{"id":13349,"date":"2019-02-26T13:03:59","date_gmt":"2019-02-26T21:03:59","guid":{"rendered":"http:\/\/depts.washington.edu\/medex\/?p=13349"},"modified":"2019-02-26T13:03:59","modified_gmt":"2019-02-26T21:03:59","slug":"breaking-down-barriers-and-establishing-trust","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/test\/breaking-down-barriers-and-establishing-trust\/","title":{"rendered":"Breaking Down Barriers and Establishing Trust"},"content":{"rendered":"<p><span class=\"dropcap\">33<\/span><strong><span style=\"font-size: 18pt\">-year-old Eric Svendsen is working<\/span><\/strong> out of a mobile health van on the edges of Coeur D\u2019Alene, Idaho. Turns out this is familiar territory for him.<\/p>\n<p>\u201cI came from emergency medicine, working on an ambulance, being out in the community and working with similar populations,\u201d he says. \u201cThat was in Sacramento, with homeless people and lots of others who didn&#8217;t have access to healthcare.\u201d<\/p>\n<p><iframe loading=\"lazy\" title=\"Eric Svendsen MEDEX Spokane Class 21\" width=\"1020\" height=\"574\" src=\"https:\/\/www.youtube.com\/embed\/uASQtsDUSwo?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe><\/p>\n<p>At that time, the ambulance team typically took patients to an emergency room. \u201cThat&#8217;s the only way a lot of these people would find healthcare, even for little stuff like blood pressure medication refills or follow-ups after hospitalization. There&#8217;s a huge population out there that doesn\u2019t have access to a continuum of care.\u201d<\/p>\n<p>A member of MEDEX Spokane Class 21, Eric is fulfilling his 4-month primary care family practice preceptorship under longtime MEDEX classroom lecturer TJ Byrne, PA-C. The mobile van belongs to <em>Heritage Health<\/em>, a federally qualified health center that provides services across North Idaho. Today, the van is parked on a lot outside of <em>Lake City Community Church<\/em>. It\u2019s a chilly Wednesday morning, and the church is servicing individuals and families in need with a simple breakfast, access to a food bank and employment counseling. Both TJ and Eric are on hand to address any medical needs of this group.<\/p>\n<figure id=\"attachment_13388\" aria-describedby=\"caption-attachment-13388\" style=\"width: 167px\" class=\"wp-caption alignright\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert1-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-13388\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert1-Eric-Svensden-167x250.jpg\" alt=\"\" width=\"167\" height=\"250\" \/><\/a><figcaption id=\"caption-attachment-13388\" class=\"wp-caption-text\">The Heritage Health mobile health van.<\/figcaption><\/figure>\n<p>\u201cOur program has evolved,\u201d says TJ Byrne, PA-C and Eric\u2019s preceptor during this 4-month period. Initially, his main mission under <em>Heritage Health<\/em> was to treat the chronically homeless. But the focus has progressed now to the point where the mobile van goes weekly to several churches in the Coeur D\u2019Alene area. \u201cThe reason we&#8217;ve changed is that we encounter the homeless in our community that aren&#8217;t necessarily the typical appearing homeless. They are families, they&#8217;re the working poor.\u201d<\/p>\n<p>Over the past several years, TJ has found that the churches are huge supporters of his mobile health services. \u201cIn fact, we have buy-in from the churches far more than we do from city and county government. We rely heavily on our churches.\u201d<\/p>\n<p>One factor that\u2019s driving people to seek out free social and medical services is the high cost of housing. Coeur D\u2019Alene is known for its lakeside location and many resorts, but this has left a lot of people behind in an otherwise thriving local economy.<\/p>\n<p>\u201cI&#8217;m from California, so I&#8217;m used to the inflated costs of buying a house,\u201d says Eric. Since moving from Hawaii to nearby Spokane in order to start his physician assistant education at MEDEX, he\u2019s seen housing prices rise by 20% to 30%. \u201cRent is going up and there&#8217;s low inventory for available rental properties. It&#8217;s just harder and harder to get into a place. And especially if you&#8217;re in financial trouble or out of work. Or if you have a criminal record, it&#8217;s almost impossible to secure a place to reside.