u003ca href=\"http://www.cpca.org/\" target=\"_blank\">CPCA\u003c/a> serves as one of several partners for the program’s California arm.\u003c/p>\n\u003cp>The SEARCH program, or some rendering of it, has been around for years. The most recent version began in September of 2009, funded by Washington stimulus money. But, “we’re at the tail end of that now,” said Scheerer-Treleven. The program will end on September 30, despite its popularity.\u003c/p>\n\u003cp>“Feedback has been overwhelmingly positive from program participants,” said Lupe Alonzo-Diaz, acting deputy director at OSHPD’s Healthcare Workforce Development Division.\u003c/p>\n\u003cp>So positive that the program grew almost exponentially over the last three years – from 25 students in year one to 45 the second year and 78 this year.\u003c/p>\n\u003cp>“It’s a great way to get students into rotations who might not have gone this route if it weren’t for this program,” said Scheerer-Treleven. “Students have loved it.”\u003c/p>\n\u003cp>Long Beach native Christine Ruby, 30, certainly did. Ruby, who has eight months to go for a master’s degree in public health plus a second one in physician assistant studies at \u003ca href=\"http://www.tu.edu/\" target=\"_blank\">Touro University\u003c/a>, completed a six-week program at \u003ca href=\"http://www.altamed.org/contact_altamed/orange_county_locations\" target=\"_blank\">Altamed’s Huntington Beach\u003c/a> community clinic just last month.\u003c/p>\n\u003cp>By the second week she was seeing patients on her own, with a “preceptor” to guide her. Over the course of her training, “I easily saw hundreds of patients,” Ruby said.\u003c/p>\n\u003cp>So was the program worth it? “The whole basis of the program is to encourage people to go into primary care and serve the community,” Ruby said. “It benefits the health care system at no cost to the system at all. It just seems silly to me not to continue to fund it.”\u003c/p>\n\u003cp>The folks at OSHPD seem to feel the same way.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While initial funding has ended, OSHPD is optimistic that it will secure funding and continue to offer students and residents the opportunity to participate in the future,\" Alonzo-Diaz said in an email statement.\u003c/p>\n\n","blocks":[],"excerpt":null,"status":"publish","parent":0,"modified":1344016844,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":824},"headData":{"title":"A Health Training Program Everyone Likes But... | KQED","description":"By Richard Kipling, CHCF Center for Health Reporting The past couple years, we’ve witnessed a seeming contradiction in state health policy. On the one hand, we’ve had an unending march of state health programs to the budgetary cutting block, victims of California’s impoverished financial condition; on the other, that same state government has busily prepared","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Health Training Program Everyone Likes But...","datePublished":"2012-08-03T18:00:44.000Z","dateModified":"2012-08-03T18:00:44.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"7835 http://blogs.kqed.org/stateofhealth/?p=7835","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/08/03/a-health-training-program-everyone-likes-but/","disqusTitle":"A Health Training Program Everyone Likes But...","path":"/stateofhealth/7835/a-health-training-program-everyone-likes-but","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Richard Kipling, \u003ca title=\"http://centerforhealthreporting.org/blog/health-training-program-everybody-likes-but…950\" href=\"http://centerforhealthreporting.org/blog/health-training-program-everybody-likes-but%E2%80%A6950\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cfigure id=\"attachment_7841\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/ToddlerExamined_Flickr_AlecCouros_08032012.jpg\">\u003cimg class=\"size-medium wp-image-7841\" title=\"(Flickr: Alec Couros)\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/08/ToddlerExamined_Flickr_AlecCouros_08032012-300x234.jpg\" alt=\"(Flickr: Alec Couros)\" width=\"300\" height=\"234\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Flickr: Alec Couros)\u003c/figcaption>\u003c/figure>\n\u003cp>The past couple years, we’ve witnessed a seeming contradiction in state health policy.\u003c/p>\n\u003cp>On the one hand, we’ve had an unending march of state health programs to the budgetary cutting block, victims of California’s impoverished financial condition; on the other, that same state government has busily prepared for the \u003ca title=\"http://www.healthcare.gov\" href=\"http://www.healthcare.gov\" target=\"_blank\">Affordable Care Act\u003c/a>, set to hit ground in January 2014.\u003c/p>\n\u003cp>While glancing at data on the website of the\u003ca title=\"http://www.oshpd.ca.gov\" href=\"http://www.oshpd.ca.gov\" target=\"_blank\"> Office of Statewide Health Planning and Development\u003c/a> (better known as OSHPD), I thought I’d found a program that was another example of California preparing for reform and decided to dig deeper.