DGIM Generally Speaking

Spotlight on Education: Jessica Zeidman — Education in a Community Health Center

By: Lessie Robb-Nicholson, Associate Chief for Education

	Dr. Jessica Zeidman

With the opening of Charlestown Health Center in 1968, MGH joined the national community health center movement – at that time a new idea. In the mid-1960’s community health centers (CHCs) were conceived to provide access to health and social services to medically underserved populations. They were mandated to exist within communities and to work with them to address their unique needs. Fifty years later, MGH has health centers in Charlestown, Chelsea, and Revere, and is affiliated with North End Waterfront Health Center. They have become not only thriving centers for clinical care but unique settings for ambulatory education for MGH residents and Harvard medical students. Ambulatory experiences at the Health Centers are highly sought after by our Medicine residents. One of our DGIM colleagues, Jessica Zeidman, MD, is committed to continuing this high-quality learning experience.

Jess is a primary care doctor at Chelsea Healthcare Center, managing a challenging outpatient panel. She has a significant commitment to medical education, precepting medical residents at Chelsea, attending on the Bigelow Teaching Service, and supporting the Subspecialty Core Educators for MGH Medicine residents as Associate Program Director for Elective Training.

Lessie Robb Nicholson (LRN): What is special about working in a community health center?

Jessica Zeidman (JZ): Community health centers (CHCs) serve a population that is restricted to a geographic area, so you can target programming to the unique local needs. Staff in CHCs understand the issues in schools or community organizations, and partner with them to treat unique health conditions and overcome barriers to care.

Many patients in my practice face barriers to care such as poverty, food-insecurity, violence, and lack of housing. These social determinants of health affect my patients’ ability to engage in the care. These needs have given rise to first-class interpreter services at Chelsea, a highly-trained team of community health care workers, and well-honed interdisciplinary care teams. The smaller size of a health center and community-oriented mission, allow the development of targeted programs to meet local needs. For example, the LINC Program (Legal Initiative for Care), a longstanding medical/legal partnership at the health center, helps patients facing eviction, utility shut off, or who need help completing forms for disability services or other resources. The Refugee Health Assessment Program (RHAP) and the Newly Arrived Central American Immigrant program accommodate refugee and immigrant groups from countries such as Somalia, Syria, Eritrea, and El Salvador to name a few.

Recently, many of my refugee and immigrant patients have voiced reluctance to engage in health care for fear of deportation. Their legal needs are barriers to care. I collaborated with an immigration law professor and her students at Suffolk Law School, which has helped to educate staff at Chelsea about the legal landscape faced by these patients. It is exciting to be able to help forge this medicolegal partnership that’s educational for all of us and has potential to help our patients overcome this barrier to care!

LRN: Why are CHCs good places to train?

JZ: Residents get first-hand experience working with these interdisciplinary programs for patients. They see the effectiveness of the local community health workers, social services, nursing, etc. and get a strong experience in team-based care. As a medical resident, doctoring for resource-poor populations can be overwhelming – success depends upon the expertise of so many. CHCs are set up with co-located services to support a patient’s range of health-related concerns and respond quickly to changing needs of the population. It makes practice in such a setting appealing. It makes a career in caring for resource-poor populations not just sustainable, but exciting and dynamic because you feel agency to make change.

LRN: What excites you about your role in education?

JZ: One of the reasons I went into Primary Care was because of my experience at an MGH health center, caring for vulnerable people and communities. I felt agency to affect change in the health of my patients because of the resources on our team and focus on the community; it felt possible and exciting.

I want our MGH residents to have that same experience and to know they can make a real difference as primary care physicians.

I want to recruit residents into Primary Care, and a health center experience is one great way to do it!”

Read more articles from the Winter 2018 edition of Generally Speaking