Being a Tulane Medical School alumni, I get a lot of information regarding my alma mater (mostly implying I should donate money). I was heartened to be spammed with a story about the growing clinical presence in community health centers. I have written in the past about the possibilities in such partnerships and have been following Tulane’s progress for several years. They are now involved in multiple sites (website found here) and have plans to expand even further.

I sent a copy of the article to my boss and he wanted to hear what I thought we could do if we chose to emulate Tulane. After some thought, I decided we might focus on these areas:

  • Tulane made a decision to partner with Community Health Centers in part because they were able to draw down resources for caring for the poor better than they could through the old Charity Hospital system . USA Family Medicine should consider partnering with a  Community Health Center and creating a Teaching Health Center under their umbrella. This would enable us to work with Medicaid/Medicare more effectively and use the additional resources to improve the program.
  • Here in Mobile, the community safety net needs to focus on health, not illness (as happened in New Orleans after Katrina). South Alabama needs to be the leaders in this. Someone needs to initiate and carry out a discussion regarding the health of our community, and who better than a medical school. We at South Alabama have focused our energy on taking care of sick people in the hospital and that is not where care will take place in the future.
  • Our medical school should add an emphasis on training learners to care for folks with chronic illness in a non-hospital setting and what better location to do it in than a well run Community Health Center. An article published last week in NEJM demonstrated excellent diabetic care could be accomplished in Community Health Center settings. Why shouldn’t students learn about this first hand?

In short, health care delivery is changing. New Orleans, as a result of a man made tragedy, has had to face some tough choices. Regarding health care delivery, the city seems to be better for it. I hope it doesn’t take a tragedy for the rest of us to take a hard look at our care delivery efforts.

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