Due to long standing inequities, the devastation caused by COVID-19 is falling more heavily on the shoulders of already vulnerable people. Families living in tight quarters cannot effectively distance themselves if a member of the household becomes infected, and “staying home” is not economically feasible for low-income undocumented immigrants who are currently being denied access to social safety net programs including the CARES Act stimulus checks.
In the early days of this pandemic, Dr. Jaya Aysola, Executive Director of Penn Medicine’s Center for Health Equity Advancement, recognized the importance of addressing the growing needs of vulnerable patients and the power of partnering with third- and fourth-year medical students. So, in collaboration with the Department of Case Management and Social Work and the Center for Public Health Initiatives, she created the COVID-19 Social Needs Response Team. The program was advertised to third- and fourth-year medical students, who were pulled from clinical rotations in mid-March to conserve PPE and slow the spread of the virus, as an opportunity to meet the psychosocial needs of at-risk patients. After weeks experiencing sideline guilt, unable to contribute clinically, I signed up.
Our team, made up of nearly thirty medical students and five social workers, assists patients experiencing distress or with safety concerns or that have immediate unmet social needs. We are connected with these patients by way of a shared electronic medical record “pool”, which we are able to access remotely. Currently, referrals come from numerous sources including telemedicine visits, triage call centers, and community-facing websites. Before contacting patients, we were provided with screening questions, suggested scripting, escalation protocols, and information about community resources. Now, with the support of social workers, we are gaining hands-on experience performing a thorough needs assessment of at-risk patients and linking them to local resources.
On my first shift with my team, a provider referred a COVID positive patient to the pool. She explained that he was experiencing homelessness, and that she was unable to contact him. Our team, with the support of employees at the department of health and local homeless shelters, as well as street outreach coordinators, was able to contact the patient, share his results, and find him housing in a local hotel. For the first time since this pandemic began, I felt like I was using my skills to meaningfully contribute to our nation’s public health response: with my help, this individual was able to quarantine instead of spreading COVID-19 to many other vulnerable individuals.
During my most recent shift, a patient with COVID-19 told me she was worried about leaving her home to get groceries, but had no one she could count on to deliver them. A few phone calls later, I found a pastor who lived nearby and was able to deliver food to her while maintaining appropriate social distancing the following day. I am convinced that this action, while certainly outside the scope of traditional medical school training, saved lives: instead of putting herself and others at risk trying to get the foods she needed, with my help this individual was able to quarantine.
I believe that this program is excelling at both its educational and service goals; we are gaining a deeper understanding of cultural humility, empathetic inquiry, crisis intervention theory, and leadership. More importantly, with the help of our outstanding community partners, our program is connecting services to those who need it most. I am convinced that supporting programs like the COVID-19 Social Needs Response Team is the best possible way I could be currently spending my time. I am also confident that the skills I am learning will enable me to better care for my future patients individually and will help me better advocate for effective public health interventions moving forward.
Eventually, this pandemic will pass, but our health system will be irrevocably changed in so many ways. My hope is that today’s medical students, and tomorrow’s health leaders, will hold onto the lessons we learned while we were kept out of the clinical setting. For me, that lesson is: if we, as future physicians, aspire to decrease our city’s heartbreaking health inequities and save the most lives, we need to do more than perform excellent clinical care to individual patients. We need to form strong partnerships with community members, local nonprofit leaders, and other health professionals, including nurses, social workers, and public health experts to design programs that address upstream factors that largely influence a person’s health--from individual social needs like food and housing insecurity to structural inequities that create unequal educational and employment opportunities. After all, this pandemic has made it crystal clear that you cannot separate an individual’s health outcomes from broader social, political, and economic factors. As health professionals, we’ve known this for years. Now is the time to embrace this reality and take bold action.
For more information about this program or for assistance, please call and leave a voicemail at 267 785 2019.
Catherine Raney
Medical Student
Perelman School of Medicine