\u201d<\/p>\n<div>[smartslider3 slider=203]<\/div>\n<p><span class=\"dropcap\">E<\/span><strong><span style=\"font-size: 18pt\">ric first connected with TJ Byrne<\/span><\/strong> and the idea of the <em>Heritage Health<\/em> mobile van when TJ lectured to the Spokane 21 class. TJ brought some of his homeless patients to the classroom in order to expose the MEDEX students to this population in need of care. \u201cWith the mobile medical van, TJ is addressing these problems and seeing people that don\u2019t have access to care.\u201d<\/p>\n<figure id=\"attachment_13389\" aria-describedby=\"caption-attachment-13389\" style=\"width: 188px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert2-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-13389\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert2-Eric-Svensden-188x250.jpg\" alt=\"\" width=\"188\" height=\"250\" \/><\/a><figcaption id=\"caption-attachment-13389\" class=\"wp-caption-text\">Eric on his first day of PA studies in Spokane.<\/figcaption><\/figure>\n<p>Eric continues. \u201cI was inspired by some of the people TJ brought to class. Some of them are the homeless that you see here today.\u201d He\u2019s painfully aware of the conditions that a lot of people would suffer without TJ\u2019s help and that of <em>Heritage Health<\/em>. Eric knows this from being out in the community with the van. \u201cA lot of these people will not seek out healthcare until they absolutely have to. We can improve the entire system just by going out and essentially finding those people.\u201d<\/p>\n<p>In order to make this work, TJ and Eric take steps to break down barriers and establish trust. To start, they\u2019re not wearing the traditional medical white coats.<\/p>\n<p>\u201cWhether we approach people or they come into the van, they want to feel comfortable,\u201d says Eric. \u201cThere\u2019s a stigma for people who are experiencing homelessness. They might be more fearful of being judged. Being able to develop a rapport with this population is very important in building trust. We take extra steps to make them comfortable and hear their story.\u201d<\/p>\n<p>Even with his earlier ambulance experiences, Eric was amazed to learn just how many people are not getting their basic healthcare needs met due to lack of access. \u201cThere&#8217;s a lot of mental health issues out here,\u201d he says. \u201cWe see a lot of that on the mobile medical unit. But the resources are not in place for people that need those types of services.\u201d<\/p>\n<div>[smartslider3 slider=204]<\/div>\n<p><span class=\"dropcap\">B<\/span><strong><span style=\"font-size: 18pt\">efore he entered the medical field<\/span><\/strong>, Eric Svendsen worked in the construction trades. Right out of high school, he saw that his path forward was that of a tile setter.<\/p>\n<p>\u201cI come from a family full of contractors, so every summer I&#8217;d go to work for them and learn as much of the trade as I could.\u201d<\/p>\n<p>In time Eric learned about an opportunity with the local fire department which required EMT training. \u201cRight away, I loved the EMT part of the job, which I was not expecting. I felt like it was both fun and challenging.\u201d<\/p>\n<figure id=\"attachment_13391\" aria-describedby=\"caption-attachment-13391\" style=\"width: 167px\" class=\"wp-caption alignright\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert4-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-13391\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert4-Eric-Svensden-167x250.jpg\" alt=\"\" width=\"167\" height=\"250\" \/><\/a><figcaption id=\"caption-attachment-13391\" class=\"wp-caption-text\">Eric on the Seattle UW campus with sons Cody and Cole.<\/figcaption><\/figure>\n<p>A move to Tennessee followed. For employment, Eric resorted to his old standby\u2014the construction trades. He worked as a roofer in part because employment with a fire department required upgrading to a paramedic license. Finally, his wife encouraged him to get the necessary training and certification. \u201cYou\u2019re not very happy on the roof,\u201d she told him.<\/p>\n<p>He entered paramedic school in Nashville and \u201cabsolutely loved it.\u201d<\/p>\n<p>After paramedic school, Eric had no desire to return to the fire department. As a working paramedic in Nashville, he spent time with physician assistants and MDs at <em>Vanderbilt Medical Center<\/em>, sometimes attending lectures together. One of these professional acquaintances was a former Army medic who became a civilian PA. He recognized Eric\u2019s enthusiasm for medicine and encouraged him to follow the PA path.