Florida Health News

At new medical school, families will help teach students

By Chris Gerbasi
6/25/2008 © Florida Health News

J. Vassell

MIAMI -- Last year, when her 2-year-old daughter Jada was in intensive care with a breathing problem, Jodricka Vassell practically lived at Joe DiMaggio Children’s Hospital. For a week and a half, she went back and forth from her home in Miami to Hollywood, sitting up all night with Jada at the hospital and then checking on the rest of her eight children, ages 1 to 11, at home.  “That was crazy,’’ Vassell said.

With three children afflicted with chronic health problems, Vassell is well-acquainted with South Florida hospitals and clinics, often traveling to them by bus with three or four of her kids in tow. Then there’s the mountain of paperwork – identification, proof of residency, pay stubs, light bills – that patients in the Jackson Memorial Hospital system, like Vassell, need to qualify for coverage.

Jodricka Vassell and her husband Tony became experts in navigating that system, the hard way. Now they’re going to become teachers for medical students who need to learn about health care in the real world.

NeighborhoodHELP, the Health Education Learning Program, will be part of the curriculum when Florida International University’s College of Medicine opens in fall 2009. This approach is being directed by Drs. Joe Greer, Florida International University’s assistant dean of academic affairs, and Cheryl Holder, medical director at the North Dade Health Center in Opa-locka.

During the last three years of medical school, students will be teamed with nursing and social work students to monitor one to three households in diverse, underserved communities. In monthly visits, the families will teach the students about their lives, their health, their cultures, their obstacles to care.

Holder hopes they will develop the kind of relationship she has with Jodricka Vassell, 28. Holder has been her primary care physician since Vassell was a teenage volunteer at the clinic.

Holder and Dr. Joe Greer, FIU’s assistant dean of academic affairs, describe the curriculum as a different way of teaching medicine. They believe that if doctors can better understand the socioeconomic and environmental factors in patients’ lives that cause disease, they can better treat those illnesses.

“[The students will] see how difficult it is to maneuver the healthcare system with a lot of kids and not a lot of resources,’’ Holder said. They will learn, she said, “all the barriers we put up.”

In the case of the Vassells, students might learn about the diet of Tony Vassell, 38, a Jamaican immigrant, or how the home environment contributes to the children’s asthma, which is common for many black children.

“What you need is not the same education [for all patients], but for the physicians to be culturally aware, that if I’m going to educate you on diet and exercise, I should at least have an idea of what your diet is,’’ said Holder, who is originally from Jamaica.

“So with the students being in the home, they’re going to see the differences in the culture. They’re going to learn firsthand what exactly is my patient eating . . . and the whole concept of health beliefs. If you’re not with the population, how are you going to know health beliefs, because health beliefs then direct how you incorporate Western medicine,’’ she said.
While cultural competency will be one aspect of the curriculum, the medical school’s goals extend farther to social responsibility and changing social policy. It is, Greer said, a “great social experiment.” He credits Dean John Rock as the visionary willing to try it.

“Basically, we’re trying to save the world,’’ Greer said, only half-joking. “What I want to be able to graduate is a highly skilled, culturally sensitive, socially aware and responsive physician, with the underlying ethics that bring the profession back to what it should be.”

Being out in the community is essential for a doctor’s development, Greer said. He wants students to be able to identify a disease, its cause, the social policy that allowed it and a solution. “That’s just part of being a doctor,’’ he said.

Hanadys Ale, an FIU graduate who hopes to be a part of the first class of 40 med students, agrees. She’s done her homework on the curriculum and sees NeighborhoodHELP as a perfect fit. “That’s the way I see medicine,’’ she said.

Ale has known she wanted to be a doctor since she was a teenager in Cuba caring for her ailing grandmother. After studying medicine for three years in Cuba, she immigrated to Miami four years ago and quickly recognized the diversity of campus life in Miami.

“You have to talk to people and find out what they have and how they feel,’’ Ale said. “That’s the primary role of a doctor, to listen to people. Not just see a chart or tests. You have to talk to the patient.

“The most important thing a doctor should do is learn about the culture of the patients, where they come from, what they believe, how they see health(care), because everybody’s different,’’ she said.

Greer and Holder say that if NeighborhoodHELP works, it could help reduce ER visits and increase preventive care. Holder said she would be happy if the program simply helps families learn how to break down barriers to healthcare, just as she has helped the Vassells.