A Forum For Community Issues : MAKING A DIFFERENCE : One Hospital’s Approach: Train Physicians for Underserved Areas
Even those who can afford medical treatment often cannot find a primary-care doctor nearby. The need is especially great in low-income, largely Spanish speaking East Los Angeles, which the federal government has long designated a “health professions shortage area” having an inadequate number of physicians, nurses and other medical workers.
At one point,reports indicated that there was one primary-care doctor for every 4,000 people in East Los Angeles, twice the government’s recommendation of one primary-care doctor for every 2,000 people.
In 1988, the Boyle Heights-based White Memorial Medical Center responded with one of the country’s first Family Practice Residency programs specifically tailored to prepare primary-care physicians to work in underserved areas like East Los Angeles. During three years of clinical education, residents receive Spanish-language instruction, information about building a medical practice in underserved communities and understanding ethnically based health-care traditions.
Of the 15 program graduates, 14 are board certified in family practice medicine; 12 are practicing in federally designated health professions shortage areas, with seven in East Los Angeles.
SAMPLE OF FAMILY PRACTICE TRAINING
Over three years each resident’s family medicine clincial training is also supplemented by specific instruction in:
How to find resources to subsidize care of indigent patients
How to introduce preventive health care or social services to patient’s family
How to get involved in the community via outreach efforts including home health-care visits and regular school visits to discuss health-sciences careers and health-care issues
ONE DOCTOR’S PERSPECTIVE
DR. MONICA LUGO 1991 graduate of White Memorial Medical Center’s Family Practice Residency program; physician director of La Clinica Sunol, a community clinic in East Los Angeles operated by Alta-Med Health Services Co., Alhambra resident
I was born and raised in East Los Angeles and went to medical school at UC-Davis. I was interested in the Family Care Residency Program because all of the physicians involved had been my role models when I was in medical school. It was exciting to think about being in a group with attending physicians who were smart, had excellent experience, and backgrounds similar to me and that I would be in an environment that was like home.
A program like this makes other groups take a look and ask, “What are we doing about serving underserved communities?” Maybe they’ll actively recruit faculty who are people of color and help emphasize how important it is to work long term within this setting. With a lot of residencies, the emphasis is that you’ll learn from these patients, but then work in a middle-class or upper-middle class area--a “respectable” community.
The Family Care Residency Program gives respect to people who work in underserved communities. Some people think that when you work in these communities you’ve given up so much you should be praised when, in many ways, it’s an honor. We’re lucky to be working here at home with people we feel comfortable with, with people who can trust us. It really bothers me when people try to put you on a pedestal because you’re working in the inner city because it’s not a sacrifice by any means--it’s where you want to be.
This is really where I belong. It’s right down the street from where I went to junior high. It’s where I’m comfortable. It’s home.
TO GET INVOLVED
For information about the White Memorial Medical Center Family Practice Residency Program, call (213) 260-5789.
