I am doing my pediatric rotation at Beacon Christian Community Health Center. This office is a New York state funded clinic serving all types of people with all insurances and even without insurance. The clinic's mission statement is to "Honor God by caring for the physical, mental, and spiritual health of the community." I did not really know what to expect from this type of clinic. It is very different from every other place I have been at. Obviously my experience here would not be as drastic as Guatemala, but I knew I would still see a lot of economically challenged patients.
On my first day I talked to my medical preceptor and she summed up very nicely what the clinic is all about. She explained that since the clinic is federally funded, the emphasis for each patient is more than just addressing their medical problems. Each patient needs to have equal parts education on diet, exercise, education, driving safety, etc as education on their medical problems. The doctors at the clinic get paid much less than a private office because they each have a desire to serve and help the people of this community and give them an equal chance to receive quality healthcare. After spending the beginning of this year in two countries surrounded by people with minimal access to healthcare, I have a new level of respect for this type of clinic. It is refreshing to see that there are places and people no matter where you go focusing their effort and energy into people that have less than you do. I feel honored to have the ability to rotate at this office.
Everything the clinic does really focuses on bettering the health and home life for children. Every child under the age of 6/7 receives a book as part of the Reach Out and Read program. This program was started in Boston and has spread to all 50 states. It provides a book to every child in impoverished ares to stimulate reading, growth, and development of the brain. This is something I never would have though of, had I not seen it. If a doctor is handing a child a book, either a picture book or even one with words, they are more likely to read it, enjoy it, and ask for more. Additionally, the parent is educated on the importance of reading to their children at a young age and eventually having their children read on their own when they become older. The level of reinforcement of important social skills is remarkable in this office.
I am also already learning so much. One of the families I saw on my second day was quite challenging. A father brought in his two children for physical exams and shots. Recently the children's mother had passed away and the kids were left without health insurance. The father is wheelchair bound after loosing a leg and does not have his own health insurance so him and the kids are left uncovered, hence their reason for becoming new patients at this clinic. The first child was an 8 year old boy with Autism. He was a very obese boy and a little aggressive, but able to communicate. I have never been more thankful for my rotation at the Eden II school (a special school for children with severe Autism) than during this encounter. Between the knowledge I had learned at the Eden II School about effectively talking to children with Autism and some additional health history from dad, I successfully obtained a complete history. What an accomplishment!
The other patient was a 12 year old female who had an extensive history of asthma attacks that had caused her to be in the ICU 17 times. There was this and many other medical issues in this child, which became quite confusing at times. Throughout the entire interview the father didn't really seem to know what was going on and was a questionable historian. He didn't know the name of medications the children were on, he kept telling bizarre stories about certain health concerns for each of his children and overall seemed confused. The doctor told me to take my time obtaining their history since they were new patients, and once I left I realized I had spent 40 minutes getting their complete histories and establishing the patient's goal for this appointment. I told the doctor everything I found, and his first response was "wow, this is complicated;" however, he also complemented me and told me I did a great job finding out everything we needed before going in for the physical examination.
I was very proud of myself for tackling this complicated case and being successful. It made me realize how far I have come in the past few months and how important it is to learn from previous rotations and previous mistakes. Very few patients are "easy" and no clinician is perfect, but practice makes perfect. I am very excited to continue learning more from this rotation, both medically and socially.
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