Q&A: Better Together with Mary's Center

Answer:

In 1988, Maria Gomez, who was a nurse in the D.C. Department of Health, saw a lot of pregnant women that were from war-torn Central America who weren't getting access to the services they needed and deserved. Ms. Gomez received a grant of $250,000 from the DC Mayor’s Office on Latino Affairs to make an impact on 200 women through midwifery care in partnership with Providence Hospital.

As women give birth, they have babies. As you have babies, you need pediatricians. As you have more kids, you'll need family practice doctors because you now have a family. As these families grow, you need certain aspects of social services, programs, interventions, education, behavioral health and dentistry.

What started off with this incredible idea, which looked at the totality of the person, has now grown into an organization that across D.C. and Maryland serves over 60,000 people. Now we all talk about the buzzwords of social determinants of health. Well, it has been ingrained in Mary's Center's whole process, but it just wasn't coined that way until recently.

Answer:

As an FQHC, I sometimes call us a health sanctuary where people come and feel safe. There are so many factors that are coming into people's lives that impact their health and are more than just the finite lab results or the vital signs you obtain. While we are considered a community health center, Mary's Center is more like a community health system that has a medical service line, a dental service line, a behavioral health service line and a myriad of other services.

All of this has a heavy interwoven aspect of nursing. It's not like a physician walks in the room and says, "hey, I've arrived." It is a team started by a nurse. We are constantly growing and constantly questioning if we can do better, how we can do better and constantly listening to the patient to see how we can serve their needs.

Working for Mary's Center feels like working in a startup. There are always opportunities where you're learning from the patients and what their needs are. You're constantly finding an opportunity to come up with a strategy or develop a program that meets patients' needs.

Years ago, we started talking about telemedicine. We've been offering telemedicine since 2017. That is an obvious example of our innovation because everybody's using telemedicine right now. We're not afraid of innovating. We're not afraid of risk. We embrace open spaces for us to engage and not be fearful of ideas. I think that's what's enabled us to grow from about 34,000 patients in 2015 to now over 60,000 patients.

Answer:

COVID-19 has laid bare the inequities that exist in the communities that are invisible in broad daylight. They're not really invisible. You know they exist. They're essential workers. They contribute to a lot of things, but they've been marginalized. So as a community health center with a comprehensive structure, we look beyond just healthcare.

One of the lessons learned was that everybody leaned into telemedicine. Well, everybody doesn't have data plans. Everybody doesn't have a smart device. Everybody doesn't have a laptop. Everybody doesn't have sufficient Wi-Fi or internet access. So what we were discovering was that there were patients who couldn't use video because their connection was weak or non-existent. So if our patients couldn't access video, then we offered televoice.

Looking forward, a lot of great effort was put into making sure people could make appointments for the COVID vaccination online. Unfortunately, there are a lot of people that don't have access to the internet, or they don't navigate online efficiently because they don't use the internet as frequently. And so we should not be surprised now that people don't have access. In particular, minority communities that have a long history of health inequities have had challenges with getting vaccinated, and you can see that pattern across the city.

It's not that the city's not trying to do their due diligence. They are. It's just that there needs to be more non-traditional ways in which healthcare is consumed. Non-traditional solutions matter and produce results. Advocacy comes out of non-traditional solutions and this is where listening to the patient is critical. You can now have an encounter with a patient who might not be able to come across town and take off from their hourly job or salary job. Now, they can go to the break room in a quiet space, and they can have an encounter with their provider that is relevant to their diabetes, hypertension, asthma, etc. That's how COVID has affected us as an organization. It's made us continue doing things that we've always done in terms of looking and listening to the patient, but having to dig deeper and ask how do we meet this moment and how do we make a difference?

Answer:

It's always appreciated when somebody wants to provide financial support of any amount. I don't even know where to start.

There are so many areas of need, whether it's a vaccine cooler, PPE, helping to pay for the costs associated with an online scheduling system or phone system, which presents an equitable solution for people who don't have internet access to call and make an appointment to get vaccinated. It goes towards the salary for a nurse helping to run a vaccine clinic. It could go towards so many different things.

The biggest thing is that we can take the grant, slice it up, and it can contribute towards everything. Ultimately, the way we look at it is that it ends up paying for more people to have access to get vaccinated.

Answer:

Top of mind is COVID and how do we do everything we can to mitigate the effects of the pandemic through vaccination and education.

We are getting on video calls to engage churches after hours. We get on a call and answer questions from their congregants. You hear a lot about vaccine hesitancy. I think it's very important that people don't paint the narrative as though minorities don't want to get the vaccine, and therefore, it's their fault. Actually, there's a very good justification for not trusting the system to a certain degree. Instead of blaming the victim, we should show them grace and give them the space and the time, even if there is a sense of urgency. We need to recognize the importance of strategies to get the community educated so that they can understand that getting vaccinated makes sense.

We were all caught by surprise with COVID. We are not even 18 months into the pandemic, and we're hearing about post-COVID syndrome or long-term COVID syndrome. Early studies have shown that more than 50% of individuals impacted are women, and they have neuropsychiatric issues, depression, fatigue, mood disorders and memory issues. I think post-COVID syndrome is something that we need to keep our eye on. There are going to be some issues that we have not seen and encountered yet. Still, we better be prepared for it, and we better be paying attention to it so we can adequately prepare our teams with the level of staffing and awareness of what to look for and how to support these individuals.

Getting past this public health crisis is not going to happen by a singular FQHC or managed care organization or a patient. It's going to happen as a team.