Medical Residents Serving the South Side: Expert Q&A

Building trust and partnerships, coming up on At the Forefront Live, we'll discuss UChicago Medicine's Community Champions program, which connects medical residents to South Side neighborhoods, where they provide care and service, and learn more about community health needs. Our experts will discuss this amazing program, and we'll take your questions live. That's coming up right now on At the Forefront Live.

[MUSIC PLAYING]

And we want to remind our viewers that today's program is not designed to take the place of a visit with your physician. Let's start off with having each of you introduce yourselves and tell us a little bit about what you do here at UChicago Medicine. And Dr. McDonald, since you're right here at the desk with me, but six feet away, we'll start with you.

Hey, how are you doing?

Good--

So Tim, it's always a pleasure coming on the show. I'm really happy to be here. I'm Dr. McDonald, I am the Associate Director of Adult Clinical Nutrition and Gastroenterologist here. But I'm also one of the directors of Diversity Inclusion for Graduate Medical Education. So in that role, I help lead our Community Champions program, which is where we're going to be talking about today. So I'm really happy to get into it.

It's a really wonderful program, and we'll get into more detail here in just a few minutes. But I think it's an exciting program, and again, it shows kind of the reach within the community that UChicago Medicine is working to expand, and it's a positive thing. So we have Dr. Ross McMillan also joining us, and now, you're across the room. So we're going to pitch to you in a little box. Tell us a little bit about yourself and what you do here.

Absolutely. Yeah, thank you for having me. So as you mentioned, my name is Dr. Ross McMillan. I just completed my three-year internal medicine residency here at the University of Chicago, and now I'm serving in the role as Chief Resident for the Internal Medicine program. I also served as one of the inaugural members of the Community Champions cohort this year.

Great. And I noticed you're an MD and PhD, what's your PhD in? I'm just curious.

Yeah. So I did some oncology work, looking at pancreatic cancer stem cells.

That's fantastic. Low achiever, MD, PhD.

[LAUGHTER]

I don't know what you do with your spare time, but wonderful programs. So we've heard a lot about the Community Champions program, at least I have, because I've been talking to people recently about it. The program does some cool things. We were just talking before the show started, Dr. McDonald, you mentioned that it's about a year old roughly.

Yes.

And so started up during COVID, which is a feat in on itself, but also, probably a very appropriate time to start it up too, because this is an opportunity to really work on some outreach with the community. Can you tell us a little bit about the background, and why you all do this?

That's a great question. So the background really came from working with Dr. Anita Blanchard, who's also native Chicagoan and great friends with Obama, and really a great physician and really a good mentor here, and a great leader at the institution. So I, like her, I'm also a Chicagoan, and we have definitely identify that there is more of a need for physicians to get involved in the community and work within the community, and work with a lot of community groups that address a lot of the social determinants of health.

So our reach within our clinics, I mean, you can only see the patient who's in front of you. But that does not necessarily mean that there's demands or issues within the community that we could address also, just by being outside of the institution.

So the Community Champions program was really an opportunity to help get our residents exposed to the community, specifically the South Side of Chicago. And encourage careers, or at least having a focus of community outreach. And one of the ultimate goals was to use this as a tool to really recruit physicians, and to serve in this community once they leave our institution. And also we want to have some of our residents even stay on here as faculty members.

To me it's a real win-win, because obviously the folks living on the South Side benefit because there are some increased outreach and services. But also the residents benefit tremendously, I would imagine. They grow and they learn, and it's just got to be a real positive for them.

And speaking of, we do have one of our community champions, Dr. McMillan back to you. Let's talk to you a little bit about your-- kind of from your standpoint, and what this has meant to you, and how this has been a growth opportunity for you personally.

Sure. Yeah. So we often get a chance to see patients in the hospital, in our environment, in our comfort level. But we don't often get an opportunity to go outside in the community and see patients as people where they are.

And so it's been a fantastic opportunity to step outside of the hospital to meet people where they are, and to just get a chance to understand, and get to know the South Side community a little bit better. And so for my own perspective, I feel like it just provides me a better perspective about who the people are that I'm treating, and helping to understand them better as people.

That's great. Dr. McDonald, you mentioned Anita Blanchard who heads GME program basically. A few minutes ago, and I've had the opportunity to talk with her multiple times in the time I've been here, and she is a tireless advocate for the community, for the neighborhood, for the South Side of Chicago. And I think that's one of the strengths really of the program, of the graduate medical education program. Because it's not just about teaching people how to be physicians, but it goes a little bit beyond that, in my opinion.

