Posted on: June 8, 2020
By Shelley Wong
Lemuel Vince S. Rivera, a first-year School of Medicine student and member of the San Joaquin Valley PRIME program, is reconnecting with his Filipino community as a student coordinator at the Mabuhay Health Center (MHC), a UCSF student-run free clinic focused on meeting the care needs of underserved Filipino Americans and other residents of San Francisco’s SOMA district.
“Living in America, in Ohio and Fresno, I grew up without other Filipinos around me that I could connect with and share my experience as an immigrant and as a Filipino. Working in this clinic, I am able to serve the community that I haven’t been engaging with for a long time, which is very fulfilling. I’m also able to connect and work with other Filipinos in the Schools of Dentistry, Nursing, and Pharmacy,” says Rivera, who immigrated to the U.S. when he was eight years old.
MHC was founded by Alvin Teodoro, MD (shown in photo with a reunion of students and volunteers at MHC), community members, and Bay Area university students, including health professional students from UCSF Schools of Dentistry, Medicine, Nursing, and Pharmacy in 2009.
Third-year pharmacy student Francesca Alcala says, “One of the core values of MHC is providing culturally competent care and through MHC’s emphasis on learning about the Filipino culture, health disparities our population may face, and ultimately, putting cultural humility at the forefront of our communication with patients. I’ve gained skills and experiences that can’t be taught in a classroom. As a Filipina-American immigrant myself, serving in MHC has been my way of giving back to my community and the lessons I’ve learned have shaped the type of healthcare provider I aim to be.”
The clinic emphasizes collaboration and exchange, where preceptors, students, community members, and patients can teach and learn from each other about providing optimal care for the community.
Jennifer Cocohoba, PharmD, professor of clinical pharmacy, says, “Serving as a faculty advisor for MHC is a highlight of my month. The spirit of collaboration, communication, and respect between health professionals that is modeled for the students is the cornerstone of what makes interprofessional care so effective. The small touches such as providing healthy, but culturally relevant meals and snacks for the patients, the ability and willingness of MHC to pilot new workflows and changes, and bearing witness to several general volunteers moving on to become health care professionals -- MHC is a really special place.”
The clinic’s interprofessional design is unique for a student-run clinic. The encounter begins with a pre-visit huddle with students, health coaches, and faculty. The team determines what should be the focus of the visit, based on chief complaint, history, and any notes from the health coach.
Students then meet with the patient as a team representing all four health professions. The pharmacy student will ask about current and past medications, the dental student will conduct an oral exam, and the medical and nursing students focus on medical history and do a physical exam. At the end of the patient encounter, the student team comes together for discussion, then presents the patient to an interprofessional team of preceptors where they develop plans for the patient for discharge. Often, a translator is present since there is frequently a language barrier with the elderly Filipino population.
Since the fall quarter, Rivera has been gaining insight into how his peers from other schools think and work, and adjusting as a medical student. “Nursing students will ask certain questions that they’ve been trained for that I miss or haven’t been trained to ask yet. Some are second-years and they are more experienced with some of the diseases than I am as a first-year medical student,” he says. “Working with other students at Mabuhay gives me a much richer medical school experience. It’s once a month so we all get closer and learn about each other’s roles, sharing feedback on how we can improve as teammates and build better communication.”
Alcala further explains, “As an interprofessional team, we learn about the clinical decision-making process that each member brings to the table whether it be watching out for adverse drug effects, considering the socioeconomic factors that play into the patient’s presentation, and determining patient’s access to quality medical and dental care. I’m always amazed at what I can take away from my peers in other professions while also feeling empowered to advocate for the role of a pharmacist within these teams early on in our education.”
Jessica Pham, a third-year pharmacy student and clinic coordinator, agrees. “At MHC, I am able to put my knowledge into practice and learn alongside students from other schools about how different health professions approach patient care,” she says. “I have learned how different students work up a patient, what they look for, and how they communicate information to each other and to the patients. What I am most grateful for is the opportunity to work with such a diverse team to provide comprehensive, holistic care to the community.”
Dental student coordinators are similarly inspired by working at MHC, a real-life clinic where "every patient presents with issues that cover all of the professions in attendance" and remarking, "Working at the MHC is one of the great joys of my life!"
Becoming involved with the clinic is a student-driven application process. Annually, UCSF students put out the call for volunteers and the student directors help select the final cohort.
The clinic offers a space for volunteers like Alcala, Pham, and Rivera, as well as local residents, to build Filipino-American community. “Many of our patients are elderly Filipinos who live on their own in single-room occupancy hotels or in a group home with other elderly patients. The clinic is an opportunity for them to connect back to Filipino culture because of who we are and the social celebrations we hold throughout the year like Christmas,” he says. “Being at Mabuhay is a way for me to connect with my culture and be more at home with my work.”