Once upon a time, a long time ago, I was an Emergency Room Tech at Brackenridge hospital in Austin, Texas. I worked mostly in the Children’s Hospital of Austin (CHOA) ER. I remember throughout my two years there, wondering why the waiting room was always full with patients needing to be seen for a cold or cough, simple, easy to treat illnesses that rarely needed any medical treatment except for some time, fluids and TLC from mom and dad. Sometimes they would come in with a six month rash or a a year of stomach aches. I also noticed the majority of the families who would wait three or four hours to see a physician were minorities and I often wondered about this particular demographic. I asked our medical director, “has anyone ever surveyed our patients to see why they utilize the ER as their pediatrician?”. That wasn’t for us to study, we were just there to treat. So instead, I kept my curiosity to myself and sometimes, when I was translating I would ask mom or dad why they didn’t treat at home and I would get answers like “because the news says children are dying from the flu and Jose has a runny nose” or “she has a fever” (wrapped in two outfits and a blanket) or “I didn’t know what else to do”. I had always worked with underserved populations, coaching gymnastics at a recreation center in my low-income neighborhood and volunteered with Americorps in Segundo Barrio, one of the poorest areas of El Paso. I had been taught home-grown remedies such as chamomile for stomach aches or yerbabuena (mint) steam baths for colds, I had even experienced them myself, yet I wasn’t hearing these stories in this Austin ER.
When I finally left Brackenridge to pursue a Master’s in Public Health, I gravitated towards working with this community again. My sister, an expert in education, and I received a grant to teach Environmental Health to 3rd graders in one of the poorest counties in the country. We loved our experience and after 12 weeks, those kids had learned quite a lot about the world we live in and how to interact with it in a non-invasive way. I went on to write my thesis on the prevalence of asthma in 3rd-5th grade students of Dona Ana County, another very poor county of New Mexico. The statistics were what you see now in regards to health disparities, lower income areas have higher rates of asthma. In fact, poor, medically underserved and minority patients experience significantly worse health outcomes with every disease than those with higher socioeconomic status.
Once I became a PA, I spent a whole five months in a private clinic that saw celebrities on a regular basis before I made the move to a rural community outside of Austin called Lockhart, BBQ capitol of the world. As I worked in a hybrid clinic of family practice and urgent care, I learned about the many barriers to care that exist in this community- lack of education about health and wellness, living in a food desert, being food insecure, little or no exercise facilities, constantly under stress, all of the ingredients necessary for dis-ease. A medically underserved area is one where there is limited access to primary care services and Lockhart was definitely one of them. I remember being the sole provider one Tuesday afternoon and calling my supervising physician to come help because I had already seen 30 patients and I still had five hours to go. I learned more real medicine and the art of physical exam as well as about the human condition and our need for interaction in my first year, than I did in the last six years of practice. Working in rural or underserved communities requires creativity, resourcefulness and imagination, but it also requires a level of cultural understanding, active listening, authenticity and digging to the root cause of their concerns. My patients gain more from just talking about everyday health and easy to apply interventions than they do from most medications. And though I think this is true for most people, the patients I serve are more open to integrative approaches, especially if they’re coming from a trained medical professional.
That’s why I am so excited to drive around the U.S, educating and empowering health care professionals about the tools that allow patients take back control of their health and treat root causes of disease. It’s not rocket science, it’s practical health. Teaching people that eating real, whole, non-chemically treated food can actually be the best medicine. Teaching our patients that increasing the number of plant-based foods in their diet will improve their overall health and help prevent chronic diseases like diabetes, high blood pressure and high cholesterol. That if they cut out soda pop and replace with water they will lose weight and feel better. Let’s start with encouraging them to change something they already do, eat and stop trying to get them to begin something new, exercise, because we all know that weight and health is 75% what we put in our bodies. Lets help them understand that if we get good quality sleep, find ways to manage stress, sweat for at least 30 minutes most days a week, eat the right foods, find time to play and laugh and share with others, that we will be able to prevent and even reverse a whole spectrum of diseases and disorders. It really is that simple and yet we don’t learn these principles in school or in health class or at home or in the exam room. That’s what I want to change with my tour. I want you to learn how to give the power back to your patients through education and engagement, about the 6 pillars of health and how to integrate them into their lives and your lives one 10-minute visit at a time.
If you’re a medical provider in an underserved community, I commend you, it’s not an easy job and your patients probably love you for being available to them. Let’s start teaching evidence-based, scientifically studied practices that can replace or prevent the band-aids we’re placing on them now. It’s time to engage and educate and quit blaming them for non-compliance. There is always more to the story than we know.
Look for my Kickstarter campaign coming soon and let me know if you want me to come talk in your town.