1. Social Determinants in Health  

Healthy places

           The Joseph F. Sullivan Center delivered their healthcare differently than most centers, which mainly coordinates with their patient’s unique “healthy places” situations. The most common variable that affected the need for healthcare at the Sullivan Center was their patients’ “availability and safety of transportation.” At the Sullivan Center many of the patients are migrant workers, their main complaint is because of their high intense jobs they do not have time or the access to adequate healthcare.  The Sullivan Center took this complaint and tackled it. Outside of the center you will find what looks to be a regular camper, but it is actually a fully functioning mobile clinic. This clinic visits migrant workers at their worksite so that after their shift is complete they can see the physicians in the mobile clinic for a free healthcare screening.

           Throughout my internship at the Sullivan Center, I have had a lot of work with a program called the Wise Woman program. This program is a federal program that gives women the tools to keep a healthy weight and stay healthy. The Sullivan Center has personalized this program by adding options in each binder that shows local trails and tracks. This helps patients see the available options for physical activity that is nearby to the offsite clinic’s location. We have provided information for Greenville, Anderson, and Oconee counties. Providing these local options helps to motivate the patient and hopefully they might use these resources to live a healthier life.

            A benefit that most of our FirstLine Therapy patients have is the “availability to the cost of foods for healthy eating” which most often centers do not see. Through FLT these patients are also paying for personal counseling on their BIA test results and their diet plans. Because these patients have this extra exposable income, they then can buy the more expensive and healthier foods that are recommended for them. Many of our offsite and migrant patients do not have this luxury as they are living with lower incomes. Many times lower incomes leads to buying food that is higher in quantity than quality and is very likely not healthy for the patient.

Employment and decent work

            Most of the patients that came to the Sullivan Center were either refereed by or employed by Clemson University. This led to many of our patients enjoying the in depth conversations about their chronic conditions or acute symptoms that they were experiencing.  The Sullivan Center always makes it a goal to have as minimum of a wait as possible so that the time spent at the center is useful time to improve the health of the patient. We had one patient one day that came in and was very worried about being fired from her job if we did not help them and then release them in time.  This really not only hindered the patient as they could not concentrate and their blood pressure spiked but also the health care provided to the patient. We were so worried about the patient keeping their job that we could not offer our best healthcare assistance as a clinic.

            Another aspect that greatly affected the need and quality of healthcare provided at the Sullivan Center dealt greatly with the “economic and social policies that ensure adequately compensated work for men and women of all origins.” This employment trait provides the backbone of the Sullivan Center and I believe was one of the main reasons that the Sullivan Center was founded in the first place. Everyday when the center is not providing care for sick patients we are constantly providing preventative programs and measures for those that otherwise do not seek the care because they cannot afford it. Through the center’s programs as the Best Chance Network, Wise Woman, and migrant health – the center does their best at making sure that not one population or social economic status is overlooked. Grants help the center run efficiently as long as we provide care to those populations that might not otherwise have a health care provider.

Access to Medical Care

               The Sullivan Center does not just offer the mobile clinic as a method of having a “presence of services delivery systems based on principles of equity of access” to paitnets. On an average week, providers are normally providing care for two to three offsite clincs a week. These offsite clinics are yet another method that the Sullivan Center uses to provide adequate care to populations in need. The Sullivan rotates between a free clinic in Clemson, SC along with other clinics such as Hillcrest and Wallhalla. They also have just begun to do work with Anmed in Anderson, SC. The center also has three transaltors that help the center provide care to the Spanish speaking population. These minorities begin to devleop a relationship with the providers and begin to not only treat them but their families because they feel as though someone finally understands them and their culture.

               FirstLine Therapy and CU4Health are both great examples of “medical systems that promote disease prevention, and health promotion, not just episodic sick care.” Last year’s intern Jasmine Thomas just received a position with the Sullivan Center as acting as the leader in the CU4Health counseling and using her health promotion degree to not just treat sick patients but to prevent them from becoming chronically ill in the first place. FirstLine therapy, led by Ms. Caitlin Moore, is another great example of a preventative program. This system examines the patient’s diet not only to look for healthy options but also to recognize if any unrecognized allergens have developed from their everyday diet. An initial BIA is taken which provides a baseline of lean to muscle mass and the percentage of each in the body. This BIA is then used as a comparison to help the aptinet see progress throughout their dietary change. Both of these health systems are used especially with borderline diabetics or patients with a  history of heart disease. The hopes of these programs is to not spend the time and money to treat a diagnozsis but to take the measures to prevent the chronic condition from developing in the first place.

1. Organizational Behavior and Governance

                 The Sullivan Center does everything for a reason. With that being said, we have given more patients influenza shots than ever before. The seasonal changes have lead to at least three patients on the schedule per day for flu shots and even if they are not on the schedule we will see them. The purpose for this is the state’s attempt at increasing the amount of people who will receive the flu shot each year. The hope is that if more and more people become immunized then there will hopefully be less cases of influenza which will not only lead to less deaths but also less money spent in the healthcare system spent on treating the flu as opposed to the less expensive option of receiving a flu shot. Insurance policies are not offering to pay for the cost of giving the flu shot so it does not become a cost factor to neither the patient nor the facility providing it.  Recently the Sullivan center is facing issues as insurance companies making it harder and harder for facilities to receive that compensation for providing this important preventative measure. If I could change the policy I would obviously change it to one that better combines insurance companies and centers like the Sullivan center that blends the two instead of having them against one another. I would create a way in which the patients are not having to pay for their shots as long as the clinics not having to pay for providing them. This eliminates the factor or barrier that some patients might see as a hazard for not getting the flu shot as well as eliminates the hassle that clinics might see as a hazard for providing it.

 

1. Concentration- Specific Questions

                 The individual that I felt had a tremendous amount of professionalism was my preceptor Ms. Caitlin Moore. Ms. Moore is still very young but has become very successful from the short years that she has graduated from school. Ms. Moore not only treats patients and the staff with respect but also every patient that enters the clinic. I have also become very impressed with her during staff meetings as if there is any question asked she is fully prepared to answer no matter whom the question is addressed to. She always seems so sure of herself and knows the schedule, which is exactly what one wants as a leader at the Sullivan Center. Ms. Moore has a very unique relationship with her FLT patients with a balance of respect and tough love. With some patients who might tell stories about their diets or decide to slack off with their diet there is a tough love moment that Ms. Moore has to have with her patients that includes her reminding them why they were sent to FLT in the first place. These conversations are not meant to bring the patient down or scold the patient but empower them for when their change of lifestyle sometimes might give then more difficulty than they expected. I believe that the most important trait of professionalism is treating every patient equally. It does not matter if the patient would be the president of the University or a low-income patient who can barely afford the care- every patient is treated with the respect and there is a strong drive to treat them and solve their needs.  That trait is what I have gained from my internship- that no matter who you are dealing with everyone should be treated with respect even if they have nothing to offer you in return. I have learned that the healthcare field is not about what others can offer to you or help you with but it should be your goal to help others.