Health Care Pt 2We have tremendous opportunity to change the face of health care in this country. It requires a team approach to caring for families, addressing not only physical ailments, but behavioral and emotional challenges, too.

In a previous post, I explained how I recently had a chance to speak on the topic of “Home Matters to Health” at the annual Cornerstone Community Housing luncheon, which was focused on ways we can improve community care.

It was at that luncheon that I shared the story of a woman pregnant with twins who fled an abusive partner and ended up in Eugene. After having her babies and having nowhere to live, she and her newborns stayed with various people who took them in, virtual strangers. She was struggling to make it to wellness appointments for her twins, she suffered from depression, and there was no one to help her—until she brought her babies to our clinic.

I explained to the audience at the luncheon about the new way we deliver care at Eugene Pediatrics, by integrating the physical health and behavioral/mental health care of children at a single location. Our medical providers work alongside child psychologists and pediatric psychiatric specialists, with the help of an experienced case manager.

It was our case manager, Jordan, who stepped in and connected this overwhelmed mother to local resources, including DHS, Catholic Community Services, Womenspace, and domestic violence grants to get her and her twins into safe, stable housing. This mom was able to access mental health care for herself and regular care for her babies at our clinic. Once lost, this new family now has a path to lasting wellness.

This new caregiving model is working, but I also believe the following steps must be taken to effectively move our community toward better long term health:

1.    We must recruit more primary care providers. The average age of a primary care doctor in the Eugene/Springfield area is 55, which means within ten years, we will face a critical shortage of health care providers. Unfortunately, it’s not easy to recruit here, because most young doctors, nurse practitioners and physician assistants settle down near their hometowns or where they were trained, and we do not have large health care training programs in Lane County. These days, new doctors graduate from medical school with an average of $300,000 in debt. In some rural parts of the country, car dealerships, local businesses and housing agencies are working together to provide incentive packages to new recruits and their families. New grads are also enticed by federal student loan repayment programs to settle in rural areas; our community is too big to qualify for those federal programs. Therefore, we must look at innovative ways to recruit and retain new providers.

2.    We should leverage the University of Oregon and other nearby programs that are training social workers, psychologists and other experts in the field of mental health and social services to work in collaborative models, like the one we use at Eugene Pediatrics. We need to get interns from those programs into our clinics. We must bring them into our community before they even graduate, so that we can keep these bright young minds here to help us care for our community.

3.    We should have a social worker in every primary care clinic and behavioral health clinic in this community. Having someone skilled at helping patients navigate the difficult social challenges many families face will help health care and behavioral specialists focus on what they do best. And most importantly, this simple change would address underlying factors that so often create ill health. Studies show that 60 to 90 percent of medical illness is based solely on social factors. Imagine if we addressed these barriers to wellness with on-site social workers in clinics. We would see money saved, and we could prevent suffering.

4.    We must push for payment reform. Currently, for example, our social worker’s time spent with patients cannot be billed to insurance. Trillium Community Health Plan and some private insurance companies in our region are rethinking how health care providers are paid. Paying for quality care and for bundled services provided by a clinic will encourage meaningful restructuring of medical care systems and are worth the cost.

5.    Collaboration must be the new normal. We cannot remain siloed by traditional thinking about how and where services are given.  Affordable housing, mental health care, physical health care, education, sustainable and healthy food sourcing and social advocacy needs to be married by experts in each field who work together with others who care about our community.

Please join me in supporting the work of Cornerstone Community Housing and other local non-profit agencies devoted to the well-being of our community. I have never been more hopeful than I am now that we can create a healthier place for our citizens. But we can only do it together.