Federal program helps UF medical resident serve the underserved

Justin Clark, MD, a resident physician at UF&Shands Family Medicine at Main Street, is shown with patient Jerri Wilson at the clinic, Friday, December 21, 2012 in Gainesville, Fla.

Erica Brough/Staff photographer
Published: Wednesday, January 2, 2013 at 1:26 p.m.
Last Modified: Wednesday, January 2, 2013 at 1:53 p.m.

Justin Clark, a first-year resident in family medicine at the University of Florida, said he became hooked on practicing family medicine for under-served people when a patient in Belize wanted his photo taken with Clark, who was there on a service project during medical school.

"It was the first time a patient had ever wanted their picture taken with me, and he had every reason not to want to have his picture taken," said Clark. "He had really bad diabetes, neuropathy, and he couldn't see. He started crying and telling me how much he appreciated me.

"That trip solidified my passion for primary care and working with the under-served."

Clark's dedication was recently given national recognition when he was selected for the Students to Service Loan Repayment Program administered by the National Health Service Corps. The program pays residents' medical school loans, provided they work in under-served communities after their residency for three years.

Clark is already working at the UF&Shands Family Medicine at Main Street, which opened last summer to serve Gainesville's east side population.

Clark said there's an overlap between his patients at Shands and those he took care of during his service trips to Belize and Guyana. He treats a lot of chronic conditions such as diabetes, high cholesterol and hypertension, which can morph into more serious illnesses if untreated. Many patients also lack access to medications, although Clark said that is beginning to change, especially with the implementation of the Affordable Care Act.

The National Health Services Corps itself is expanding because of health care reform, said Dr. Mary Wakefield, administrator of the Health Resources and Services Administration, which supports the NHSC in Washington, D.C.

Wakefield said there will be about 10,000 health care providers who are part of the NHSC, compared with 3,600 before the health care act.

"This is a very concrete impact and a positive impact for communities," Wakefield said, noting that in Alachua County alone, the program supports six physicians, one physician's assistant and two nurses. "Take them out, and I believe you'd find a difference if they weren't there."

Wakefield said a major focus of the NHSC awardees' work is on keeping people healthy through preventive care and on quality care when people are sick. Managing diabetes and high blood pressure, and making children get regular dental checkups, are just a few of their most frequent tasks.

Wakefield said the program is a "win-win" for patients and providers.

"It's a win for the community because they don't have enough providers. It's also a win for Justin and his colleagues because a lot of them have a passion for service. That for them is what health care is all about," Wakefield said, adding that another benefit for the communities where the residents serve is that many physicians in the National Health Service Corp — about 80 percent — end up staying after their obligatory three-year commitment.

Emmanuel Isaac, another NHSC awardee who practices in West Park near Miami, said he intends to continue serving the patients at Broward Community and Family Health Centers when his loans are repaid. Isaac, who is originally from Haiti and moved to the Miami area when he was 10, said his impulse to serve the under-served comes from childhood experiences of watching his immigrant parents struggle to go to the doctor.

"I was always concerned with the way they were treated," Isaac said. "People knew that we could not afford the care. I remember it at times played in the discussion whether to even go to the doctor because of fear of being treated poorly."

Isaac said he makes an effort to ensure all patients are treated fairly.

"When a person walks in, whether they are on a payment plan or have expensive insurance, they get the same care," he said.

Isaac has many Haitian patients, and it helps that he can speak to them in Creole, he said. He also sees a lot of patients who haven't been to the doctor in years and in whom he diagnoses illnesses, such as cancer, when they are still treatable.

"Otherwise, these patients would have been a statistic — in the emergency room or dead," Isaac said. "Most of us want to go into medicine to really help people. The NHSC allows us to do that."

Isaac said he is hopeful the implementation of the Affordable Care Act will ease patient burdens inasmuch as it expands his own role in the health-care system.

"When I tell them to do a colonoscopy or a mammogram, that patient doesn't have to choose among getting the test, getting their blood pressure checked or feeding their family," Isaac said.

Contact Kristine Crane at 338-3119 or kristine.crane@gvillesun.com.

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