By Jason L. Lohr ’01
Seven years ago, my wife and I returned from the mission field to be with family who needed us. We had spent five years in Nigeria and two years in Honduras and were unsure how we could continue to serve in the United States. We settled in the Loma Linda area, and in this next phase of our lives, my wife and I opted to engage the underserved population in San Bernardino via SAC Health System (SACHS). Started as Loma Linda’s Community Health Clinic in the 1960s, many of our alumni have rotated through SACHS.
Around a year ago, we started a unique type of grand rounds at SACHS. Called Health Disparities Grand Rounds, this monthly meeting of all clinicians and staff highlights our integrated care model and our unique combination of both vertical (behavioral health, social work, community health workers, clinical pharmacists, and dieticians) and horizontal (Gateway students, Loma Linda University graduate students, residents, fellows, and attendings) education that exists at SACHS.
The synergy that exists from this model makes SACHS not only an amazing opportunity for learners but also the ideal setting to care for patients. Having such a wide spectrum of services allows the family medicine resident to walk down the hall to get a sidewalk consult with orthopedics or OB-GYN, the internal medicine or pediatric resident to ask a specialist (who is seeing patients in the same pod) about a challenging case, and a specialist or dentist to connect patients with primary care so that all of the care a patient receives is in one location. Where else can a patient receive high quality medical, dental, and behavioral health care all in the same day?
At Grand Rounds, we get to see our staff in action as the entire team (behavioral health, social work, community health worker, medical assistant, pharmacist, dietician, resident, and attending) participates in the presentations. However, the highlight of Grand Rounds is always the patient stories. What makes this so unique is that we do not just talk about cases; we have the patients themselves come and share their story. We interview them, and the focus is not only on their medical diagnosis but also on how they access care, what challenges they have getting the care they need, and how we as an organization are fulfilling our Mission. And the stories have been powerful.
There was the young woman who was sexually abused as a foster child during her teenage years. She lived outside of California, visited her pediatrician multiple times during those years, and was never asked about safety in the home or abuse. If asked, she said she would have shared her story. She now has a small daughter and is studying to be a medical assistant, determined to prevent a similar situation from happening to others. Moved by her story, our clinicians apologized publicly for how the system had failed her. What better way to learn not to skip those critical questions than to see a patient share her story about not being asked those questions?
Then there was the orthopedic patient who had bilateral shoulder replacements due to multiple years of severe domestic violence by her husband who beat her close to death multiple times and even collected money from other men to sleep with her. She endured this for years, thinking it was normal and that she deserved the treatment. Abused as a child, she did not know anything different. Her whole life had been filled with trauma. She finally left her husband and found a counselor who helped her process all the years of abuse. She began to study to become a psychologist and found the strength to choose to counsel not victims of sexual violence but perpetrators of sexual violence. As she counsels the perpetrators, her experience has been that she finds that they have also been scarred by past abuse.
There was also the real estate agent who came to our addictions clinic after many years of heroin use. He had lost his job and his wife was ready to divorce him. One week after he became clean, his best friend, who he always injected drugs with, overdosed and died. If he had not become clean, he would have been with his friend at the time, and he is convinced he also would have overdosed since the heroin the friend used was tainted with fentanyl. Now, this young husband and father has been clean for more than a year and has his job back as well as his wife and children back. He shared his story at our Grand Rounds as well as the Loma Linda University Church a few weeks later. With tears in his eyes, he shared his gratitude to SACHS for providing him the resources to become clean.
These are only a few stories of the 31,000 patients and 120,000 office visits at SACHS clinics in 2018. SACHS has grown significantly in the past few years and now has clinics in both San Bernardino and Riverside counties, 29 specialties, 240 attending physicians, and 200 residents seeing patients within the clinic system.
As CEO of SACHS, I am more than convinced that the communities we serve are true mission fields and an amazing setting for local service.