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Stanford University School of Medicine

Health care in communities: A MD/MBA student reflects on a recent visit to West Virginia

IMG_1817I recently traveled to Mingo County, West Virginia with business students and innovators from across the country as a member of Impact Experience, an organization that works alongside community leaders to stimulate investment in local initiatives. Our goal was to help the Williamson Health & Wellness Center (WHWC) with its efforts in health, education, workforce development and tourism.

I was excited to work with Christopher Beckett, DO, the medical director of WHWC. Beckett is a family medicine physician who leads efforts in patient care and regional economic development. He does these not as separate jobs, but as a cohesive strategy for addressing health disparities. This is a rare feat. In my opinion, medicine does not incentivize physicians to contribute outside of clinic settings. Such work is often framed as extracurricular or recommended as a late-career focus.

After Hurricane Katrina, Beckett visited New Orleans to understand how entrepreneurship had played such a large role in the city’s rebuilding process. His own city and the health of its people was also suffering from a disaster: the downturn of the coal industry.

Employment in Mingo County has fallen by 30 percent in the last two years. More than a quarter of its 25,000 or so residents now live in poverty, and many are unhealthy - nearly half have high blood pressure and high cholesterol, a third are obese, and a substantial number struggle with opioid addiction.

I often struggled to classify Williamson. Was it like many other small American cities? Or did its poverty stand out? Its downtown, sprinkled with boutique shops and law offices, has a charming aesthetic. Its collection of hillside homes conjures an uncanny resemblance to the foothill neighborhoods of San Francisco. But even the briefest of strolls will reveal signs of difficult times — an unfinished distillery, an empty hotel, and ads for opioid addiction and diabetes programs.

Beckett and his team at WHWC are holding on to hope and creating programs to help the entire region. On the health front, their care coordination and community health worker approach has been shown to improve the health of patients with diabetes. Trained health workers provide diabetes education, regular in-home visits and assistance to patients referred by local primary care providers. The workers update providers on a weekly basis and give recommendations for changes in treatment plans. Initial data suggests the model generates substantial cost savings through reductions in emergency room visits and hospital admissions.

This is just the tip of the iceberg. WHWC’s active lifestyle initiatives have turned a sedentary town into a hive of runners. Its farmers market has expanded to include a mobile delivery service and soon will have a permanent food hub for vendors and cooking classes. And its partnership with the county’s redevelopment agency has helped retrain and reeducate unemployed miners in construction, agriculture and solar energy.

These initiatives are not silver bullets. A successful approach to the opioid addiction crisis, for instance, remains unclear. However, plans to convert one of the city’s hotels into a rehabilitation center in the same part of town that once housed an illegal, physician-run opioid pill mill capture the community’s desire to turn its challenges into assets.

I highlight Williamson not only because I visited, but because its coalition of changemakers are taking incredible risks to build optimism and progress and have pioneered a health care model that resonates with the role I believe medicine should play in communities. I sincerely hope they succeed.

Michael Fu is a MD/MBA student at Stanford. He is interested in adolescent health, youth workforce development and violence prevention.

Photo courtesy of Jenna Nicholas

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