<\/p>\n<p>However, there were obstacles. Eric didn\u2019t have a bachelor\u2019s degree, so he would have to start down that road to qualify for a masters-level PA program.<\/p>\n<p>Twenty-six at the time and with a wife and young child, Eric started taking college courses and never gave up on the goal, despite some challenges. \u201cWe did a lot of moving around during that time,\u201d he says. \u201cSo, for my application to get into PA school, I had transcripts from 11 different colleges.\u201d<\/p>\n<div>[smartslider3 slider=205]<\/div>\n<p><span class=\"dropcap\">T<\/span><strong><span style=\"font-size: 18pt\">he process of applying to PA school<\/span><\/strong> was intimidating from the get-go. Eric didn\u2019t have an early history of good grades. The fire academy was a pass\/fail certificate program, so academic achievement had not been a priority. The thinking was, \u201cJust get through the class and you can be on the fire department.\u201d Still, Eric believed that it was his larger life experience that tipped the balance in his favor for a PA career.<\/p>\n<p>But anyone coming up against the prospects of a 2-year PA program understands that the admissions criteria are fierce. \u201cGoing forward, I knew that I had to have perfect grades if I was even going to measure up against the competition,\u201d Eric says.<\/p>\n<figure id=\"attachment_13385\" aria-describedby=\"caption-attachment-13385\" style=\"width: 250px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Horz3-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-13385\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Horz3-Eric-Svensden-250x167.jpg\" alt=\"\" width=\"250\" height=\"167\" \/><\/a><figcaption id=\"caption-attachment-13385\" class=\"wp-caption-text\">On Maui with wife Laura, sons Cody and Cole.<\/figcaption><\/figure>\n<p>Eric and his wife were living in Hawaii when MEDEX came up for consideration because of its proximity to the islands. \u201cI started looking into MEDEX and it just seemed like it would be a perfect fit with my background.\u201d He got interviews at a couple PA programs, but it was MEDEX Northwest that recognized his potential.<\/p>\n<p>Upon learning of his acceptance to the Spokane 21 Class, Eric was \u201cblown away. Honestly, I didn\u2019t expect to get into a program like MEDEX,\u201d he tells us. \u201cI\u2019d been all over the place in employment and geography, so it took resourcefulness and pulling everything together that allowed me to be here today.\u201d<\/p>\n<p>After observing Eric interact with several homeless patients on the mobile medical unit, it\u2019s clear that his empathetic qualities helped open the doors to MEDEX. Michael Smith, PA-C, and the MEDEX Spokane Site Director recalls all the considerations behind Eric\u2019s admission to the program.<\/p>\n<figure id=\"attachment_13390\" aria-describedby=\"caption-attachment-13390\" style=\"width: 188px\" class=\"wp-caption alignright\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert3-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-13390\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Vert3-Eric-Svensden-188x250.jpg\" alt=\"\" width=\"188\" height=\"250\" \/><\/a><figcaption id=\"caption-attachment-13390\" class=\"wp-caption-text\">Eric kayaking with son Cole at Davis Lake, north of Spokane.<\/figcaption><\/figure>\n<p>\u201cWhile Eric may have struggled early in his academic career, his more recent GPA was near 4.0,\u201d says Michael. \u201cAs a paramedic, the scope of his clinical experience was above average, as were his total patient contact hours. He had glowing letters of reference and his essays displayed compassion and his commitment to providing care for the underserved. Simply stated, Eric embodies the \u2018whole person\u2019 concept. His strong application package combined with a stellar interview made the decision to select him very easy.\u201d<\/p>\n<p>We asked Eric what\u2019s behind his huge heart for the homeless.<\/p>\n<p>He explains that there are two things that really engage his conscience: seeing somebody who needs help, and lack of access. \u201cI see this as a way to make a difference, and it&#8217;s attractive to me.