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Featured Member

Community Member First, Doctor Second

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."

Briefly, what is the mission of your organization?
What do you most want people to know about the work that you do and the unique characteristics of your organization?
What are you passionate about in your work? What has motivated you to become involved in community-university partnerships?
What is your dream for the future of your organization and/or community-campus partnerships you're involved in?
What wisdom would you like to communicate to others in this field? What advice would you give to a student or professional just entering into the field?
What is the biggest challenge you face in your work and how are working to overcome it?
If you could give advice to a policy maker (Congress, President, Secretary of Health, Surgeon General, etc.) what would you recommend? Say?
Why did you join CCPH? How would you describe the organization to your colleagues?
What does "community-campus partnership" mean to you?
What value do you see in being a member of CCPH to meet your future goals for your organization and for the field?
What strengths and talents do you bring to CCPH?

Q) Briefly, what is the mission of your organization?

Adam Gordon enjoys making a difference in the lives of the underserved.

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.

Q) What do you most want people to know about the work that you do and the unique characteristics of your organization?

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.

Q) What are you passionate about in your work? What has motivated you to become involved in community-university partnerships?

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!

Q) What is your dream for the future of your organization and/or community-campus partnerships you're involved in?

Adam meets with one of his students during a weekly mentoring session.

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.

Q) What wisdom would you like to communicate to others in this field? What advice would you give to a student or professional just entering into the field?

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.

What is the biggest challenge you face in your work and how are working to overcome it?

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:

  1. An integrated data management system that can facilitate patient tracking through multiple systems of care;
  2. Pilot programs that avail the social support and community-based services our partner agencies have available in a health promotion, disease prevention-based model that reduces health service utilization;
  3. Patient pathways to allow patient care to be redirected from more expensive, tertiary care sites to community based settings with wrap-around services;
  4. Means to increase and foster greater community collaboration and inclusion;
  5. Curricula for students, residents and faculty that facilitate teaching and learning in these settings.

Q) If you could give advice to a policy maker (Congress, President, Secretary of Health, Surgeon General, etc.) what would you recommend? Say?

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 our partnership.

Q) Why did you join CCPH? How would you describe the organization to your colleagues?

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.

Q) What does "community-campus partnership" mean to you?

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!

Q) What value do you see in being a member of CCPH to meet your future goals for your organization and for the field?

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!

Q) What strengths and talents do you bring to CCPH?

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!

For more information please contact:

Adam Gordon
Assistant Professor of Medicine
University of Pittsburgh
Sect of GIM (130-U), Room 11E-118-U
University Drive C
Pittsburgh, PA 15240
Phone: (412) 688-6000 x5264
Email: adam.gordon@med.va.gov
CCPH Member Since: July 11, 2001

To read about other previous featured members click here.

 

 
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