Beyond Dx and Rx

I’m way overdue for a blog post on what I’ve been doing with AmeriCorps since I started my job in September. I can’t cover it all in one post, but I’ll start with this.

General overview—I’m working as an AmeriCorps volunteer with the Institute for Family Health in New York City. I am doing case management for four different health care sites in Manhattan which see mainly homeless patients. As a case manager for our patients, my role is to eliminate barriers to care. Basically this means I enroll people in Medicaid, deal with insurance problems, help patients get access to free or cheap drugs and help them with applying for different public assistance programs the city offers.

I really like my job. Day to day I’m dealing with patients one on one which I love doing. There are some moments when things are slow that I find myself without anything to do but those moments are more than offset by the amount of time I spend with my patients. I also really like that I’m working at the intersection of social work and medicine—it’s an area I find fascinating and the experiences I’ve had so far will certainly stick with me and hopefully make me a better doctor.

When I was at my interview at UMD I was talking with a fourth year student who was going to residency interviews for vascular surgery. When I asked him why he was interested in surgery he gave me a bunch of reasons but one really struck me. He said that as he was doing his general medicine rotation in med school, he felt like he was doing more social work than medicine—he didn’t like that he had to worry about how a patient was going to get his meds or where the patient would go after being discharged. In surgery you don’t worry about that. And that is part of the reason why I don’t want to do surgery. I am interested in and want to be part of the whole care of the patient. You can’t make someone better if that person doesn’t have access to food and shelter and treatment. I love being part of a team that has a doctor, a social worker, and a case manager—we care for the whole patient and looking at medicine from the non medical side of it has really made me aware of just how important it is for physicians to pay attention to the aspects of a patient’s care which go beyond diagnosis and prescription.