Patient-to-doctor ratios in 12 Chicago neighborhoods equal to third-world countries'

Patient-to-doctor ratios in 12 Chicago neighborhoods equal to third-world countries'

In 12 communities in Chicago (most of which are on the city’s South and Southwest sides), there are more than 3,000 people for every one doctor. That’s about the same as the patient-to-doctor ratios in third-world countries, like Yemen, Myanmar and Namibia.

Those 12 communities are Ashburn, Auburn Gresham, Austin, Brighton Park, Chatham, Gage Park, Hermosa, Rogers Park, Montclare, Mount Greenwood, Roseland and West Englewood.

But the statistic, shocking as it is, doesn’t surprise Dr. Kohar Jones, a physician at the Chicago Family Health Center, which has a center in Roseland.

“It’s difficult,” said Jones. “We book a few months ahead for a regular appointment. We try to keep open walk-in appointments for emergencies, but sometimes the patient need overwhelms the system and we can’t see everyone.”

Jones has been a physician on Chicago’s South Side for three years, after completing her undergraduate degree and medical school at Yale University. When I asked her about the patient-to-doctor ratios released this week as part of a Feinberg School of Medicine report on Chicago’s health disparities, she said the numbers sound about right.

“When there are uninsured patients, or many patients on Medicaid, it can be very difficult to keep open a private practice,” said Jones. “Private practice is not financially viable in this neighborhood.”

Jones is a National Health Service Corps Scholar, a government program where doctors agree to work in underserved communities for the length of time that they were in medical school. In return, a portion of their student loans are forgiven or they receive scholarships. Even though Jones went to a prestigious school, she said her dream has always been to work in underserved communities.

“It was what had brought me into medicine  – the feeling of ‘What can I do to support a healthier world?’,” she said. “Promoting community health, increasing access was a clear avenue for supporting a healthier America.”

But the work is tough. She sees patients who should have come in years ago, who haven’t gotten routine care or can’t get the services they need. She described one man, a former patient, who tore his biceps’ tendon in a car accident.

“His car insurance paid up to $5,000 to get an MRI, to see an orthopedic surgeon and be told that he needed surgery. Then the insurance ran out,” she says.

The man now has limited use of his arm, and it’s affected his ability to earn a living. He used to do physical labor, but now, that’s not possible.

Then there are the uninsured, who often wait until things are out of control before they seek care, she said. Jones described patients with diabetes who couldn’t afford routine care and medication, and sometimes lost their job when the disease caused severe complications.

“Many patients are uninsured and very cost conscious. It’s difficult to get them specialty care and hospital care when they need it, as they need it,” she said.

Does it get to her? I asked. Such a tough job with so many hard stories and realities. But she’s surprisingly optimistic.

“The weight begins to weigh on you when you feel helpless to change anything,” said Jones. “The problems that I see also have solutions, and as long as I see myself working toward solutions, I don’t feel weighed down.”

What are those solutions? She says we need more physicians going into primary care and being willing to make public health a priority. She teaches at the University of Chicago, inspiring the next generation of family physicians as part of the Urban Health Initiative. Soon she’ll continue that work as the Director of Community Health and Service Learning at the Pritzker School of Medicine.

In addition, Kohar said,  government resources for clinics like Chicago Family Health Centers need to remain strong. And a team approach to health care – centers that include nurses, social workers, case managers, psychiatrists, health educators, and nutritionists – to help meet the needs of their patients.

Chicago’s 12 communities could also use more doctors like Jones who are willing to lower these third-world ratios to make sure Chicago’s citizens have access to care.

© Community Renewal Society 2011

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