Pediatricians are breaking away from the pacifying walls of Yale-New Haven Hospital and taking it to the city streets.
The Adopt-A-Doc program at Yale-New Haven Hospital puts pediatric residents in contact with the neighborhoods of New Haven. Through the program, the residents learn about factors outside the hospital that impact the lives of their patients. The Pediatrics Department recently created a program, Building Medical Homes, to identify and address the barriers children face in attaining preventive health care.
Dr. Brian Forsyth, who created Adopt-A-Doc three years ago, said the program will first analyze barriers restricting children’s medical care and then look to remove those obstacles.
“The Building Medical Homes program comes from the recognition that a fairly large number of children still do not get preventive health care to the extent we would like,” he said.
Diana Edmonds, community coordinator for Adopt-A-Doc, said she is currently searching through logs of children who do not list a primary care provider and contacting social workers to help the children find providers with their insurance or get a policy.
She said refugee families face the most sizeable barrier to preventive health care — fear of deportation. This new program visits the homes of these immigrants to make medicine less intimidating, Edmonds said.
“We’ve been instrumental in setting up a refugee clinic for those children,” she said.
Many other countries do not have preventive medicine, Edmonds said, so refugee families often do not seek out preventive care. She said the hospital is working on hiring interpreters because so many of its patients are Spanish-speaking.
Forsyth said the Building Medical Homes program is still new, so its organizers are still in the exploratory phase of learning what barriers prevent children from attaining preventive care.
“A major impetus for the program is recognizing the ethnic and cultural disparities in the health of children,” he said. “The only way of really making an impact on those differences in health and health care of children from different backgrounds is to first understand them and have knowledge and expertise in addressing them.”
The Adopt-A-Doc program was started to get pediatric residents into New Haven communities to give them experience dealing with cultural diversity and sensitivity, Forsyth said. The program develops physicians who are advocates for children, especially those from disadvantaged backgrounds, he said.
Edmonds said residents are assigned to neighborhood teams, so they get to know one area of New Haven in depth. The program covers six of New Haven’s neighborhoods: Dixwell, Dwight, Fair Haven, the Hill, Newhallville and West Rock.
Residents are exposed to the various demands and resources of different communities, Forsyth said, and are encouraged to get involved in local activities.
The program’s doctors take bus tours of the neighborhoods, eat dinner with locals, attend diversity training, participate in community programs and visit the community center.
Edmonds said doctors make house visits during their first year to form relationships with families and familiarize themselves with the neighborhoods. In the second year, the residents go to after-school programs, high school classes and shelters, she said. After spending time in the community, they advocate for children’s health care on the local, state or national level.
Adopt-A-Doc is required for all pediatric residents at Yale-New Haven, Edmonds said.
“This is the only residency program in New Haven that gets the residents out into the community as part of the curriculum,” she said. “The cultural competency is incorporated into all aspects of their training, as is advocacy.”
Katie Smentek, a pediatric resident, said she worked with lobbyists to protect children’s health insurance and attended a national legislative conference on the topic. She said the knowledge she gained during the program will be valuable to her future as a general pediatrician.
“[My experience with Adopt-A-Doc] has really taught me a lot about how to be an effective advocate, how to lobby the government effectively, how to work with local organizations, and how to apply that back to clinic patients,” she said.
Judy Lowry, a lifetime New Haven resident, has mentored residents in the Dixwell-Newhallville neighborhood since 2000. She brings doctors into housing projects and community centers to meet the staff and residents. Lowry said the program imparts practical knowledge, and is also effective in breaking down prejudices in both physicians and the community.
“I learned a lot myself about getting rid of stereotypes, that sort of thing,” she said. “That’s the training the doctors have found really invaluable. We all have these preset notions about other people.”