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Board member Dr. Edgar Jackson explains the barriers to health and well-being that many of Cleveland’s inner-city residents face, and discusses how one Saint Luke’s Foundation grantee partnership is helping to overcome these formidable challenges.



Cleveland native Dr. Alexandria Howard aspired to practice family medicine for as long as she can remember. “I always had this idea that family medicine is what I really wanted to do,” she recalls. “I thought, ‘I can care for patients of all ages with a multitude of medical problems…I can change so many parts of their lives in this one setting.’”

Now a first-year resident at University Hospitals Case Medical Center, Dr. Howard is moving closer to achieving that goal. Yet despite her longtime interest in family medicine, she admits that taking the first step along this career path was difficult.

“All of us walk into medical school with the ambition to change as many lives as possible in the best way you can,” she says. “Once school began, though, there were voices from inside and outside the medical community, telling me, ‘You’re too smart to go into family medicine, you’re too driven…all you’re going to do is treat high blood pressure and diabetes. Wouldn’t you want to do something more interesting with your life?’”

Dr. Howard’s dilemma is far from uncommon. Today, the U.S. health care industry faces a 20 percent shortage in primary care physicians. The reasons for this are varied, but its effects on the health and well-being of underserved and vulnerable populations are dramatic.


University Hospitals Case Medical Center and Care Alliance Partnership

“It is a validated fact that countries with better health care systems are those that maintain a strong primary care base,” says George Kikano, M.D., Department Chairman, Family Medicine, University Hospitals Case Medical Center. “Here in the U.S., we have outstanding specialists who deliver the best care in the world – one person at a time, and one disease at a time. But from the perspective of delivering primary care to a broad population, we drop off.”

Responding to this challenge, University Hospitals and Care Alliance Health Center in Cleveland have developed a community-based residency training program that provides clinical care and education with hands-on training at the main Care Alliance clinic. It will develop a new generation of family physicians who are knowledgeable about the unique needs and barriers to care for underserved populations. Moreover, as residents develop their skills, Cleveland’s underserved populations will receive consistent and quality primary care in the process.


The Grant: Family Medicine Residency Program

Saint Luke’s Foundation has supported this University Hospitals--Care Alliance partnership since its inception. In 2011, the Foundation deepened its support with funding to expand University Hospitals’ Family Medicine Residency Program into the Care Alliance sites beginning in the 2012 - 2013 academic year.


Better Health Care for Those Who Really Need It

The partnership will graduate its first group of family medicine residents in the spring of 2015. The expectation is that through clinical and social involvement, bright, emerging physicians like Dr. Howard will better understand the broad health care challenges that urban, underserved populations face, and over time, advocate effectively on their behalf.

“I come from Cleveland, I know this community, and I know about the population that Care Alliance serves,” Dr. Howard says. “Still, the exposure that the Care Alliance partnership provides is really important. By working directly with that population, even if it’s for a short time, I and other residents are forced to take a step back and question whether we’re making assumptions about that population that may or may not be true. As a result, we may need to adjust expectations, and our approaches. That’s a tremendous benefit for the people who are being served.”


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