{"id":8613,"date":"2016-05-17T10:43:54","date_gmt":"2016-05-17T17:43:54","guid":{"rendered":"http:\/\/depts.washington.edu\/medex\/?p=8613"},"modified":"2016-05-17T10:43:54","modified_gmt":"2016-05-17T17:43:54","slug":"building-trust-between-the-homeless-the-medical-community","status":"publish","type":"post","link":"https:\/\/familymedicine.uw.edu\/test\/building-trust-between-the-homeless-the-medical-community\/","title":{"rendered":"Building Trust Between The Homeless & The Medical Community"},"content":{"rendered":"

In 2014, members of the first class of physician assistant students at the newly opened MEDEX Tacoma training site considered taking on a community outreach project in addition to their classroom studies. \u201cIt was important to us that we leave a mark,\u201d says Kate Osborne, then a member of Tacoma Class 1 and co-founder of the Tacoma Foot Clinic.<\/p>\n

Kate and her cohorts had heard about the Sunday community breakfasts held at Urban Grace Church, a nondenominational ministry and the only remaining church in downtown Tacoma. \u201cWe came and observed the breakfast one morning, and got a sense that this is a place where we could really help,\u201d Kate says.<\/p>\n

Each Sunday, around 300 free breakfasts are served at Urban Grace Church. According to Pastor Ben Robinson, the folks who come through the community breakfast are evenly split between the actively homeless and those that are more food insecure. \u201cOf course, the church is surrounded by a lot of subsidized housing,\u201d Pastor Robinson adds.<\/p>\n

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For Kate and her classmate, Mike Carter, the need was clear. At the community breakfast they encountered people who were on their feet all the time. \u201cDepending on their situation these people could be walking between five and eight miles a day,\u201d says Mike. The remedy seemed clear as well. \u201cWe could help educate them in foot care, but also help them with their feet,\u201d says Kate.<\/p>\n

Now alumni of MEDEX Northwest and working in their profession, Kate Osborne and Mike Carter remain firmly attached to the Tacoma Foot Clinic, which is held on the second Sunday of each month at Urban Grace Church. Along with current PA students from MEDEX Tacoma Class 3, they show up at 8 am to set up the makeshift clinic in a small room off the breakfast dining hall. An announcement is made to the 300 or so people present, and interested individuals find their way into the clinic, where they are greeted and directed to a chair for something more than a pedicure.<\/p>\n

\u201cIt\u2019s having something looked at,\u201d says Pastor Robinson. \u201cIt\u2019s having medical professionals care for them. They\u2019re building relationships with medical professionals, especially notable since there\u2019s a lot of mistrust between the homeless population and the medical community.\u201d<\/p><\/blockquote>\n

\u201cIt\u2019s having something looked at,\u201d says Pastor Robinson. \u201cIt\u2019s having medical professionals care for them. They\u2019re building relationships with medical professionals, especially notable since there\u2019s a lot of mistrust between the homeless population and the medical community.\u201d<\/p>\n

\"Pastor<\/a>
Pastor Ben Robinson of Urban Grace Church in Tacoma<\/figcaption><\/figure>\n

\u201cI\u2019m hearing that folks are looking forward to the foot clinic,\u201d he says. \u201cWhat I hear is an appreciation for the human connection.\u201d<\/p>\n

For the MEDEX volunteers, it\u2019s an opportunity to connect with a population that\u2019s often marginalized and pushed aside, to treat them with dignity and care. \u201cAs a pastor and leader of a faith community, I see this as so in line with the model of Jesus, who washed people\u2019s feet,\u201d says Pastor Robinson.<\/p>\n

The majority of the clients seen at the Tacoma Foot Clinic are in some state of moderate distress with their feet and foot care. \u201cNormally we see pretty bad fungal infections, calluses and diabetic foot ulcers,\u201d says Mike Carter. \u201cYou see a lot of swelling as well.\u201d<\/p>\n

\"Missy<\/a>
Missy Griffith and Mike Carter, PA-C, work with a 60-year-old man presenting with severe bilateral lower extremity edema.<\/figcaption><\/figure>\n

On occasion, individuals show up in acute distress, where the condition of their feet indicates something much more serious. Mike explains. \u201cA gentleman we saw today has long-standing diabetes. Most likely he’s got underlying heart failure and cardiac issues, as well as severe bilateral lower extremity edema, which was cutting off blood supply to his feet and leading to actual gangrene of his toes. He’s got open wounds\u2014 open sores on both of his feet\u2014 which are not going to heal properly due to the amount of swelling and the underlying chronic medical conditions. Unfortunately, he’s most likely going to need those toes amputated at some point in time if he does not get follow-up care, as needed, very soon.\u201d<\/p>\n

The client is 63 years old and on the streets. After spending time with him, Mike has little faith in the client\u2019s ability to follow through and get the care he needs. \u201cAbsolutely terrible,\u201d he says.<\/p>\n

The client revealed to Mike that his cellphone had been stolen, along with his antibiotics and water pills to get rid of the edema. \u201cHe watched a man eating those on side of the road from his stolen bag. So, between lack of access to medications, and the fact that he was in the ER last week and they said there’s nothing they would do for his feet, I think that his chances of getting the care he needs are pretty slim. I think this is a true failure of the system.\u201d<\/p>\n

