Saturday, 19 April 2014
The People's Doctor
Color Magazine Feature-"I used to always say to my family," recounts Dr. Chidi Achebe, "why is it that when you go to clinics in the wealthy neighborhoods, like Wellesley, they have labs? Why don't we have that here in Dorchester?" Standing in front of the door that leads to the newly installed laboratory at Harvard Street Neighborhood Health Center, located in the Dorchester neighborhood of Boston, Achebe turns the knob, opens the door and enters the lab with his arms spread wide open.
"I don't ask that question anymore," he says. "If it's not in Wellesley, then I don't want it here. I just want the same standards, since we're in the same country."
The newly developed, state-of-the-art lab is decked out with several computers, microphones, freezers and fancy machinery that can conduct urine analyses, blood work and other tests that, less than two years ago, had to be sent to an off-site lab.
"In a recession we've been very blessed," says Achebe who took on the position as executive director of Harvard Street Health Center 18 months ago.
The lab was a gift of the University of Massachusetts Memorial Labs, one of the largest and growing lab companies in the New England region.
"They pumped close to four hundred thousand dollars into the center, with facilities galore so that we can provide our patients with the best of standards."
"A lot of this came through pleading," he says proudly. "You go and you say to them, ‘Listen, please!' And it's amazing how powerful the word please can be. It really does a lot."
Leading the way out of the lab and into the Dental Department, Achebe points into a room where an empty, bright orange dental chair sits cocked up and ready for the next patient.
"We're very proud of the dental section. The facilities here are first-rate, and we have a director who trains fellows, which is unique for any dental department. We have five residents from Boston University that rotate through, and we are able give them the kind of education one would expect from a hospital."
Down the stairs, and in the main lobby of the health center, he looks around, smiles and says, "This building has had many lives." Looking up at the ceiling and around the room, he continues, "Believe it or not, it used to be a Volkswagen lot 42 years ago, and that's about how old Harvard Street Health Center is."
But it has only been since Achebe took the job and hired an outstanding team of medical workers, that Harvard Street Health Center has received, what he calls, a facelift.
The Center has historically concentrated on primary care but with a difference - according to Acheb, they are open to black men with criminal records who are being released on parole.
"I am a black male, and I think that one of the things that we are suffering from in our community is the fact that our men have not gotten the kind of health care that they deserve. They're not able to function in the family unit to lift the whole family, and one of the things that we want to remind the men is, that if the pathology is yours, then it's going to be ours as a community, because people look at themselves as silos. But if the men are not taking care of themselves and it's all about the women taking care of the kids then the balance isn't there."
To him, it's not about being married but about the children.
"I'm not here to preach to you about how the structure of your relationship is, but I am here to remind you that if you do not play your role as a black male in the community the children will suffer and so we have another generation of pathology."
The Center also has a food pantry that is conspicuously tucked away in its basement.
"This is a big secret," says Achebe. "One of the reasons why this pantry is arranged this way is to give our patients the respect that they deserve. We want to make it possible for people to come here and leave without drawing any undue attention to the fact that they are here picking up food."
Outside of the building, several feet away, is the metal skeleton of a structure that Achebe says is the Center's dream. "We want to move into the new building - which is 10,000 square feet, and we are hoping that if everything goes well with that building, we will have space for radiology, eye care, hematology and other special services. The idea being that you walk into the building, you see your doctor, visit the pharmacy, and then you go home without having to be referred out to anywhere."
Achebe calls this the money saving model.
"I can deliver the same services at a fifth of the cost of a fancy hospital with doctors that are just as well-trained."
Taking a moment to mention a handful of the doctors that he has on staff, Achebe continues, "We have been blessed with fantastic physicians who are committed to the community. My commitment to them is to work as hard as I can to help keep the standards similar to what you would expect in a mainstream hospital so that these well-trained doctors don't feel like they're slumming. You want them to know that they are working in our community and it's not so bad. That's why we're trying to get into this building next door, and if we get everything else that we're dreaming of then guess what? It's in Dorchester!"
With seven major health clinics located throughout the neighborhood, there has never been a plan to have so much compacted into just one of the centers in Dorchester. The strategy, says Achebe, is to be the first.
"I spent two years getting an MBA from Yale University and one of the things that I loved the most about the time was a course that I took on strategy. Getting to the finish line first is a humongous strategic advantage because you get to announce, ‘Hey, I'm here!' Anyone else who is getting there behind you looks like a copy-cat."
When asked to suggest some strategic approaches to the national healthcare crisis, Achebe cited a unique trend taking place in hospitals throughout the city of Boston, which involves hiring doctors who can run hospitals - like himself.
"A lot of these doctors can be productive towards the bottom line because they can see patients. I'm in clinic part of the week, so even though I have an MBA and I can speak the business language, I am also contributing to the bottom line as opposed to some figure that is clearly getting a big salary. Clinicians, physician assistants, nurse practitioners, any one of these people, with an MBA and the experience, can run a clinical setting. All of the major and tertiary hospitals in Boston are run by medical doctors and I think that is the future."
The Center is open twelve hours per day on weekdays.
"That's part of what the federal government wants; to move the health care model away from nine to five, making it convenient for working people. In the past, people would end up in the emergency room and that drove up the cost of health care because there was nowhere else to go and it was so expensive to go to the emergency room. But if you know that your doctor is there until eight, then you don't have to go to the ER, and the cost comes down."
Targeted medical care is another area that can be useful when dealing with the healthcare crisis, according Achebe.
"There is a statistic out of Oklahoma that says that there is an area where there is one doctor per every 10,000 patients. We can't have that in America. We don't need another doctor to go to Massachusetts General Hospital. What we do need are more doctors in Dorchester, Oklahoma, Appalachia and other places. And it's not about race at all, it's about need. Targeted medical care will be very useful in making sure that all Americans get a certain quality of care, and that's what we need to begin to look at."
He also says that there needs to be an open dialogue where more information is provided to the population about why healthcare is important and how that impacts everyone.
"What happens in Dorchester, will eventually impact everywhere. Let's just say that there's an outbreak of some dreaded disease because they've had terrible healthcare. Do you think it will not come to your community? It will. It should be our selfish motivation to make sure that everyone gets good health care because it protects us all."
Achebe is the son of acclaimed Nigerian novelist Chinua Achebe whom he says is his greatest role model. "I've learned a lot from him, and I call him every night. He's the reason why I call the community of Dorchester my own, because he broke through the myth. You are me and I am you. James Baldwin said to my dad before he died, ‘You are my brother that I have not seen in four hundred years.' That was so deep. We have to begin, as people with shared histories, to understand what that means and where we fit in it."