Definitely.

And it teaches physicians, I think, some empathy. Not that our physicians don't have empathy, they do. But I think it really teaches some empathy, and can you talk a little bit about that and just how that makes a doctor a really, really good doctor.

Yeah. So I think with the program and exposing our residents to the community, it really allows the residents to see social determinants of health firsthand. So our residents come from all different parts of the country. Some are from Illinois, some are from Chicago area, but the majority are not necessarily from this community, yet they're in a position to serve this community.

So how can you effectively serve a community that you may not know anything about? So part of the spirit of the Champions program is to get our residents more exposure to the South Side, to members of the South Side, so we can really identify how these social determinants are affecting the everyday lives of the community members that we serve.

Now I would be remiss if I did not mention the Urban Health Initiative. So the community champion program is really a partnership between GME, the residency programs, and the Urban Health Initiative, which is really the community outreach arm of the hospital.

So Urban Health Initiative has had a long history of having amazing outreach programs. But a lot of our residents and trainees, we're not necessarily involved in those programs. So we wanted to formalize a way to get our residents involved in the work that the Urban Health Initiative is already doing.

And I think for me that is an amazing process. Because for me as a resident, I trained at a different institution, and I did a lot of community outreach, but it was by my own doing. So I was the one contacting churches, I was the one contacting community organizations. And just the amount of groundwork that I had to lay in order just do something, I took away from effectiveness and also my own capacity. But now that we have the Urban Health Initiative, the residents, they don't have to go through the same struggles that I went through as a trainee.

It's a wonderful program, and I'm glad you brought up Urban Health Initiative, because they do fantastic work within the community. And in bringing it all together is really kind of the key, I think, as you just pointed out.

Oh, It's amazing. I mean for the Urban Health Initiative, maybe in a community focus, the physician, they are definitely one of the reasons why I chose to come to work here, because I knew my community outreach efforts would be supported.

Fantastic. Dr. McMillan, can you talk to us a little bit about some of the things that you've done as a community champion. What are some of the examples of abilities to serve within the community?

Sure. Well, obviously this has been a unique year, year and a half for us throughout the world. And so one of the opportunities that has been available has just been to get out into the community and really talk about what COVID means, what it is, and how we can protect our communities from the virus and from the disease.

And so initially back in April and May, myself and some of my coresidents, even before being a part of the Community Champions program, we're able to do some Facebook Lives and just talk about some of the problems, and some of the issues that might come about with COVID, as well as dispel some of those rumors. And so we continue that on into being a part of the Community Champions program with other public service announcements. And then we're able to get out to the community.

And so there have been a number of pop-up clinics, including some that are through the Protect Chicago Plus program, that we've been able to go to really see advocate for people to get vaccinated, and be able to actually perform those vaccinations with them. It's been a wonderful opportunity to do that and really feel like we are protecting a vulnerable community from such a devastating illness.

I'm glad you brought up the pop-up clinics and your work talking through various means, Facebook Lives, Zooms, things like that, because I think that's important to get the word out to the community. And this is-- the community we're working with or you're working with on the South Side and West Side is particularly vulnerable community, and it's an underserved community, which is a huge issue.

Can you talk to us, Dr. McMillan, about your efforts and what that's been like to get out and talk to people, dispel some of the myths and some of the fears, because there is, I think, maybe a little bit of an inherent distrust of the medical community among some folks in these underserved communities, particularly when it comes to this vaccine, people worry about it. What's it been like and what have you told people?

Absolutely. So as you mentioned, there has been an inherent distrust that goes is back, not just decades, but centuries. Being African-American or other people of color are underrepresented communities. And so number one just to have an empathetic ear to people I think has been helpful. And I've gotten feedback that, that has been helpful. Just knowing that they have somebody to be able to ask those questions and to give them some real answers about those questions.

And so particularly as you mentioned with some of the distrust with the vaccine, people have mentioned that we've had-- well, the vaccine has just come about so quickly, that it's new technology that they haven't understood. And so just breaking it down in layman's terms has been very helpful. And I've actually gotten some feedback that, because I've just taken the time and been able to answer those questions for people, that they've been more trusting and willing to go.

And so I won't say everybody, but there have been a number of people that because of these experiences have gone out and been vaccinated. But not just that, have understood why we are asking them to wear their masks and distant socially, and whatnot. And so I think it's just really important, not just to provide people with a handout or with a commercial, but really talk face to face and give people an opportunity to ask their particular questions, which is something that this collaboration, this program has allowed me to do. And it's been very well received, in my opinion.

