Past Featured Member
The new CCPH Featured Member is John
Blossom, Project Director for the California Area Health Education
Center (AHEC) in Fresno, California. In this spirited interview John explains
how after nearly three decades of work with the California AHEC he has
witnessed the transformation of patients and doctors in underserved communities,
the return of physicians to communities they grew up in, and why the California
AHEC is more than just a training program.
Q: Briefly, what is the mission of your organization?
A: The mission of the California Area Health Education Center (AHEC) is to improve access to and quality of health care for underserved Californians by funding community-based health workforce training activities as outlined within the framework of community-academic partnerships. In its 30 year history the California AHEC has launched many well-known and now self-sufficient programs, such as founding the Drew College of Allied Health, the Pacific AIDS Education and Training Center Program, and the California Health Education Training Center Program. A new program that we are excited about is called "Hablamos Juntos." We are helping a pilot project in the central valley which will train and certify Spanish language interpreters and the health professionals who work with them.
A: The AHEC is one of the few statewide University of
California programs that engages communities and health professions schools
in conjoint assessment, planning, and implementation of activities that
respond to community health workforce needs and opportunities. The ten
centers which receive our University of California and Health Resources
and Services Administration (HRSA) support are all skillfully sustaining
partnerships; this is no easy task, given that the kind of communities
AHEC targets have not often had the experience of successful partnerships
in any form, let alone with health professions schools.
A: First of all, I cannot imagine NOT doing this for a living! I am passionate about asset investing....many of the raw materials needed for the solution of health workforce problems are in underserved communities already. Examples: the many AHEC pipeline programs are identifying youth with potential and "ganas" (drive or desire in Spanish) who are moving into health professions and careers. This is now starting to happen even at the Junior High level and we will reach down to kids as young as we can to recruit more people to health professions because these recruits bring so many assets with them - familiarity with language, culture, and community health issues. As these recruits come into contact with AHEC faculty around the state, they double their efforts to achieve their dreams. And fulfill them they do! Some AHEC programs now boast of having high school participants returning to work as physicians in the communities they grew up in! And they are not just serving as highly effective caregivers but as educators too. Because of this we are now more than just a training program I am happy to say we're much more comprehensive than that. We are a part of all phases of the process - "recruitment, training and retention." I can't tell you what a difference this makes in the delivery of health care to the underserved.
A: The ten AHEC centers which are so busy and so successful do not nearly cover the state; neither geographically nor in terms of the sheer size of its population. I would like to see twenty AHECs in California; that would mean ten new centers located around the state. The development of these partnerships would be a challenge, indeed! But the contributions that ten new community-academic partnerships could make would be tremendous. It really takes a special mixture of community will and wisdom in combination with academic know-how and standards for each AHEC center to be successful. So the labor required would be great....and so would be the rewards.
A: I have been involved with AHECs since my residency (I graduated in 1974) and, thus, I still consider myself to be a "student" of the process. Each community with which the AHEC relates seems to present learning opportunities for me personally. My advice, mostly to myself, is look for the strength that underlies the status quo. By this I mean a lot of literature and experts focus on "health problems" and "social disasters." Why do we always focus on studying minority health problems and not look for the strengths that these communities possess? Often in these same communities you will find incredible assets such as commitment to overcome the current situation, ability to deal with adverse circumstances and build a better life. The tragedy of the "problem-focused approach" rather than an "asset-based approach" is that it often results in pouring a lot money into an area without much success. The real solutions lie in the communities themselves. If you draw upon the resident wisdom, you will be able to pull assets in line with problems and you will make your money count! This is one concept that I have unreservedly co-opted from CCPH. Essentially, let's take the wisdom of the community and the knowledge of academe and put them together. But the key is that the community must first identify the problem. The knowledge comes from the community and the energy comes from the communities and the partnerships. That is where the responsibility for success also must be centered!
A: Nationwide and in California it has proven difficult to measure and quantify the impact and measure the successes of AHEC programs despite the fact that anecdotal and narrative information abounds.
I could tell you so many impressive stories that otherwise just wouldn't show up on the radar screen. One that sticks out in particular happened 15 years ago already. I was part of a then daring plan to start a family medicine practice with only bilingual female physicians. At the time naysayers wondered out loud "Who is going to want to go see a bunch of female family physicians?" Not only did they thrive, but there has consistently been a long waiting list of patients who want to get into the practice. In reality, these physicians have been able to access significant numbers of patients from underserved communities and now these patients won't even think of switching to another doctor. More importantly, these patients have demonstrated a greater willingness to talk about complex issues and change behaviors.
Not only are these doctors medically competent but they are also relationship-competent and that has made all the difference. I believe one of the keys to success as a doctor in family medicine is the ability to be good at relationship building - this is part of being a member of the community. It is an amazing thing to watch a doctor/patient relationship transition from being guarded to open. This new relationship unlocks an empowerment for the patient as she/he begins to trust the doctor and follow the prescribed remedy. This is not a quick fix approach, but it is a key factor in changing behavior and having success with patients. If you increase competency in these areas you will increase capacity.
A: Administration assertions that the AHECs are "not effective" are not founded on good data; AHEC and the Health Resources and Services Administration should collaborate on the construction of measurement tools that are reliable and capture the reality of AHECs and, in particular, demonstrate accurately what AHECs have achieved.
A: When CCPH was forming I saw it happening in the distance. I didn't quite fully understand it at first but then I had my "ah-hah" moment. At first I thought it was very similar to an AHEC but then I discovered that CCPH was much bigger than that and ahead of the curve. My experience with CCPH has helped me expand the AHEC consciousness of community, academe and service-learning. All of our activities can now be viewed from the CCPH philosophy; in many ways AHECs and CCPH were "made for each other." The vision that communities and academic campuses can collaborate to improve health and access is central to both organizations. The additional contribution of CCPH, that service-learning is of value to those serving as well as those served, is a wonderful addition to the AHEC armamentarium. If you like what AHECs are about, you'll love CCPH!
A: Due to my relationship with CCPH, I have a much more sophisticated view of community-campus partnerships. It is exciting and very satisfying, to help get academe participating in a balanced fashion with communities.
A: I am an avid reader of the e-newsletter and have found it very helpful as a tool to keep me up to date. I have attended CCPH presentations and found them to be stimulating and energizing.
A: I like problem solving. I like to build collaboration, consensus, and coalitions. I appreciate diversity because I live in California. I am not sure if these are strengths or talents; they are my perspective.
For more information about Area Health Education Centers in California please contact:
H. John Blossom
To read about other previous featured members click here.