In underserved areas of the United States, finding a doctor to treat your medical needs can be difficult.

Cochise County, Arizona, designated an underserved population by the Department of Health Resources Services, is just 19 miles from the US-Mexico border. The county lacks primary care medical services for its residents and faces economic, cultural and language barriers to healthcare.

Darlene Melk, M.D., of the Chiricahua Community Health Center in Cochise County, needed another source of support for her staff when she was informed that a nearby hospital in Tucson was no longer participating in free consultations with local doctors. . Rural health care options were limited before the pandemic and even more so after the pandemic. Problems such as physician burnout and turnover have worsened, increasing the need for medical support.

“Sometimes patients have to become rheumatologists, endocrinologists and psychiatrists because they are uninsured or have mobility problems,” said Merck, CCHC’s chief medical officer. .

Merck reached out to the MAVEN Project, which stands for Medical Alumni Volunteer Expert Network, a nonprofit organization that provides support to clinicians. The non-profit organization hosts medical consultations via email and Zoom meetings, medical education webinars, and clinical and leadership coaching by retired volunteer physicians. MAVEN partners with his over 300 clinics in 21 states and within Puerto Rico.

Merck said all CCHS staff now have access to MAVEN, which they use for guidance and consultation.

“It’s just incredible to be able to leverage this resource,” she said. “It’s been a wonderful blessing. I really appreciate it. Hopefully I can keep it up for years.”

Connect through shared experiences

Hundreds of clinics have access to Maven, but CCHC has its own set of challenges.

Denise Walt, Minister of Foreign Affairs and Executive Director of the Foundation, said the CCHC serves the cross-border community due to its proximity to the border. In addition to cross-border patients, some employees frequently cross borders to see loved ones and friends. Walt said many CCH staff chose to work in health centers because of their connection with the people they serve and because they believe everyone deserves quality care. rice field.

Nearly 13% of the population in Cochise County was born outside the United States, and approximately 36% of the county population is Hispanic, according to census data. With only 15% of his CCHC patients able to best respond in a language other than English, cultural competence and language access are top priorities, but limited funding requires qualified medical professionals. recruiting and maintaining can be difficult.

Merc is the daughter of a political refugee from Cuba. Her Maven mentor Dr. Lo An Nguyen was a refugee from Vietnam who relied on Medicaid for her health care in the 1970s. The two met virtually over the course of a year and a half, mostly discussing conceptual issues, recruiting, retention, and organizational vision on how to maintain a high-functioning team. Nguyen said it is important to Merck that CCHC employees feel part of the solution and have a consistent workflow as a team. Nguyen, a physician, also worked at Kaiser Permanente before retiring in January 2020 and volunteering at Maven. She is one of her 170 volunteers.

“I grew up in a place where health care was very inaccessible, and this is my chance to be a part of the solution to help those underserved,” she said. “It just won my heart.”

According to Dr. Jill Einstein, Maven’s Senior Director of Physician Engagement, Maven seeks to connect clinics and physicians based on mentorship, skills and shared interests.

“Everything Maven does is through this holistic approach to preventing or reducing burnout,” said Einstein. “So if providers have more skills and more confidence in patient care, it will be less of a challenge. It would be less stressful for them to have immediate access to

In 2021, CCHC reported to the Department of Health Resources Services that 83% of patients were living below the federal poverty line of 200%. Arizona introduced and introduced Medicaid expansion in 2014, but in 2021 nearly 20% of CCHC patients did not have health insurance. At the time, 41% were enrolled in Medicaid or CHIP.

As a student, Nguyen was eligible for Medicaid, but care was not always available. When she contracted pneumonia, she was forced to go to the emergency room because she was unable to see a practitioner who had met her Medicaid quota for the month, and her condition worsened. In another example, Ms. Nguyen suffered from back tooth pain for a week while waiting for her appointment. She begged for a root canal treatment on her phone, but instead she was offered a cheaper and more effective extraction, she said.

“I knew exactly what people had to go through with that program, and a lot of bad things happened. [when I was enrolled]said Nguyen. “So I’ve always felt that more needs to be done for people who don’t have adequate health insurance.”

CCHC hired its first psychologist in 2021 and has hired two more since the clinic became available on MAVEN. Merck said mental health was and will remain a top priority during the pandemic. Today, the number one request from doctors and nurses is to see an endocrinologist.

HRSA data show that 16% of CCHC patients have diabetes, 36% have hypertension, nearly 58% see CCHC for hypertension management, and 72% seek CCHC for prevention and treatment of cardiovascular disease. I am looking for

Merck said it was helpful to have access to experienced clinicians who provided reassurance and resources. She described the partnership with Maven as a “beautiful concept” given that she gets a response to her consultation in just hours. She doesn’t want to ask patients to travel to Tucson to see a specialist if she doesn’t have to. Appointments can be difficult to get because some patients have mobility problems and their work schedules often conflict.

“I think the ultimate goal as a clinician is to alleviate suffering and somehow ease the patient’s journey to health,” she says. “So we’re here to help. This helps when you feel your hands tied with too many barriers to get there because you can’t go, you don’t have insurance, etc. .”

Direct Relief and the MAVEN project have worked together to connect community health centers and free charitable clinics in underserved areas across the United States with medical expertise.