Health care providers at Five Rivers Family Health Centers know refugee stories well. For many years, the center has served as an access point for refugee patients, helping to welcome our new neighbors to Dayton.
The work is always rewarding but never easy. Language and cultural barriers can hinder the delivery of care, requiring in-person interpreters or others working over the phone or via video conference call. Refugee families have had challenging experiences with outpatient scheduling systems, pharmacy logistics, and access to reliable transportation when first arriving to the United States.
A desire to help improve the care experience for refugee families led Kate Conway, M.D., ’05, M.P.H., director of medical education and assistant professor in the Department of Family Medicine, to pursue a Patient-Centered Outcomes Research Institute (PCORI) grant in 2017 to support community engagement and clinical services for refugees.
“We wanted to create a more intentional process that would allow collaborative relationships to flourish between Public Health Dayton and Montgomery County, Five Rivers, Boonshoft School of Medicine, Catholic Social Services of the Miami Valley, Welcome Dayton, and the refugee community itself,” Conway said. “The PCORI grant we worked on was a great way to bring these partners together and start working on how we can create what the refugee community and stakeholders were saying we needed most — a medical home for our newest neighbors.”
The result of that effort was the Global Health Clinic. Nicole Turkson, M.D., ’11, Ph.D., assistant program director for the Wright State Family Medicine Residency and assistant professor of family medicine took the lead in helping to create a “clinic within a clinic,” a way to maximize the work already being done and to create a better experience for both the refugee patients and the physician-led medical teams. The Global Health Clinic provides more time and coordinated resources for the team to care for refugees patients.
The clinic has support from all levels of leadership at the Boonshoft School of Medicine. Those backing the effort include Dean Margaret Dunn, M.D., M.B.A., FACS; S. Bruce Binder, M.D., Ph.D., chair of the Department of Family Medicine and associate professor; Mamle Anim, M.D., Ch.B., associate professor of internal medicine and chief medical officer at Five Rivers; and Peter Reynolds, M.D., associate professor of family medicine and residency program director.
At Five Rivers, refugees are welcomed by a resident physician, faculty attending, medical assistant, medical students, and center staff. They also have access to resources including a pharmacist, registered nurses, behavioral specialists, and social work professionals.
“We hold dedicated time slots every week where we only see those patients, and we’ll see whole families at a time rather than separating them out as individuals,” Turkson says.
“Many of these patients have little to no experience with regular medical care, so for their first few visits we spend extra time with them and help orient them to a very confusing process,” Conway said. “This will hopefully result in more utilization of primary care services and avoid unnecessary use of the emergency room as their only access point.”
Launching the Global Health Clinic has allowed for medical students in the Global Health Scholars Program to learn and practice the principle that “global is local.” They can meet and care for patients from all over the world right here in our local communities.
“It also has allowed our resident physicians to gain better training on how to take care of a global population in our own community and how to apply what they already are learning for the best care of every patient,” Conway said.
“A lot of residents have a great interest in global health, so they’re pretty excited to have the Global Health Clinic,” Turkson said.
The extra care given to refugees helps them to become familiar with our health care system. For the physician residents and other care providers at Five Rivers, the appointments also offer an opportunity to extend a warm welcome to new members of the community.
The results have so far been good. There is a waiting list of patients, and more refugees are expected to arrive in Dayton each year. Many of those arriving are from the Congo. “It very quickly has gotten to be more than we even hoped it would be,” Turkson said.
As the Global Health Clinic continues to be successful, there is potential for a strong global health program for the Family Medicine residency. It would be a great benefit to residents who have a desire to train and work with global populations here at home and abroad.
“We look forward to future partnerships so that other health professional students and trainees can benefit from this rich training experience and so that our community of patients can be welcomed by our medical teams here in a way that makes them feel safe and cared for,” Conway said.
— Daniel Kelly