February 1, 2023
A partnership between Mayo Clinic and Community Health Service Inc. is reducing barriers to health care by bringing care to patients at a time that's convenient and in a place that's familiar.
Pablo Ochoa is no stranger to the challenges that face non-English speakers in finding access to health care. He's lived them.
"I grew up translating for my parents," says Ochoa, whose parents immigrated to the United States from Mexico before he was born. "I saw health disparities at home."
So when Ochoa, now a second-year student at Mayo Clinic Alix School of Medicine, learned about a new effort — the Mayo Clinic Otolaryngology Community Outreach Clinic — designed to address some of those disparities in Rochester, he was eager to get involved.
Addressing unmet needs
The program is a collaboration between Mayo's Department of Otolaryngology (ENT) - Head and Neck Surgery and Community Health Service Inc., a federally qualified health center. The center serves a largely uninsured, immigrant population, most of whom live in households with incomes below 200 percent of the Federal Poverty Level — about $55,000 for a family of four.
"This is a population that has big barriers to getting care," says Janalee Stokken, M.D., who launched the program with her colleague Sami Bayan, M.D. "They have work and child care constraints as well as language barriers."
In addition, uninsured or underinsured patients are unable to book appointments for specialty care without potentially insurmountable financial costs.
The Mayo Clinic Otolaryngology Community Outreach Clinic aims to close this health care gap through hosting a clinic at the Rochester location of Community Health Service Inc., a place where all patients can receive care, regardless of insurance status. It allows this population to receive specialty care at a place that is affordable, convenient and familiar.
One evening a month, a team of ENT surgeons (both physicians and residents), advanced practice professionals, audiologists, interpreters, and medical students travels to Community Health Service Inc. and provides care to patients who have received an ENT referral from one of the community clinic's primary care professionals. Patients who need treatment beyond what can be provided on-site are referred to Mayo Clinic, where their costs are covered by Mayo's charity care program.
Ochoa and other medical students help patients who are referred to Mayo navigate the process and offer other support through the Medical Student Community Partners Program.
"Before this program was established, we had a zero percent show rate for Community Outreach Clinic patients who were referred to Mayo," Dr. Bayan says. "That number is now 100 percent thanks to the dedicated student team."
The students provide support and continuity to patients.
"We're usually the first contact patients have at the community clinic," Ochoa says. "We meet them in the lobby, and explain that we're there to help them and that their care will be provided at no cost. We let them know we'll follow up with them and touch base after their appointment or treatment. We help them navigate an unfamiliar system."
Supporting the community
Funding for the partnership comes from Mayo's Center for Health Equity and Community Engagement Research, which provided $85,000 in startup costs to purchase equipment and medications.
"The CHECER team has been instrumental in terms of funding as well as providing ongoing support and mentorship," Dr. Bayan says. "Adeline Abbenyi and Dr. Katherine Price have been amazing resources."
The clinic has also received benefactor support.
Since launching in June, the Community Outreach Clinic has cared for more than 50 patients and referred 10 to Mayo Clinic for additional care, including surgical treatment.
The team has also begun identifying and addressing health disparities, including a lack of access to affordable hearing aids among the population being served.
"The success of this program is all thanks to Jill Gruenwald, Au.D., and Corey Stoelb, Au.D.," Dr. Bayan says. "We are fortunate to have so many people collaborate to bring this care to patients. It takes a village to take care of each other."
Teaching students to care for all patients
The Community Care Clinic also helps broaden students' understanding of health disparities, taking their education beyond the classroom into true patient encounters.
"This experience is very different than learning about social determinants of health from a book," says Tissiana Vallecillo, a first-year medical student who volunteers at the clinic. "We navigate the barriers firsthand. We get to learn about the challenges some of the patients at CHSI face."
That's one of the goals for starting the clinic says Dr. Stokken, who serves as director of the Otolaryngology — Head and Neck Surgery Residency.
For Vallecillo, volunteering at the Community Care Clinic has reminded her why she's studying medicine — and why she's studying it at Mayo Clinic.
Continuing the work
Community Health Service Inc. welcomes additional partnerships.
"I really think this model can be replicated for other specialties and that many of Mayo's medical residents would benefit from expanding their medical training experience beyond well-resourced populations," says Stephanie Low, M.D., chief executive officer and chief medical officer at Community Health Service Inc. "If we truly believe that all are deserving of care, we have to know how to provide excellence of care in every situation — even when you don't have every resource at your fingertips for diagnosis and treatment, and even when the patient has limited funds to spend and no access to health insurance coverage."