Grace Lee, 2012 W&L intern
In the midst of the most important healthcare debate in U.S. history, I was working with patients who fell through the cracks of our current system. This summer, I had the opportunity to intern with the Camden Coalition of Healthcare Providers and Cooper University Hospital in Camden, NJ. Camden is one of the poorest and most dangerous cities in the country with a history of governmental corruption. Through this internship, I was able to learn about how urban poverty impacts individuals’ health and what can be done to break the cycle of impoverishment and deteriorating health.
The Coalition has an innovative, holistic approach to healthcare in the context of urban poverty. Dr. Brenner, executive director and founder, found that 90% of the healthcare costs in Camden, NJ, were spent on 20% of patients. Collaborating with healthcare providers across the city, he began the Camden Coalition of Healthcare Providers to provide targeted care and support to the neediest and costliest patients. Teams consisting of a nurse practitioner, social worker, and community health worker provide medical and social support to help patients stabilize themselves, manage their health, and engage in preventative care. These efforts have led to a reduction of costs estimated to be in millions of dollars. My work at the Coalition involved reaching out to pharmaceutical companies to provide uninsured patients with medications, assisting with a diabetes management group therapy class, and joining health coaches as they go to support patients during their appointments or check up on them during home visits.
At Cooper University Hospital, I undertook a project in collaboration with the local federally qualified healthcare center, CAMcare. My project aimed to explain why CAMcare patients visited the hospital’s emergency department for non-urgent conditions instead of their primary care providers. After researching the subject and surveying patients in the emergency department, I met with administrators at CAMcare to draft a plan that would divert patients back to their primary care providers. I was able to hear from the patients about their habits and perspectives regarding the healthcare system. Their lack of continuity of care often resulted from a lack of trust or communication between the patients and their primary care providers. Understanding and working to change this was an important step towards promoting a medical home for the patients and decreasing costs caused by unnecessary hospital visits.
My experiences at both sites increased my awareness of the failures and gaps in the current health care system and how they impact an impoverished community. Due partially to symptoms of poverty such as unsafe or unkempt environments, there is a high prevalence of treatable chronic conditions and preventable diseases among indigent citizens. Unfortunately, the processes involved in necessary preventative care (filling out paperwork, securing transportation to clinics, applying for government assistance benefits, coordinating primary and specialty care, etc.) are geared largely toward socially and economically stable citizens. By targeting the patients who are suffering from multiple chronic and social issues, and working with them
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