\u201d<\/p>\n<p>There was also Eric\u2019s time in Tennessee. As a paramedic there he encountered a sizable underserved population. Tennesseans rank above the national averages for adults with diabetes, poor mental health, and obesity, as well as low-birth-weight babies. \u201cSeeing that there was such a huge need early in my career stimulated my interest in the underserved.\u201d<\/p>\n<p>It takes a special person to work with this population, and Eric also attributes much to his time with TJ Byrne.<\/p>\n<p>\u201cTJ is a blessing for a lot of people,\u201d he says, citing his preceptor\u2019s patience. Eric recalls when TJ came to lecture at Spokane Class 21 and brought some homeless men with him. They all sung his praises. &#8220;He&#8217;s done so much for us and gone beyond what we could ever imagine just to help us find a way through the maze of healthcare,\u201d they\u2019d say.<\/p>\n<p>Witnessing TJ\u2019s good works in person, Eric has nothing but accolades. \u201cHe meets a lot of other needs far beyond healthcare, making sure people have sleeping bags and enough food. Just anything and everything you can think of pretty much.\u201d<\/p>\n<div>[smartslider3 slider=206]<\/div>\n<p><span class=\"dropcap\">N<\/span><strong><span style=\"font-size: 18pt\">ow in the midst of his clinical year rotations<\/span><\/strong>, Eric looks back fondly on his didactic year with Spokane Class 21. At the close of classroom instruction, everybody in the class was so happy.<\/p>\n<p>&#8220;This was kind of sad for me because we were all about to go our separate ways,\u201d he says. \u201cI was trying to enjoy every moment of those last couple months being in class, with these people, with our instructors.\u201d<\/p>\n<p>\u201cThere a lot of people in Spokane Class 21 that also come from unconventional backgrounds, like me. Our class was exceptional in how everybody got along and meshed. We all became great friends throughout our program and we still are.\u201d<\/p>\n<p>Ahead are several 1-month rotations that will expose Eric to a wide range of specialties, including behavioral medicine, general surgery and inpatient. Eric is open to what lies ahead after graduation in August 2019.<\/p>\n<p>\u201cI&#8217;ve been pretty much just open to everything because I really enjoy all the different aspects of medicine so far,\u201d he says. &#8220;It\u2019s like going into EMT school. I was convinced that I wouldn\u2019t like it, and then I loved it. Right now, I\u2019m not closing myself off into any one area of medicine until I have a better idea and see everything. But, right now it seems like there&#8217;s a lot to learn in primary care and family medicine. This gives me a broad knowledge base that I need.\u201d<\/p>\n<figure id=\"attachment_13384\" aria-describedby=\"caption-attachment-13384\" style=\"width: 1200px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Horz1-Eric-Svensden.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-13384\" src=\"https:\/\/depts.washington.edu\/medex\/wp-content\/uploads\/Horz1-Eric-Svensden.jpg\" alt=\"\" width=\"1200\" height=\"800\" \/><\/a><figcaption id=\"caption-attachment-13384\" class=\"wp-caption-text\">Eric (in the center) with MEDEX classmates Russ Evans (left) and Hershell Cummings (right).<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>The first in his family to graduate college, Eric Svendsen worked in construction but found his passion for medicine. It was his years as an EMT in Tennessee that exposed him to poverty and poor health outcomes. Working on a mobile medical van in Coeur D\u2019Alene during his clinical year at MEDEX, Eric finds an affinity for addressing the needs of the homeless and underserved.<\/p>\n","protected":false},"author":1,"featured_media":13387,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[],"class_list":["post-13349","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-experience"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/13349","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/comments?post=13349"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/13349\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/media?parent=13349"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/categories?post=13349"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/tags?post=13349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}