One Health Center Doctor’s Perspective from Boston


Today’s guest blog post is by Yhu-Hsiung (“Henry”) Lee, MD.  Dr. Lee  recently retired as an emergency medicine physician at East Boston Neighborhood Health Center, where he served patients for over four decades. He was also on the staff at Boston Medical Center, Massachusetts General Hospital, and South Shore Hospital, and on the faculty of Harvard Medical School.

I never set out to become an emergency medicine physician, let alone to see patients in East Boston’s first emergency room.  Nor did I set out to settle in for nearly a half century, serving the diverse medical needs of the people living in a vibrant neighborhood where, not long ago, health care was difficult to access.  My path to East Boston started in  in Taiwan, where I was born, raised and educated.  I came to the United States to gain access to broader educational and professional opportunities as a physician. While trained as an Ear, Nose and Throat specialist, I found my options to enter an ENT residency limited, with few positions for foreign-born doctors.

After pediatrics training, I began an infectious disease fellowship at Boston City Hospital – today’s Boston Medical Center. During my fellowship, I met Dr. James Taylor, who was also in the program and had undertaken a study of hypertension in East Boston.  When Jim Taylor got to East Boston in the early 1970s, the need for a full-service health center was manifest. At the time, East Boston was a largely working-class Italian neighborhood, geographically isolated from the rest of the city and medically underserved.  Lacking a hospital, and separated from vital treatment by lengthy rides on public transit, this five square miles of the city was a veritable medical desert.  When East Boston Neighborhood Health Center (EBNHC) began, its two exam rooms had diagnostic tools that seem primitive compared to what exists today: a small lab, simple X-ray machine and an EKG.

Today, EBNHC has come a long way.  It is equipped with nearly all of the diagnostic equipment found in a hospital.  There are 15 exam rooms, surgical rooms, a slit lamp for eye exams, ultrasound, a negative pressure isolation room to treat patients with infectious diseases, a full-service, on-site lab with rapid diagnosis capability, and mental health services.   The health center’s emergency department is open 24 hours a day, 7 days a week.   It is the only health center in New England, and one of the few in the country, to provide around-the-clock care.  The change in East Boston, its health center, and the field of medicine over the course of my career have been dramatic. The one constant has been my love for the profession.  Medicine has been richly rewarding to me.  It has allowed me to give back to a community in need, to improve the public health, while providing me with a meaningful and deep connection to my adopted homeland.




The NACHC CHI Is Underway in Chicago


Acting Assistant HHS Secretary for Health, Karen DeSalvo addresses the NACHC CHI.


Former Surgeon General Regina Benjamin and Grace Wang, MD, Vice Speaker, NACHC Executive Board

The NACHC Community Health Institute and Expo in Chicago has officially opened and it’s the usual swirl of events and inspiring speakers.   During the General Session NACHC Board Chair J. Ricardo Guzman underscored the accomplishments of health centers in responding to emerging public health issues, saying, “Whether it is Zika, opioids, floods, fires or contaminated water systems, these are community health problems that demand a long-term integrated community response.  And, as frontline responders, we have a vital role in meeting these crises.”  Guzman also described the work of health centers in reaching beyond the walls of the exam room to address the social determinants of health, and expressed hope that health centers should be viewed as an asset to be “preserved and expanded.”   Indeed, there is now a call underway for health centers to serve 50 million people by the year 2026, and the key question being asked at the gathering is: do health centers have the workforce, the technology, and the resources to be ready and tackle population health?

Karen DeSalvo, Acting Assistant Secretary for the Department of Health and Human Services, focused on the topic of population health in her remarks, noting the work that health centers are already doing in building healthy communities and addressing the social determinants of health (these two tasks go hand in hand in the health center world).  Asserting that “health is more than health care,”  DeSalvo also described research in health outcomes that has found that “Social determinants like your zip code determine your health far more than your DNA.  The richest Americans outlive the poorest by 10 to 15 years. For the poorest Americans this gap in life expectancy can be wider or narrower depending on where they live.”  DeSalvo went on to talk about the importance of achieving “health equity” in our system and that health centers continue to partner with local and public health entities to optimize health for all.

Former Surgeon General Regina Benjamin,  who practiced medicine at a health center, also reminded us about what patients need beyond clinical care. “I learned my patients had problems that my prescription pad wasn’t enough to solve, problems such as housing, or nutrition.”  Dr. Benjamin also shared a story about a patient who sought her help for severe back pain due to a slipped disc.  Dr. Benjamin prescribed pain medicine but when the patient returned to her office — in such pain that she was unable to sit — she learned the patient had not picked up the medicine because she could not afford the co-pay.  She was waiting until she received her paycheck in a few days.  Dr. Benjamin sent a nurse to pick up the prescription and when she handed the medicine to the patient her eyes welled up with tears of embarrassment.  “I realized then that I had taken away her dignity.”  Benjamin added that this was an important lesson.

“Cultural compentancy has nothing to do with the color of your skin, it has to do with allowing a patient to maintain their dignity,” she told the audience.

Aside from the General Sessions, there have also been a host of cutting edge education sessions that deal directly with the frontline work health centers are doing now  — addressing the Zika virus, opioid addiction, and caring for victims of human trafficking.  These sessions demonstrate that even though the world around us seems more complicated and perilous than ever, there is a vigilant safety net ready to respond.

