The CCPH Featured member is Adam Gordon, core faculty member, and director of detoxification services, of the Program for Health Care to Underserved Populations (PHCUP) within the Division of General Internal Medicine at the University of Pittsburgh School of Medicine. As a medical student in the early 1990s, Adam was one of the first trainees in a partnership between Pitt Medical School and the Salvation Army - now he's helping to lead it. The experience of going from being a mentee to being a mentor in the partnership gives him an invaluable perspective that he now freely shares with the students he trains. When Adam talks to them about seeing himself as a community member first and a doctor second, they understand that he is not just pursuing a career but a passion. Sometimes students, colleagues and even patients are surprised by his attitude but more often they are energized by it. Therefore, it is no wonder why he was recognized by the Pittsburgh Post-Gazette in 2001 as one of the "Dozen Who Are Making A Difference" and received the American Medical Association's Young Physicians Section, 2001 Community Service Award. Of course, he merely shrugs the praise off, "The recognition that I have individually achieved is but a measure of the support of others around me."
what is the mission of your organization?
A: I am a core faculty member, and director of detoxification services, of the Program for Health Care to Underserved Populations (PHCUP) within the Division of General Internal Medicine at the University of Pittsburgh School of Medicine. CCPH member Thuy Bui leads PHCUP and has provided excellent direction. Wishwa Kapoor, Chief of the Division of Internal Medicine at the University of Pittsburgh, continues to support the multiple services, education and research missions of the program.
PHCUP was founded in 1992 by CCPH members Thomas O'Toole
and Paul Freyder. This community-campus partnership began as a free-care,
drop-in medical "clinic" at a Salvation Army drop-in center.
After more than 10 years the partnership has become a regional leader
in providing free health care to underserved populations, and conducting
research involving disadvantaged populations. PHCUP trains hundreds of
health professional students annually about how to care for the needs
of underserved people. Volunteer physicians, health professional students
(medical, pharmacy, nursing, nurse practitioners) and service providers
(e.g. AmeriCorps members) provide entirely free healthcare to the underserved
community of Pittsburgh at nine clinical sites in five locations every
week. The partnership has been recognized for its collective accomplishments
by the US Department of Heath and Human Services and various regional
organizations. Several of our faculty and community members, who lead
the partnership, have also been individually honored for their leadership
in providing health care to underserved populations and health education
to students by such organizations as the American Medical Association,
the Pittsburgh Post-Gazette, and various foundations.
A: Nothing exists in a vacuum. Although it only takes one person to make a difference, it takes the concerted efforts of many dedicated colleagues and staff, in addition to an institutional commitment to make lasting change. I am proud that I am a collaborative member of a larger partnership that provides real services to underserved populations.
Just as importantly, community and campus program mentors have fostered faculty and community leadership development. I am a product of this mentorship. Initially, I matriculated through the program - first as a medical student at the University of Pittsburgh and then as a resident in internal medicine and fellow in internal medicine at the University of Pittsburgh.
As a fellow, under the mentorship of community and campus leaders, I became the Medical Director of two substance abuse facilities in Pittsburgh: The Salvation Army Public Inebriate Program (a residential detoxification program) and The Salvation Army Harbor Light Program. The experience made a significant impact on my decision to become an academic faculty and investigator focusing on underserved populations.
I now serve as a mentor to students. I am excited about developing a graduate level community-campus partnership training program at the University of Pittsburgh to enhance the ability of future physicians to promote scholarly, service, and educational activities in underserved communities.
A: While I am energized by delivering
health care to disadvantaged populations, my passion toward this work
is teaching young professionals about providing this kind of care. I often
host pre-clinical medical students in my evening clinics. I am so excited
to see the rapid progression of these students in the clinics. In the
blink of an eye they transition from being afraid to see a drug-abusing,
homeless patient to enthusiasm about staying past clinic hours to interact
with the patients more. It is extremely satisfying when I go home to know
that I have helped to dispel myths about homeless people, emboldened students
to learn more about homeless health care, and encouraged students to serve
the underserved. It's no wonder I am passionate about my work!
A: My dream for the future of the Program is to increase our capacity to attract other volunteer health professionals to help the underserved of Pittsburgh and to increase the capacity of our Program to conduct quality community-based participatory research and health services research to improve the quality of health care to this population. As we struggle to confront the challenges of sustainability, I am excited that the growing pains exist only because we have maintained our commitment to serve the underserved.
