Community health centers exude cultural diversity. They are fun and exciting places to work as a healthcare provider. Most Community health centers can be found in inner cities and rural farmlands which offer opportunities to connect on a more intimate level with diverse populations.
The experience of working at a Community Health Center usually starts on the streets before you enter the clinic. You drive by acres of rural farmlands that offer the sweet scent of manure as migrant workers pick their crops. You may pass many make-shift tents that serve as housing for the homeless population in an inner city. You may walk by street vendors making savory tacos that make your mouth water while small children walk hand in hand with their parents. As they see you, they may start screaming “Doctora, Doctora” and offer a sweet smile and a kind waive with their hands because they remember who you are. This scenic landscape before entering through the community health center’s doors begins to tell a story of what terrain your patient’s may have conquered before presenting themselves to you in your exam room.
“I usually have diarrhea from my mouth, but today it’s coming from my butt!” A quirky 5-year-old Latino American girl sits on my exam table and blurts out the phrase trying to stifle a laugh with her hands pulled immediately to her face. Her mother just rolls her eyes and smiles while her ‘abuela,’ sits back in her chair, eyes bulging, looking mortified. I laughed and ask, “Are you trying to be Sarah Silverman?” “Who’s that?” she squeals as she proceeds to giggle and spew off several more jokes as I try and examine her. This family of 3 had to take several buses through an overcrowded urban city to show up at the clinic as a walk in. It also saved them a visit to the Emergency Room.
Community health centers are unique and special places. And yes, on many days they can resemble comedy shows which adds to the fun of working at them! One of their main purposes is to serve underprivileged communities, increasing access to timely care and to avoid costly Emergency Department (ED) admissions.
When you are working at a Community Health Center, it’s not just about the patient you are seeing, but about the whole family structure. It’s not uncommon for a mother, father, siblings, grandparents and even great grandparents to be present at a newborn’s first well check. This offers a great opportunity for assessment and teaching on so many levels as a practitioner.
Originally, community health centers were started in 1965. They were launched as a small demonstration program in conjunction with President Johnson’s ‘Office Of Economic Opportunity’ with a main focus on medically underserved communities. Today, clinics can be found in inner suburban cities servicing the homeless population to rural locations servicing migrant farmworkers.
Approximately 1400 community health centers provide healthcare to 28 million people throughout the United States. The main source of funding for these clinics is Medicaid along with other sources of funding which include Federal Community Health Center Program 330 Grants, Ryan White Funding, Title X Funding, and local county funds. The Affordable Care Act also offers additional funding.
Many clinics deliver a broad area of services which include mental health, dental, podiatry, maternal child health, pediatrics, HIV services, and Transgender services. They specialize in diagnosis and management of chronic illnesses such as diabetes, asthma, heart and lung disease, depression, cancer and HIV/AIDS. One of the main goals is to reduce mortality, health disparities and risk of low birth weight with the care they deliver. Services such as transportation, translation, case management, and health education are offered to ensure continuity of care.
Working with a lower socioeconomic population can offer challenges as well as a variety of learning opportunities which may include language barriers, poverty, and compliance to healthcare regimens. Community Health Clinics offer healthcare providers an opportunity to flex their creativity, employ a sense of humor and have an open mind in order to better meet a patient’s needs.
Community health clinics are great places for Physician’s, Nurse Practitioners, Nurses, Dentists, and Psychologists to practice. They offer an abundance of experience that can only be acquired at the rural clinic level and inner city. It’s a rich cultural exposure that can be incredibly humbling. You don’t necessarily have to be a comedian to work at one, but it doesn’t hurt.
Ersilia Pompilio RN, MSN, PNP