• Caring for Underserved Where They Need It

    March 19, 2018 11:44 am David Mitchell – When he was a medical student in Chicago, Ravi Grivois-Shah, M.D., M.P.H., M.B.A., already knew he wanted to help patients who needed it most. What he didn't realize was that he'd be doing it on wheels.

    "My goal is to address the social justice aspect of health equity," Grivois-Shah said. "I wanted to work with underserved communities and provide access to care. Being director of the mobile health program allows me to stay true to what drove me to family medicine in the first place."

    Grivois-Shah provides care in prenatal clinics twice a month for the University of Arizona College of Medicine at Tucson Mobile Health Program. The program, which Grivois-Shah also directs, operates in several Tucson communities, providing access to health care for homeless people, migrants, those without insurance or transportation, and others.

    The program makes regular appearances at food banks, churches, community centers and schools, and those community partners help ensure that people who need care know when and where to find it. The program is expected to expand to a second van later this year.

    "We're adding health care to a site they already trust," Grivois-Shah said. "Trust can be a big barrier, especially with undocumented patients."

    In addition to its undocumented population, Arizona has resettled more than 70,000 refugees in the past 40 years. Grivois-Shah, who also is medical director of the University of Arizona Department of Family and Community Medicine's Alvernon Clinic, estimated that roughly 20 percent of his clinic's patients are refugees or descendants of refugees. Those patients speak more than two dozen languages, so Grivois-Shah, who also is an associate professor of family medicine, said cultural competency is emphasized to students and residents.

    The Tucson family medicine residency program and the Alvernon clinic are participating in the Clinic First Collaborative. The initiative, sponsored by the Association of Family Medicine Residency Directors and the Center for Excellence in Primary Care, puts an emphasis on training in the outpatient setting.

    "Clinics can be an afterthought after in-patient care and rotations," Grivois-Shah said. "What time is left over goes to clinics. The goal of Clinic First is to get that back."

    As the name implies, clinic training is scheduled first, and residents work with a continuity panel.

    "We want to make the clinic the most valuable learning experience during residency," Grivois-Shah said.