There exists a patient population with chronic conditions that have difficulty managing their illnesses. As a result, this group of patients is frequently admitted to the emergency room in medical crisis. Without proper control of their condition, they have decreased life expectancy and quality of life. These patients tend to have limited financial resources and a lack of social support networks.
The problems that these patients regularly face cannot be addressed by doctors or social workers. Often social workers do not have the required medical knowledge to discover the points of medical conflict in a patient’s daily schedule, while the doctors and nurses don’t have the time. This presents an opportunity for medical students to use newly-acquired knowledge to directly help these patients.
We are proposing a project in which we would identify a target group of patients with poorly managed chronic conditions and work with them to identify the barriers to their care. Identifying the patients would be a process involving doctors, nurses and the social working staff, specifically from the patients who visit St. Elizabeth’s health clinic in North Philadelphia. Once identified, we would educate ourselves about the specifics of the conditions faced by the patients, as well as the social circumstances under which they live. With this knowledge we would begin a regular counseling session to identify ways to improve management of their health and their quality of life.
The barriers that these patients face might include lack of knowledge of their illness, lack of access to medications, restrictive or unreasonable diet plans, perceived costs of care, lack of consistent primary care, and lack of knowledge of available resources. We have spoken with the care staff at St. Elizabeth’s, who have enthusiastically expressed that an opportunity exists with known patients.
St. Elizabeth’s is a part of the project H.O.M.E. community, whose mission is, “to empower adults, children, and families to break the cycle of homelessness and poverty, to alleviate the underlying causes of poverty, and to enable all of us to attain our fullest potential as individuals and as members of the broader society.” According to the staff at St. Elizabeth’s and the Philadelphia Health Management Corporation, health statistics regarding the patients who live in the area served by the clinic (ZIP 19121) are significantly worse than the city average. Therefore, in working with these patients we would be directly addressing the disparities that exist in the Philadelphia area.