The future remains a centerpiece topic for this conference, yet there was also a nod to the past.  NACHC Board Chair-Elect Jim Luisi reflected on the recent loss of health center leaders Wilford Payne, Elizabeth Swain, and Merle Cunningham, all of whom helped blaze new trails in the early days of the Community Health Center Movement.

Stay tuned while we keep you posted on developments at the NACHC CHI.


We’re Getting Ready for the CHI in Chicago!

August-28-30Chicago-ILWe’re getting ready for the NACHC Community Health Institute (CHI) and EXPO which kicks off in Chicago from August 28th to the 30th. The conference draws thousands of health center clinicians, board members, executives from across the country to gather under one roof [read media advisory]. Speakers from the U.S. Department of Health and Human Services, the Centers for Disease Control and Prevention and the U.S. Department of Veterans Affairs are scheduled to speak. There are nearly 140 exhibiters at the EXPO exhibition, not to mention the NACHC games in the exhibit hall. But the real meat and potatoes of the conference will be addressing the issues that health centers are confronting in their daily work.  As a recent article about the CHI in Modern Healthcare Magazine noted, attracting and utilizing the primary care workforce will be a central theme.  Speakers such as Dr. Karen DeSalvo, the Acting Assistant Secretary of Health for the Department of Health and Human Services will discuss how innovative care models such as patient-centered medical homes will drive which types of healthcare professionals are most needed to serve the clinics’ low-income patients.

In addition to exciting speakers during the CHI, there will also be a host of education sessions, including ones that focus on emerging public health issues that have made headlines, such as the Zika virus and the nationwide epidemic on opioid addiction. Health centers are among the responders to these crises, which makes these cutting edge sessions all the more vital. The recent work health centers are doing in addressing addiction is an issue NACHC President and CEO Tom Van Coverden wrote about in this op-ed, also published in Modern Healthcare. There is also a session focused on the prevention, screening, care and prevention of the Zika virus. We will be live streaming that session on Facebook starting at 8:30 am on Tuesday, August 20th.

Stay tuned to this blog for more developments and features as we report from the NACHC CHI. Follow @NACHC and #2016CHI.

An Update on Louisiana

bestfloodThe deadly floodwaters in Louisiana are receding but more rain is expected this week. There have been 13 reported deaths from high waters and 40,000 homes have been damaged by floodwaters, according to news reports.  Thousands of people are currently displaced and living in shelters. The federal government declared a major disaster in the state, and 30 parishes are to be declared flood disasters. NACHC has reached out to our friends at the Louisiana Primary Care Association (LPCA) and learned that while their Baton Rouge building is unaffected, dozens of employees have been impacted, including three people whose homes remain underwater. LPCA is still trying to assess the damage to the FQHC community, but estimates that, based on reports from the field, about 100 employees from health centers in the area have lost their homes.  LPCA is working with a emergency preparedness consultant. Any inquiries or requests to help should be directed to Jasmine Watts.  NACHC’s partner Direct Relief is working to fulfill urgent requests of medicines and medical supplies from health centers and providers throughout central Louisiana.  Here’s what we know so far:

Among the health centers affected is RKM Primary Care, a FQHC under Primary Care Providers for a Healthy Feliciana, Inc. (PCPFHF), which serves over 20,000 patients at five clinic locations. Three of these sites were affected by flooding and were closed. The health center did manage to open a makeshift clinic outside of their Livingston site, which was damaged by flood water. In Clinton, only two of their providers were able to get to the clinic on Monday to treat patients. Direct Relief has sent the health center their first shipment of supplies, which includ Medical Outreach Backpacks, insulin and a Hurricane Prep Pack.

Even if health centers in area avoided flood damage their service areas have been affected. Among them is Eunice Community Health Center, which reports that 200 people have been displaced and are living in shelters. The health center is currently planning their outreach strategies in addition to treating patients at the clinic. They report that seventy percent of their patients are diabetic and are in need of supplies.

There is also St. Gabriel Community Health Center  which operates sites in St. Gabriel and another in Monticello. Both of these sites are operating with minimum staff but have extended their hours. In the immediate area there are 800 homes damaged and about 8,000 people impacted. There is a Red Cross shelter set up across the street in St. Gabriel, where they are performing outreach.

CareSouth is a health center located in Baton Rouge.  The health center did not experience any damage but have since depleted medical supplies while responding to community needs and have requested a replenishment from Direct Relief.

Special thanks to Direct Relief for keeping us updated and for their immediate response to help the FQHC community.  We will keep you updated.

#NHCW16 Is Almost Over… But What a Week It has Been!

There were so many things going on during National Health Center Week 2016  our heads are spinning!  Over 75 Members of Congress toured a health center in their Congressional district, there have been thousands of different events going on — health fairs, breakfasts, picnics,  grand openings of new sites, and much more.  There was even this marriage proposal  that took place during what was supposed to be a fire drill at Ellen Jones Community Dental Center  (a site of Harbor Health Services) in Cape Cod, MA.    Though it may be hard to top a marriage proposal, there are other highlights during #NHCW16 worth noting:

Stay tuned to this blog and we’ll continue to update you on NHCW highlights!