WVU Family Medicine residents focus on reaffirming humanity

Program provides resources for homeless patients

MORGANTOWN, W.Va. – The process may start with providing basics, such as socks and a sleeping bag. A group of West Virginia University Department of Family Medicine residents offer these necessities to homeless patients who come seeking treatment at Ruby Memorial Hospital.

But the true gifts are listening ears, trustworthy advice, and the reaffirmation of humanity – all wrapped into the package of inpatient care for the homeless population.

The homeless patient consult service began in 2010 as an inpatient extension of the WVU School of Medicine’s Multidisciplinary UnSheltered Homeless Relief Outreach of Morgantown, more commonly known as MUSHROOM.

“We are a group of residents in Family Medicine who are interested in helping the homeless,” said Katie Hill, M.D. “When homeless patients are in the hospital, we go to visit them. We get the story of how they became homeless. Sometimes these patients don't have anyone to visit them, so they are just happy to have someone to talk with.”

Chris Reynolds, M.D., Katie Richardson, M.D., and Hina Zaman, M.D., also participate in the homeless consult service, which includes discussing medications with patients and helping them find them affordably.

“One of the valuable things we do is give them a formulary list from (Milan Puskar) Health Right since that’s where a lot of them get free medication,” Dr. Hill explained.  “We’ll talk with the primary teams taking care of them and say, ‘I see you’d like to give them a beta blocker, but instead of this one that they’ll never be able to afford, they can get this one for free and they’re more likely to take it.’

“We’ll also spend time with the patients, making sure they understand, ‘Someone’s told you that you have diabetes. Do you know what that means? Do you understand why you have to take your insulin? And do you understand how to do it?’” she added.

The hospital consult service grew out of a need Family Medicine residents saw while working during MUSHROOM rounds, which take place every other Thursday on the streets of downtown Morgantown.

“There’s some research showing if you have a hospital consult service, it can decrease re-admissions,” Hill noted. “If you look at homeless rates, most of them use the emergency room for their primary care doctor, and the life expectancy is greatly lowered. The average homeless person’s life expectancy is 42-52 years.

“We’re also starting to address if they have a primary care doctor because it’s much easier to treat a patient, whether they’re homeless or housed, early on in the disease course before it progresses and they’re very, very sick and have to go to the hospital for long periods of time.”

The residents have realized that building trust with homeless patients is an essential part of their work.

“Trust is very hard to come by. It takes a lot of time,” Dr. Reynolds said. “There may be several meetings before a patient opens up enough. Trust precedes communication.”

Dr. Zaman added, “It can take years to build a relationship of trust, especially because of the trauma in their lives.”

Ultimately, Hill noted, she wants to ensure that homeless patients receive medical care that is consistent with care other people are getting.

“It’s nice to be able to help people who really need it,” she continued. “Sometimes in medicine you can get stuck on the drudgery of refilling the same medications or dealing with chronic pain. It’s nice to have someone there who really needs your help, and you can see the benefit of helping them.”

Medical literature about homeless patients, according to Hill, shows that more people are dying of acute and chronic disease, which is in line with the rest of the population in West Virginia, than dying of substance abuse or exposure. “That’s what most people think homeless people are dying of, and it’s not. It’s the same thing that’s killing everyone else – heart attacks, strokes,” she explained.

Before homeless patients leave the hospital, the Family Medicine residents help them find a primary care physician. The residents also provide resources about temporary housing in the area, such as the Bartlett House in downtown Morgantown and its transitional facility on West Run Road.

The residents agreed that the most important way they serve homeless patients is by reaffirming their humanity. “We let them know that they are still humans, and we are not viewing them as a number or a condition, but still a person,” Hill said.

“We’re all called to help our fellow man and woman. You don’t have work in healthcare to do that,” Reynolds shared. “There are creative avenues to fulfill that calling. Providing this service creates a lasting bit of change. It’s the small things that make a big difference, especially when you have nothing.”

Photo captions:
Family Medicine resident physicians, from left, Hina Zaman, M.D., Chris Reynolds, M.D., and Katie Hill, M.D., regularly treat homeless patients at Ruby Memorial Hospital.

Chris Reynolds, M.D., provides a homeless patient with a sleeping bag.