Digital Art: A Glimpse into the World of Ill-Housed Individuals through the primary care lens. Created by Peyman Namdarimoghaddam with the assistance of generative artificial intelligence.
As a first-year medical student, I recently had the opportunity to delve into the realm of ill-housed individuals through a 5-week project that encompassed a comprehensive literature review about the role of primary care and shadowing experiences in both an urgent primary care center and an urban outreach clinic in Kelowna, BC. This experience has been truly eye-opening, allowing me to witness firsthand the challenges faced by this vulnerable population and observe the remarkable impact of a multidisciplinary approach to care.
My initial expectation was to encounter patients experiencing homelessness at the Interior Health Urgent Primary Care Center (UPCC), as it seemed to be a natural intersection point between healthcare and this underserved population. However, I quickly realized that the visibility of this group was far greater in an inner city clinic located in the downtown core, the Outreach Urban Health (OUH) clinic. This realization highlighted the critical role such outreach clinics play in addressing the unique healthcare needs of marginalized individuals.
The OUH clinic demonstrated an exemplary model of care, incorporating a diverse team of healthcare professionals ranging from doctors and nurses to psychiatrists, social workers, and life skills workers. This interdisciplinary approach enabled comprehensive and holistic care, addressing not only physical ailments but also the complex psychosocial needs of ill-housed individuals. Witnessing the implementation of the findings from my literature review within this clinic was both inspiring and affirming, reinforcing the importance of evidence-based practice.
One aspect that particularly impressed me was the clinic’s mobile outreach service. By reaching out to shelters and specific locations where marginally housed individuals are known to seek refuge, the clinic ensured access to care for those who face significant barriers in seeking traditional healthcare services. Furthermore, the clinic’s commitment to expanding telehealth services underscored the potential of technology in bridging the gap in healthcare accessibility. However, the practical challenges faced by this population, such as limited access to phones and reliable internet connections, served as stark reminders of the obstacles that still need to be overcome.
Collaboration between health and other agencies that provide services to ill-housed individuals such as social services, community-based organizations, and emergency services, to holistically address the complex needs of this population emerged as a recurring theme throughout my project. The OUH clinic recognized the importance of connecting with external stakeholders, such as housing providers, to address the multifaceted needs of their patients. However, discussions within the clinic revealed a desire for improved communication and collaboration, suggesting that even successful models of care can continually strive for enhancement.
One area that left a lasting impact on me was the urgent need for diverse housing options for the marginally housed population. Traditional housing providers often reject individuals with complex conditions due to behavioral concerns, leaving them without stable shelter and exacerbating their healthcare challenges. Witnessing the dedication of the clinic team to finding housing solutions for these individuals highlighted the crucial role healthcare providers can play in advocating for systemic changes that address the social determinants of health.
My literature review reinforced the importance of a comprehensive approach to care for ill-housed individuals, encompassing not only medical interventions but also screening for chronic conditions, preventive care, mental health services, health education, advocacy, and patient satisfaction assessment. I learnt that Interior Health, the Kelowna Homelessness Research Centre, shelter providers and other stakeholders are prioritizing enhancing collaboration to better support the needs of ill-housed individuals as part of their pandemic recovery efforts.
In conclusion, this project has been a transformative experience that has allowed me to witness firsthand the challenges faced by ill-housed individuals and observe a model of care that embodies the recommendations put forth by the literature. The multidisciplinary approach, mobile outreach services, and collaboration with external stakeholders have demonstrated the potential to improve healthcare outcomes for marginalized individuals. However, it has also highlighted the persistent barriers and gaps that must be addressed to provide equitable and inclusive care. This experience has invigorated my commitment to advocating for change and has solidified my belief in the transformative power of comprehensive and compassionate healthcare for all individuals, regardless of their housing status.