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Working Together to Make Healthy Communities

Community Medicine Fellows present programs that lay the foundation for healthier communities across Southern California.

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“How can a physician help a patient be healthy when the zip code in which they live can have a higher impact on their overall health than their genetic code?” –Ngozi Chukwu, M.D., M.P.H, Kaiser Permanente Community Medicine Fellow.

This question is at the center of Kaiser Permanente’s Community Medicine Fellowship program, a 13-month endeavor that prepares recent medical residency graduates to become agents of positive change by working together to make healthier communities.

At a recent culmination ceremony held in Pasadena, California, the 2014 – 2015 selected fellows shared the results of their work, showcasing a number of innovative solutions they developed to positively impact community health in four diverse communities across Southern California.

During Kaiser Permanente’s Community Medicine Fellowship Program, graduates of Family Medicine, Internal Medicine and Pediatrics residency programs provide care to underserved patients while working with community health leaders to improve health care delivery and outreach. The emphasis in community medicine is on the early diagnosis of disease, environmental and socio-economic factors that contribute to one’s health, and the prevention of disease in the community.

One of this year’s six culminating fellows was Ngozi Chukwu, MD, Family Medicine, Fontana Medical Center. “Consider the story of Mrs. Brown, a patient in her 80’s who can’t afford to retire because she still has three dependents, including an adult daughter with an illness and a teen-aged granddaughter who had to leave her home after getting pregnant,” shared Dr. Chukwu during her presentation. “‘What can you do to help me?’ she asked. Suddenly the instructions I had provided about medication adherence, diet and exercise seemed out of place.”

Mrs. Brown’s story illustrates the growing need for health care providers to assist patients with issues that extend beyond their physical ailments. “How many times have we been told that we are the only people our patients know to turn to?” asked Dr. Chukwu.

She went on to examine the impact of education levels with health care, showing a direct correlation between higher education and good health. With a background in teaching, Dr. Chukwu developed a longitudinal peer-to-peer health education curriculum for grades K-12. Her curriculum was piloted on fourth and sixth grade students at Poplar Elementary School in Fontana and will expand to other grade levels in the next phases.

To help increase access to health care for community members who are under- or un-insured, community medicine fellow Karina Melgar, M.D., Family Medicine, opened a student-run, free clinic in Orange County. Despite some challenges, Dr. Melgar partnered with several health organizations including Undergraduate Student-Run Free Clinic Project at UCI, Lestonnac Free Clinic and Kaiser Permanente Orange County Family Medicine to see her project through. To date, the clinic has served 140 patients over 25 Saturdays, with 30 medical students donating their time and talent.

Other projects included a speech development program to trains parents how to work with their children for improved literacy skills, support groups for diabetic patients, and a youth health leadership academy.

“I grew up uninsured and saw my mom go through the community clinic system,” explained Moises Cruz, M.D., M.P.H., program director, Community Medicine Fellowship. “I am committed to making a difference in building Thriving communities that produce healthier, happier people through the community medicine fellowship program.”

 “I am so proud of this year’s fellows, and the program as a whole,” added Marc Klau, M.D., M.B.A., director, Graduate Medical Education. “We have the largest footprint of community medicine fellows in the country, and it is astonishing to think of all the individuals outside of Kaiser Permanente who are touched by this work.”

The 2014 – 15 Community Medicine Fellows are:

Neil Chawla, M.D., Family Medicine, Los Angeles Medical Center. Dr. Chwala founded the Teen Health Leadership Academy (THLA) in collaboration with Kaiser Permanente Community Benefit and the STEM Academy of Hollywood.
Ngozi Chukwu, M.D., M.P.H., Family Medicine, Fontana Medical Center. Dr. Chukwu developed a peer-to-peer health education curriculum for grades K-12 that will expand to several grade levels.
Gladys Felix, M.D., Pediatrics, Los Angeles Medical Center. Dr. Felix founded and directs “Hablamos Juntos / Talking Together,” an organization aimed at improving child literacy through parent skill building in low-income Latino communities.
John Hann, M.D., Family Medicine, Woodland Hills Medical Center. Dr. Hann collaborated with local community members to start a support group for diabetic patients. Monthly groups meet with promotoras to discuss techniques and motivate patients to improve blood glucose control.
Janani Krishnaswami, M.D., Internal Medicine, Los Angeles Medical Center. Dr. Krishnaswami has gained invaluable hands-on experience in bridging “ivory tower” research with community welfare. Her work includes spearheading “FitVille,”a community-engaged technology application and designing local health needs assessments, and organizing and leading KHEIR Clinic’s first Spanish-speaking, community-engaged diabetes group.
Karina Melgar, M.D., Family Medicine, Orange County. Dr. Melgar opened a student-run, free clinic in collaboration with several medical groups and community clinics. Future plans for the clinic include health education programs, connecting with community resources and specialist clinics, health fairs, undergraduate case management, quality improvement projects, and clinic-based research.

Now entering its eighth year, the Community Medicine Fellowship Program is funded by Kaiser Permanente’s Community Benefit, and it seeks to improve the health of our communities by focusing on upstream social and economic determinants of health beyond the medical model.

Photo caption: 2014 – 2015 Community Medicine Fellows pose with Ed Ellison, M.D., Executive Medical Director and Chairman of the Board for the Southern California Permanente Medical Group. Pictured from left: Ngozi Chukwu, M.D., M.P.H., Janani Krishnaswami, M.D., John Hann, M.D., Ed Ellison, M.D., Neil Chawla, M.D., Gladys Felix, M.D., Karina Melgar, M.D.