Yeah, I agree. I think the ability to speak with somebody, sometimes face to face, sometimes through technology, but the ability to speak with somebody that maybe residents know and trust, or get to know and trust is just so important. And again, thanks for all your work, because I think that's making a huge difference.

We did have an opportunity to do some interviews with some of the other community champions. And I wanted to see if we could hear from them now, John, if we can roll that. Because they talk a little bit about kind of their time within the program and what it means to them, and then we'll come out and chat some more.

For me something that I want to be a big part of my career is community outreach and advocacy. As a pediatrician, that kind of comes naturally. You have to be an advocate for your patients, especially when they're unable to advocate for themselves. But a really big passion of mine is nutrition. And there are a lot of issues surrounding food security, deserts food swamps, and a lot of complicated issues around that. And that does impact the health of our children.

I think the community in the South Side faced so many challenges that probably I'm not aware of. And that's part of the reason I'm even doing this program, so I can kind of understand more about my patients.

I think like any job, at some point it can be easy to just fall into a routine, and this helps me not do it, this helped me always remember why am I doing this. Why is it so important to employ these people that we're taking care of.

I wanted to develop more understanding of our patients and empathize with them and understand them, because I'm often with them during the most vulnerable times in their life. Going into surgery is a very scary headspace for a lot of people. And I think that as an anesthesiologist, anything you can do that helps the patient feel more at ease, feel that you understand them, that you care about what they care about helps you become just a more, I think, well-rounded provider.

As a resident, we work a lot of hours. We're feeling like we're giving so much in the hospital. But then to kind of step away from that and be able to give in a service oriented way that's like not connected to like the requirements I have to do, like the number of hysterectomies I have to do, or the number of like hysteroscopies I have to do. But just like doing it, because it's needed.

Very beneficial. You get to network and meet potential mentors, both clinically and people who work in the community and who do the type of work that we want to do.

I think if we can show that there's a way to do medicine better that connects you to the people you serve and actually makes the community better, that's something that can be an example for everyone.

It's pretty inspiring to hear from the various residents, and from you gentlemen, and about this work, because it's just such important work, I think. I think our GME program, first of all, is top notch. It's one of the best, obviously, in the country and the world for that matter. But this just really kind of puts it over the edge in my opinion, because it really affords the opportunity for residents to get out there and do some real work. And can we talk a little bit about-- I kind of want to go back to the start and what the thought process was when this was being designed and conceptualized, and I imagine you were part of those meetings. Dr. McDonald, could you tell us a little bit about that?

Yeah. I mean, the thought process was really, again, rooted in figuring out ways to get our residents more exposure to the South Side, and really to get them just a realistic perception or perspective of the community members of which they're serving. And then there are also aren't really any programs like this. So to my knowledge, we're one of the few, if the only program-- if not the only program in the country, who specifically are doing something like this.

And I know you mentioned medical mistrust. So even medical mistrust, part of the program is geared towards addressing some of the reasons why that mistrust exists in the first place. So when you're a patient who may have some pre-existing mistrust and your only exposure to the health care system is when you're sick or coming to the hospital, and there's a certain degree of vulnerability associated with that, the community champion program gives you another opportunity for exposure outside of a hospital within areas that may be a little bit more comfortable. And hopefully, with time, this program in itself can address some of the mistrust issues that do exist, that have existed for generations as Dr. McMillan pointed out.

And we talked a little bit about COVID clinics and vaccination education, but there's more to it than just that. And I know one of the things that's near and dear to your heart is proper nutrition.

Yes.

And we talk about the South Side there being food deserts and that sort of thing, which is a very real situation. And if-- a lot of people don't understand even what that is. So first of all, if you talk to us a little bit about what that is. But what are some of the efforts maybe that are happening there as well?

Yeah. So a food desert is area in which people essentially do not live near any grocery store or supermarkets. So we're not saying convenience stores, actual supermarkets. And the definition of supermarket is any area, any store that has at least had eight checkout aisles. So your convenience store that has the one checkout like a gas station or so, that is not a supermarket.

And we also address food swamps. And so food swamps are areas where the unhealthy foods inundate the healthy foods. So the majority of the neighborhoods within our 12 zip code service area are really food swamps. So there's plenty of food there, just not a whole lot of healthy food and an excessive amount of unhealthy food.

So one of the programs that I have going on in partnership with Urban Health Initiative, Common Threads, and another community organization called Family Farm is we're doing cooking demonstrations at Oakwood shores. So Oakwood Shores is a mixed income community in the Bronzeville area, and we're working with the seniors there, we're working with the youth population.