\u003c/p>\n\u003cp>Its moniker, \u003ca href=\"http://www.oshpd.ca.gov/hwdd/cal-search/\" target=\"_blank\">Cal-SEARCH\u003c/a>, stands for Student/Resident Experiences and Rotations in Community Health. Its description reads like a perfect fit for this health-reform, getting-health-providers-to-underserved-communities world we’ve entered.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Cal-SEARCH, its literature says, “will provide funded training opportunities for health professional students and residents statewide\" who are enrolled in one of 15 programs ranging from primary care residencies to clinical psychology to clinical social work. Those who qualify “will serve a 4-8 week, 80-hour minimum, clinical rotation in CCHCs (community clinics and health centers) and complete a community project.”\u003c!--more-->\u003c/p>\n\u003cp>If students successfully complete their stints, they get “a modest stipend” of $700. The program provides no money for housing or food or transportation. That’s all on the student.\u003c/p>\n\u003cp>And speaking of modest, I found that Cal-SEARCH is part of a national SEARCH program, funded by the U.S. Department of Health and Human Services, that since its inception three years ago has cost the government a paltry $579,000. That’s right, a little more than half a million for three years, less than the cost of one moderately priced home in California. Since the program operates in a number of states, it’s a safe bet that the budget for California’s version is a modest part of that modest amount.\u003c/p>\n\u003cp>It sure sounds like an unusually cost-effective way to open the world of medically underserved California to medical students, to acquaint them with the challenges, opportunities and rewards that working in such an environment can offer.\u003c/p>\n\u003cp>And again, the state uses \u003cem>federal\u003c/em> monies, not its own, to get a leg up on a major challenge facing California -- getting medical professionals to underserved areas and populations.\u003c/p>\n\u003cp>So, using exclusively federal dollars to solve a California problem? Too good to be true, eh?\u003c/p>\n\u003cp>Well, it is.\u003c/p>\n\u003cp>Money for the program has run out, and there are no federal dollars to keep Cal-SEARCH alive, said Donna Scheerer-Treleven, senior program coordinator with the California Primary Care Association. The \u003ca href=\"http://www.cpca.org/\" target=\"_blank\">CPCA\u003c/a> serves as one of several partners for the program’s California arm.\u003c/p>\n\u003cp>The SEARCH program, or some rendering of it, has been around for years. The most recent version began in September of 2009, funded by Washington stimulus money. But, “we’re at the tail end of that now,” said Scheerer-Treleven. The program will end on September 30, despite its popularity.\u003c/p>\n\u003cp>“Feedback has been overwhelmingly positive from program participants,” said Lupe Alonzo-Diaz, acting deputy director at OSHPD’s Healthcare Workforce Development Division.\u003c/p>\n\u003cp>So positive that the program grew almost exponentially over the last three years – from 25 students in year one to 45 the second year and 78 this year.\u003c/p>\n\u003cp>“It’s a great way to get students into rotations who might not have gone this route if it weren’t for this program,” said Scheerer-Treleven. “Students have loved it.”\u003c/p>\n\u003cp>Long Beach native Christine Ruby, 30, certainly did. Ruby, who has eight months to go for a master’s degree in public health plus a second one in physician assistant studies at \u003ca href=\"http://www.tu.edu/\" target=\"_blank\">Touro University\u003c/a>, completed a six-week program at \u003ca href=\"http://www.altamed.org/contact_altamed/orange_county_locations\" target=\"_blank\">Altamed’s Huntington Beach\u003c/a> community clinic just last month.\u003c/p>\n\u003cp>By the second week she was seeing patients on her own, with a “preceptor” to guide her. Over the course of her training, “I easily saw hundreds of patients,” Ruby said.\u003c/p>\n\u003cp>So was the program worth it? “The whole basis of the program is to encourage people to go into primary care and serve the community,” Ruby said. “It benefits the health care system at no cost to the system at all. It just seems silly to me not to continue to fund it.”\u003c/p>\n\u003cp>The folks at OSHPD seem to feel the same way.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“While initial funding has ended, OSHPD is optimistic that it will secure funding and continue to offer students and residents the opportunity to participate in the future,\" Alonzo-Diaz said in an email statement.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/7835/a-health-training-program-everyone-likes-but","authors":["240"],"categories":["stateofhealth_11","stateofhealth_14"],"tags":["stateofhealth_335"],"featImg":"stateofhealth_7841","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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