As a core faculty in several large research programs
I am excited that my interest in community-based participatory research
is gaining academic acceptance. I am looking forward to PHCUP collaborating
with multiple research endeavors. The research programs I now work with
as a core faculty are: the Center for Health Equity Research and Promotion,
VA Health Service Research and Development Center of Excellence based
at the VA Pittsburgh Healthcare System, Philadelphia VA Medical Center,
Center for Research on Health Care at the University of Pittsburgh and
the VA Mental Illness Research, Education, and Clincial Center of VISN4.
All of these research programs have embraced interventions to improve
underserved community health.
A: Simply put: Get involved and stick with it! Too often, when just getting in this field, people get frustrated. I often relate to them that this is natural part of the process and not the end result. This is especially true in community-campus partnerships because there are often diverging political agendas. A leader, organizer, and collaborator can bridge these agendas. It is also a learning process, an EVER CHANGING learning process. There are no "professional" partnerships or leaders in the field. Everyone is faced with unique challenges regardless of where you are in the maturation partnership process.
Thus, the one thing I would like the readers to know is that community-campus partnerships can be difficult to accomplish and maintain, but are personally very rewarding. Even though we all face challenges, such as sustainability, resource limitations, and changing foci of community and/or academic leaders, maintaining the focus of your partnership is paramount to overcoming these challenges. On a personal level, the focus I have maintained in my partnership has enabled me to become a better community advocate, clinician, and educator regarding underserved and disadvantaged patients.
While this partnership was developed and grew in response to a need, it has also positioned itself strategically to respond to challenges in the evolving health care delivery arena. These upcoming challenges include: (1) the advent of Medicaid capitation and mandatory managed care enrollment; (2) the current carve-out of behavioral health care services for patients with complex and multidisciplinary needs; (3) the positioning of the University of Pittsburgh Health System within lower socioeconomic status communities and the risk-bearing role it now has as carrier of Medicaid insurance products; and (4) the need of health professional schools to shift their teaching sites to outpatient settings and to incorporate issues of care to disadvantaged and distressed communities into their curricula for accreditation and grant-writing purposes.
To meet these challenges, this partnership is developing the following initiatives:
A: My advice would be simple
and direct: see it for yourself. Too often leaders rely on other "leaders"
to gain perspectives of problems and solutions. Policy makers should see
the problems for themselves, talk to "frontline" personnel,
and go beyond the "executive summary". Too often policymakers
are entrenched in their own environment and not cognizant of the unique
needs of the environments that they are responsible to lead. Hunger cannot
be solved by a piece of legislation or a committee. Hunger can be alleviated
by providing people with resources or reducing the barriers that exist
for current resources to work. Clichés work in partnerships. My
favorite is "small steps win marathons" not giant leaps. I use
its message everyday, particularly with regard to my association with
A: CCPH is an organization that
provides a networking of community and campus members dedicated to enhance
cooperation between often disparate groups. I joined CCPH for the camaraderie,
the education, and the networking with like-minded peers.
A: An ideal of a partnership is when the community and the campus cease to be independent from one another. In other words, the partnership becomes such a powerful relationship that it is greater than the sum of the parts while retaining the identity of the parts. I often describe this in an equation of inequality:
one community + one campus = one partnership
The campus and the community partner are often unique regarding the challenges that they face and how they face them. A successful partnership is one that bridges those separate challenges and faces them as a new entity - the partnership. When I look back upon the partnerships that I have worked to establish, I feel the positive outcome is when I can no longer distinguish the community member from the campus member. The partners have created an equation of equality and of strength. We are simultaneously functioning separate and as one.
Personally, I now affiliate myself more as a member
of the community than of the campus. This is sometimes a surprise to my
bosses and other faculty!
A: CCPH has allowed me to strengthen my ties with other like-minded faculty and persons committed to community and campus partnerships. I have enjoyed the networking at the national meetings. I have been encouraged by CCPH's commitment to enhance the scholarly aspect of community-based participatory research and community-campus partnerships.
CCPH allows emerging partnerships to increase their ability to network with other partnerships that have similar challenges. CCPH has helped our maturing partnership confront challenges of sustainability and rapid growth.
The field can only grow. However, with emergence of
many maturing partnerships (ours is 10 years old!), a new set of challenges
will need to be confronted. We look forward to conquering them!
Besides my association with the Program for Health Care to Underserved Populations, I have recently been thrilled to assist in the development of the Free Clinic Association of Pennsylvania (FCAP). This organization will help assist emerging free clinics to network with other more established clinics. I am excited to see how CCPH and FCAP may collaborate in the future.
Otherwise, I would say my strengths are in 1)
community-based participatory and health services research, 2) community
and campus advocacy, and 3) undergraduate and graduate education regarding
community-campus relations and research. In addition, people say that
I am fun to be around
which is the best strength and talent of all!
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