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Vanessa Bester, site director of MEDEX Tacoma, agrees. \u201cA lot of people assume that because we have the Affordable Care Act that everyone has access to healthcare now, and that’s not the case,\u201d she says. \u201cSeeing this gentleman today, I\u2019m very frustrated we can\u2019t give him the care that he needs right here and now. This sort of thing really lights a flame in me to start pushing and figuring out how we can raise more funds, get more support to expand, and eventually provide full clinical services.\u201d<\/p>\n

Never short on vision, Vanessa spells out exactly what they need to be able to expand their reach.<\/p>\n

\"Kate<\/a>
Kate Osborne, PA-C, checks in foot clinic clients as they arrive.<\/figcaption><\/figure>\n

\u201cMoney,\u201d she says. \u201cAnd we need space. Urban Grace is a wonderful setting where they have provided us room to do our work for free. But if we were to expand and provide true medical care, we would need true clinical space with running water and exam rooms.\u201d In the current quarters at Urban Grace, the MEDEX volunteers must lug water in 10-gallon jugs back and forth from the kitchen to provide warm water for the foot care.<\/p>\n

Despite the makeshift nature of the foot clinic, however, happiness in the room is tangible. The MEDEX volunteers are enthusiastic and attentive. The clients are basking under the light of such attention. It all seems worth it, every bit. Pastor Robinson is appreciative. \u201cWith MEDEX it\u2019s been a good natural match,\u201d he says. \u201cThey were looking for a good spot. We have access to a sometimes elusive population with needs and a good setting to offer care. The church doesn\u2019t have the capacity to offer direct services ourselves, so to find a partner organization like MEDEX was ideal. It\u2019s a good model as we continue to look forward and think about what other organizations we may partner with.\u201d<\/p>\n

For current MEDEX didactic students, participation in the foot clinic offers a much-needed relief from the classroom and a reminder of what they\u2019re working towards. Prior to PA school, Missy Griffith was a paramedic for 10 years in Bremerton. Now she is a member of MEDEX Tacoma Class 3, and has taken on a leadership role with the clinic for her class, a mantle that will be passed on to a member of class 4, as Missy enters her clinical year.<\/p>\n

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Arriving at her first foot clinic, Missy was struck by what an impact such a small task could have on the community, and how thankful the people were. \u201cI think that’s been true for everyone in my class who’s come and volunteered,\u201d she says. \u201cThey’re all just like, \u2018Man, this makes us feel better than anything else we’re doing,\u2019 because we’re in the classroom in our books all year long. We’re not seeing patients.\u201d<\/p>\n

\"In<\/a>
In April both Mike Carter and Kate Osborne were presented with the 2016 MEDEX Humanitarian Award at the annual MEDEX Reception for their work with the foot clinic. Vanessa Bester looks on at the right.<\/figcaption><\/figure>\n

For Missy and other volunteers in the didactic year, the foot clinic brings them back to why they\u2019re in PA school after all. \u201cI was really honored to be able to take it over from Kate and Mike, because I know it was hard for them to let go of it, and I can see why. It’s awesome that they’re still involved in helping to keep the clinic going.\u201d<\/p>\n

In lieu of expanded clinical services, there are things needed to keep the Tacoma Foot Clinic afloat. Chief among them are material supplies: packages of men\u2019s white classic crew socks, Lysol wipes, travel size lotion, pumice stone, emery boards, oatmeal bath single packets, travel size soap, toe nail clippers, garbage bags and Ziploc bags.<\/p>\n

Vanessa Bester also makes a direct appeal to MEDEX alumni. \u201cPlease contact me,\u201d she says. \u201cContact Mike or Kate, and get a hold of us at medxfoot@uw.edu.<\/u> We are always looking for preceptors to help guide our students in foot care. We’re looking for people who really want to get down in the trenches and help. If you know of a place where we could use clinic space on the weekend, if you work in general surgery, or with any kind of resources that could help us start providing a broader base of care, contact us.\u201d<\/p>\n

\"Volunteers--Tacoma<\/a>
Foot clinic volunteers on Mother’s Day, left to right: Amanda Brown, Vanessa Bester, PA-C, Kate Osborne, PA-C, Mike Carter, PA-C, Missy Griffith, Aimee Edmunds, Doug Aguirre and Frantz Alphonse.<\/figcaption><\/figure>\n

The MEDEX Tacoma Foot Care Clinic<\/strong> takes place the second Sunday of each month from 8:30 to 10:00 am at Urban Grace Church, <\/em>902 Market St, Tacoma, WA 98402. For more information, to give your time, materials supplies or money write <\/em>medxfoot@uw.edu.<\/u><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

For three years the MEDEX Northwest Tacoma site has partnered with Urban Grace Church to offer a free monthly foot clinic to the underserved and homeless in the downtown Tacoma community. For some clients this is their only connection with medical providers\u2014a chance to have their feet cared for by a physician assistant-in-training, and obtain a referral to address more serious health concerns. <\/p>\n","protected":false},"author":1,"featured_media":8615,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[],"class_list":["post-8613","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medex-stories"],"_links":{"self":[{"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8613","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=8613"}],"version-history":[{"count":0,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/posts\/8613\/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=8613"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/categories?post=8613"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/familymedicine.uw.edu\/test\/wp-json\/wp\/v2\/tags?post=8613"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}