Homelessness affects both physical and mental health and makes access to health care difficult. As a result, people experiencing homelessness often have higher rates of poor health than those who are housed, according to the Centers for Disease Control and Prevention.
In Lafayette, more than 660 ambulances were called to the Catholic Charities of Acadiana shelter and transported patients to area hospitals. Geographically, Ochsner’s University Hospital & Clinics, located at 2390 West Congress St., receives most of these patient visits.
That’s two patients a day coming through the emergency department from Catholic Charities of Acadiana’s shelter.
UHC doctors recognized a pattern. Many homeless patients who visited the emergency room did not have their medications, had delays in refilling their medications, and experienced an overall lack of access to care.
“Obviously, they’re not coming in with headaches,” said Dr. Farha Khan, internal medicine associate program director at LSUHSC Ochsner University Hospital and Clinics in Lafayette. “They only come in when the sick person reaches the end of the road of how they feel, which means being hospitalized for several days in an ICU environment.”
Dr Farha Khan
Photo by Danny Izzo.
Dr. Paul Walker works in a clinic that treats patients with chronic liver disease. Walker and his team treat these patients and then leave.
Walker said if a homeless patient leaves the clinic, there is a high chance they will become a repeat patient.
“We find out the hard way,” Walker said. “They come back to the hospital and say, ‘Oh, I didn’t get this drug,’ or ‘I didn’t have this procedure.'”
Khan said when the shelter runs out of medicine, so do they. Homeless patients have little access to return to the clinic for follow-up visits.
Physicians from the Graduate Internal Medicine Clinic at Ochsner University Hospital & Clinics, also located at 2390 West Congress Street, have been visiting Catholic Charities sites for several months, interacting with potential patients and meeting members of the shelter. We built a relationship.
The solution is to bridge the gap through transportation.
Ochsner UHC internal medicine physicians, along with LSU internal medicine residents, initiated a hospital-to-shelter assistance program and volunteered their time to work at the shelter.
After the medical team did the math, they realized it was more efficient to go to the patient than wait until the situation worsened.
Practitioners not only visit with shelter members to build rapport with potential patients, but a van transportation system provided through an agreement with MediTrans transports homeless patients to Lafayette’s Graduate Internal Medicine Clinic. will take you directly to.
“Our (medical) residents live here (in the clinic), all the equipment is here, and it’s just a real-world clinic experience,” Khan said. “We’re closing the transportation gap. We’re trying to fill it,” he said.
The second factor is that homeless shelter facilities have electronic medical records systems that can track patients’ progress, previous medical conditions, medications, and more, said Glenn Daly, CEO of Ochsner University Hospital and Clinics in Lafayette. He says it never happened. .
“Success is keeping at least one patient out of the hospital,” Daly said. “There, you can live a normal life by taking the right medications and receive preventive care.”
What does success look like?
“We all inherently want to help in any way we can. The people living in shelters are just like us. We want to help them. I We want to write their prescriptions,” Khan said. “But once you get into the weeds, you find it’s not that easy.”
According to Khan, it takes a lot of humility to admit that you don’t know something. For example, an older woman, explaining how to care for her diabetic feet, asked what she should look for when her doctor said, “Please check your feet for changes.”
As she spoke to her students about her experience working in the community and later in a shelter, Khan began thinking about the knowledge gap between health care workers and patients.
“We look pale and say to patients, ‘Your toenails are huge, they’re rough and they look dirty,'” Khan says. I think as we educate, we educate ourselves to understand where the gaps are.”
Khan has high praise for the medical residents and medical students who accompanied the medical team that toured the homeless shelter in Lafayette.
“They were very caring,” Khan said of the medical students. Treating homeless patients “involves a wide range of emotions, from humility to pride to investment, a sense of belonging.”
Walker said the program is also about prevention. The homeless patients he treats at his clinic have access to ultrasounds, blood tests and other standard emergency room procedures to assist with preventive care.
Walker said patients who have previously participated in the program have failed tests for cancer screening, chronic liver disease, lung disease and other conditions.
“Sometimes it’s too late,” Walker said. “They’re in my hospital. They’re terminally ill and in the ICU. This program is a way to detect diabetes, heart failure and other diseases early.”
Eventually, Daly said, the program will offer more care in more specialized treatment opportunities, such as gynecology. Right now, we’re focusing on patients who need it most.
Currently, this program only provides treatment in the clinics of internal medicine university hospitals.
Physicians who helped create and popularize the new program include Dr. Gregory Ardoin, Dr. Christopher Chedid, Dr. Jacob Canning, Dr. Ryan Falcone, Dr. Arden LaGrone, and medical students Hannah Adams Schilling and Rory・Includes Mr. Hughes.