But a lot of our champions were involved in some of those cooking demonstrations. So due to COVID, we were doing everything primarily via Zoom. So myself and another chef will be responsible for some of the cooking, but we had a, ask a doctor section. And I would bring in one of the community champions, and they would participate and ask a doctor session, but they would also talk about the health benefits of whatever recipe we were cooking.

So one of the benefits of the Champions program is that we have such a diverse array of residents coming from diverse specialties. So I would have a pediatric resident come on, and a lot of parents would ask pediatric focused questions. I think we had anesthesia resident come on, and a lot of people were asking questions about preparations for surgery, or concerns about sedation, et cetera. So I think for our community members. It's really a service that is beneficial, and people seem very engaged and interested in it.

Yeah. It's a fantastic idea, and it's I'm sure getting a lot of traction.

It's good to see that it's well received.

That's great. So let's actually talk a little bit about that. And Dr. McMillan, I kind of want to hear your thoughts on, and what you've heard as far as feedback from the community, because I would imagine people are pretty excited about this.

Absolutely. So feedback from both the resident fellow side as well as the community side has been phenomenal. So from the resident fellow side, we've been able to interact with each other in a way that we might not have otherwise done. Meeting like minded individuals that are interested in, not just treating people here at the University of Chicago, but out into the community. It just has opened our eyes to other possibilities and potential future collaborations.

And then going into the community, people that have interacted with us, whether it is via Zoom or in-person, we've gotten really, really great feedback. So they've been very appreciative of us taking the time and going and meeting them as they are, and really answering those questions that we've had. So I would say the feedback has been very positive.

Dr. McMillan, I don't think I asked you this at the first, I meant to. How did you actually get involved in this, and why did you get involved in this?

Sure. A few different ways. And so one of them is that Dr. Blanchard and McDonald, are two of my mentors here, and had talked about the program and talked about its initiation. And so that was an exciting opportunity for me, because I recognized that they had a vision for the program. And it's a similar vision that I have for just wanting to be a part of the surrounding community.

So I'm not a native South Sider, I'm not even a native Chicagoan, but I am someone that really appreciates going out and being into the community, and meeting people where they are. And so that was something that was exciting for me to be able to do. And while I had not partnered with the Urban Health Initiative, I have been able to do other community service programs, and really wanted some mentorship and guidance about how to implement some of those community service programs in and on the South Side of Chicago.

And so in addition to what we do here, meeting people in the community, there's also an educational aspect for us as champions. So there's a lecture series. And then we have interaction with some of those faculty members as well, in which we can bounce ideas off of them in order to enhance our own community service programs. So all of those aspects made this program something that was truly exciting for me.

One of our viewers has a question, I think this is a fantastic question. You alluded a little bit to this topic at the very start of the show, and that's basically how do we convince? And maybe part of the reason behind this is to convince physicians to practice on the South Side or stay in the general area. And can you talk to us a little bit about that, because I think that's one of the efforts here.

It is one of the efforts. I mean, that's definitely one of the reasons why we started the program to convince people to, not only train here, but to stay in this community. And one of the ways we are doing that is to really get people more familiar with the community, more familiar with the community members, the needs of the community. And honestly, I think it's our responsibility to create and generate community focused trainees that would be community focused faculty members.

We are one of the premier institutions in this country for multiple different fields. And I think if we have people, even if they don't stay here, but if they come with this community minded mindset, I think we would really be creating a generation of leaders that could help really address some of the social determinants of health that have led to health disparities, that have existed for years.

And so W. E. B. Du Bois, he documented this in 1899 in a book called The Philadelphia Negro, is really one of the first social science studies, first public health studies that was done in the United States. And the social determinants he highlighted are the same social determinants that we're talking about to this day, lack of education, cigarette smoking, tobacco use, poor nutrition crime, et cetera.

So these are all things that I can't address within a clinical setting. And if I really want to have an impact on some of those social determinants, we have to get out into the community. But we have to do it in a way that's very organized and in a concerted fashion.

And with the Community Champions program, we are laying the groundwork for that organization, and even providing examples to our trainees what community outreach can look like. And hopefully, they take that community outreach to heart. And that hopefully will be something that inspire them to, not only stay on the South Side of Chicago, but the South Side of any other city.

So Chicago is not the only area of need. Ideally, I wanted my trainees to stay here, but you can go to the North Side of Philadelphia and find the same issues that they see here. You can go to South Central LA and see the same issues. And if we are really training people, some of the best residents in the country and inspiring them to go to those locations where the needs are, that's how we start making an impact.

