Blog Health Equity

Complexity of care: Voices from the field

Written by Laura Whitehill, medical student at the University College Dublin and participant in the Institute for Public Health Summer Research Program

This week’s seminar brought together a panel of experts on various aspects of healthcare. The panelists were:

  • Amy McQueen, PhD, professor at Washington University School of Medicine, whose research specializes in strategies for improving health behaviors in the community;
  • Will Ross MD, MPH, associate dean for diversity for at Washington University School of Medicine, who has founded numerous non-profits in St Louis working to reduce health disparities;
  • Jorge Riopedre, president of Casa De Salud, a non-profit community healthcare provider for immigrants and refugees in the St. Louis Area.

The talk was moderated by Erika Hayes MD, professor at Washington University School of Medicine and director of the Pediatric and Adolescent HIV Program and Infection Prevention at St. Louis Children’s Hospital. The panel discussed a range of public health issues, from barriers to health care access to insufficient mental health services, all of which are complex topics.

I have a personal research interest in health inequalities and social determinants of health and all the problems our healthcare system has can feel overwhelming. For example, Dr. Ross shared a story of a patient who became upset when told he had to return to the clinic in two weeks to receive the rest of his care. The patient had taken off work to drive 1.5 hours to the clinic where he had to pay $50 as a copay and he was not going to be able to do that again any time soon. All the panelists’ agreed that this is a common occurrence. Dr. McQueen spoke of her research in which patients shared the sentiment that they put so much time and effort to get to their appointments only to leave feeling disappointed because they couldn’t receive all the help or information they needed in the short 15-minute appointment with their doctor. These stories highlight shortcomings of the United States healthcare system. Yet when the panelists spoke about their experiences I felt excited not discouraged because it was clear they had the passion and knowledge to effect change within their community.

The panel discussion opened up into a question and answer session as students in the audience became energized to get involved. Students asked about the panelists experiences of integrating mental health services into their clinical practice, how to integrate and improve case management to improve practice, and how technology is utilized to maintain contact with patients who otherwise wouldn’t seek or receive any follow up care. Dr. Hayes and Mr. Riopedre both spoke of their clinics expanding to include in-house psychiatrists, reducing the complexity of finding and making an appointment for mental health care. Additionally, Dr. Ross helped start the 2-1-1 program in St. Louis, a call service connecting people with social welfare resources, and the St. Louis Regional Health Commission, a network of healthcare providers, government officials and community members working to expand healthcare access in St. Louis.

Despite the complexity of the healthcare system and the uphill battle healthcare professionals face to improve care, I want to thank the panelists for presenting the thoughtful and innovative ways they’re involved in creating a better healthcare system.