Recently, a patient of mine was late for her appointment, and was asked to reschedule. She began crying. She told me she woke up at 5 a.m. to make her appointment at 8 — but she missed her bus. Here in the United States, these sorts of barriers are far too common.
Olugbemiga E. Jegede, M.D.
Senior Vice President and Chief Health Equity and Community Impact Officer, Cone Health
We must meet our patients where they are — to educate, foster trust, and bring healthcare to them.
Our “CATCH 5 in 5” initiative (Collaborative Actions Toward Community Health), aims to add five years to the lives of our community members over the next five years by addressing the factors that influence life expectancy. To accomplish this goal, we must connect individuals to the care that will enhance their lives and longevity.
Social drivers of health
Just because something is available does not mean it is accessible. Thousands of my patients have no way to access healthcare. The bus routes do not go everywhere. They may not have refrigerators in their homes for insulin — or homes at all. The actual care provided influences just 20% of healthcare outcomes. Transportation, food security, housing, community support — the social determinants of health (SDOH) — are far more impactful.
Overcoming these barriers requires trust. You can’t build trust over the phone. You have to go where your patients are and bring healthcare to them.
Mobile healthcare
Our mobile screenings are about treating the whole person — not just a symptom or disease. We ask people, “Do you have food to eat at home? Do you have a house to live in? Do you have a cell phone? Do you have broadband?”
Mobile screening vans allow us not only a place to see patients, but also to perform blood pressure screening, blood sugar checks, cholesterol testing and patient education. Point-of-care tests enable early detection of risk factors and intervention for health conditions such as diabetes, cardiovascular diseases and metabolic disorders on the spot. For example, if we see a patient at risk for developing diabetic ketoacidosis (DKA), which can be potentially life-threatening, we can offer them a continuous glucose monitor (CGM).
Now they have more control over their health because they know their glucose numbers, and have more trust in their provider because it’s shared decision-making.
The second key is education. People don’t know that they have resources available for quality care even if they don’t have insurance. We can educate on smoking cessation, exercise, and chronic diseases such as diabetes, empowering them to better manage their health. We can even organize group visits, where people can learn from each other.
Know your numbers
In the end, this is about building trust. It’s not about what’s the matter with them, it’s about what matters to them.People are very busy. One appointment with a doctor might mean a whole day, maybe missing work, and so many people do not even know they have diabetes, pre-diabetes, or high cholesterol. That’s why you must know what matters to them, so you can identify the barrier and bring healthcare to them in a way they can access, in an environment they trust.
That’s my mission. I want everyone to live a long, healthy life. If we can bring healthcare to where people are, we can bridge those gaps and bring true healthcare equity everywhere.