It's interesting. Before the program, we were talking a little bit about some of the technical changes that have happened just within the past year, and the ability to use things like Zoom, and Skype, and Facebook Lives. And I know you've done a lot of work there. But you've also done in-person work as well, the pop-up clinics, and that sort of thing. You see that aspect of it growing as we kind of come out of this pandemic?

I do. And I think there's ways to get creative with it. And so there's definitely opportunities to have more lifestyle medicine focus pop-up clinics, more clinics that are really focused on some of these social determinants. So with the era of COVID, a lot of our pop-up clinics we're primarily focused on COVID. And I think it's really touching to see our residents interacting with the community when it comes to COVID, because you have to realize our residents, they've been at the forefront of COVID.

I mean, these are the trainees that were in the COVID ICU, and they've really seen the extent of what this virus can do to the human body. And to have these-- and the residents really are leaders in that aspect. So they have more exposure than many of the faculty members and attendings. So for them to be the people going out into community and talking about this, to me it's really impactful, it's very touching. And in many ways, they have more expertise than most of the faculty members.

Yeah. Really powerful. So Joyce has a question, another Facebook Live question. Where are the satellite clinics? Do they change, do they just move around, or do we have specific clinics that you all work at?

Yeah. Yeah. So the pop-up clinics, I mean, there's some variety. We have some FQHCs that we work with. And we've done some stuff with a friend center over here on Cottage Grove. But then they're pop-up clinics that can happen with churches and shelters, and in food pantries. So thanks to the Urban Health Initiative, they've really been helping kind of identify the best places for some of these pop-up clinics.

Great. Great. And we'll see if we can do some work, maybe online. We could get some information later on Facebook as far as locations, if we have some upcoming locations. So we'll try to get that. I kind of put you on the spot there and I apologize.

Dr. McMillan, let's talk a little bit about how this supplements your experience as a resident, and how this really prepares you as you move forward with your career and your calling. And we've got a couple of minutes left, so we'll try to wrap it up pretty quickly. But I wanted to ask you that question before we get out of here--

Sure. Yeah. So number one, it gives me an opportunity to think about where and how I want my practice to evolve. And so in what type of community, in what type of setting, and how to interact with that community. And so I came here to the University of Chicago purposefully to be a part of a community that serves underrepresented and underserved. And so this allows me to have that experience, and to really see if that experience is something that I want for my future in my practice, which it is.

And so in moving forward I'll be able to take these experiences and implement these into some of my own community service and outreach programs in order to more effectively just grow my practice in my future as, this year, a chief resident, and in the future as hopefully, a GI fellow and GI attending.

Fantastic. We've run out of time. I don't know if you want to leave us with a final thought Dr. McDonald.

I will. So I love the program, because I think the Community Champions exposes our community members to possibilities. And what I mean by that is even if you take Dr. McMillan, for example. So he's an African-American male physician, who also has a PhD. For a lot of folks in our community, he will be the first person with that combination of training and degrees that they may have come across. And that opens the door to possibilities. When they see something, someone doing what they may not even thought was possible, that is a source of inspiration.

And I think just from that sheer aspect alone, that's one of the reasons why this program is wonderful. Because, again, as a Chicagoan, I didn't see a lot of young male physicians growing up. But the fact that we're able to get our residents and have them serve that purpose is amazing to me.

It's got to have just a tremendously positive impact. And I would be remiss if I didn't add that you are quite the chef as well. And I'm sorry, I'm kind of springing this one on you too, tease me a little bit. But I'm serious about that, because I know that's passion, you talked about a little bit before. And I think if we play our cards right, we're going to have you do some cooking demonstrations for us on some of our Facebook Lives in the future. See, now I've said it on air, so we can't get out of it.

Hey, we can't get out of it. So I would be honored to come back here and do some cooking.

I think that will be so cool. I'm very excited about that.

And matter of fact, we should get a-- I should do it for Community Champion.

Yeah, that'd be great.

Yeah.

It'll be great. We'll definitely do it. That's a plan.

OK.

We'll make it happen. We are out of time. In fact, we're overtime, sorry about that John. A special thanks to our physicians for being with us today. And a big thank you to those of you who watched and participated in our program today.

Please remember to check out our Facebook page for a schedule of programs coming up in the future. To make an appointment with one of our physicians, go to uchicagomedicine.org or you can call 888-824-0200. Thanks again for being with us today, and hope everyone has a great weekend.

[MUSIC PLAYING]