2019 Parents Fund Internship Grant Reflections: Meredith Palmore
Internship Location: The Fauquier Free Clinic
Journal Entry #1
Hello, I'm Meredith, a fourth year Biology and Global Public Health Major! I just finished week one of my internship with the Fauquier Free Clinic, a nonprofit organization that previously gave free care to uninsured people in the community. Why do I say previously, you may ask? Since Virginia just expanded its Medicaid services, now the Free Clinic accepts patients with Medicaid as well. It is quite obvious that the organization is undergoing a major shift, and there are plenty of things for an intern like me to do and to learn! My duties this summer will include a wide variety of tasks, including helping to make sure that all eligible patients have in fact applied to Medicaid and maintaining a list of those who must, calling offices to which the clinic will refer patients to see which health plans they accept, training front desk staff to check patients in using electronic health records system, and finally, helping the clinic with evaluations on quality of care using measures defined by an executive board. I am most excited about the latter task, since it will allow me to employ skills that I have learned in my courses, and relates to my future goals of becoming an epidemiologist! I will run you through some of the major things that I have already gotten to do my first week.
This week, I had the opportunity to sit in on a meeting with all staff led by a professor at UVA. Her name is Professor Engelhard, and she is an expert in health policy. I learned a lot from her presentation. One of the things that stuck with me the most from her presentation was that although the United States health care system is poorly ranked, especially in comparison with European nations of similar economic statuses, Americans feel that there is no problem with their health care and value a private system, because Americans value their freedom of choice so much. Another thing I learned, a point made by a volunteer at the meeting, is that oftentimes people without citizen status that go to the Free Clinic for their care are wary of signing up for Medicaid due to concerns of privacy.
Along with this, so far, I have started filling in the many gaps in a list of providers to refer patients to, where certain insurances are not currently represented in particular specialties. I will be finishing this list in the future. I have also helped to make a list of whether or not patients have applied to Medicaid. The clinic has decided that patients must provide proof of their application if they are eligible, since it would not be fair to provide free services to people who are eligible for insurance. Lastly, I scanned missing information from the old paper charts into the electronic system in preparation for dental appointments.
One day, I worked different hours because I went to a community outreach event with the director of the clinic in the evening. It was very fun! We went to a school sponsored event in a less wealthy part of the county where many people are underserved. There, we passed out dental goody bags to children with cards of information about the Fauquier Free clinic. We also offered free blood pressure testing and spoke to adults about the free services we offer. By the end of the day, we had recruited a few new patients. I remember that at the beginning of the day, the director of the clinic had said, "As long as we help one person without care to get care, spending my day out here will be worth my time." How incredible is that, to have a leader so genuinely interested in helping people? When I heard him say this, I had never been so proud to be working for anyone. I am really looking forward to the variety of things that I will be doing this summer at the clinic, and all that I will learn and experience!
Journal Entry #2
These past several weeks, I have been working on a variety of projects at the Free Clinic. One of the main things I have been doing is figuring out how to pull data out of the electronic health records for the quality measures. I have learned how to build the reports with the necessary data, and how to use excel to manipulate it so that the result of the measure can be calculated. It was exciting to work with this data, as I have never been given a project that requires this amount of judgement and problem solving at a job before. I have also created reports for the dental clinic that the director needed, not for the quality program, but instead to present to the head dentist who leads the dental clinic. I also created an interactive graph in excel for the mental health clinic to track depression screening scores over time. I did not expect to be developing my excel skills as much as I have been in this internship.
In addition, I have been working at the front desk of the dental office a lot lately, something of which I had no previous experience doing. It is a good experience because this way, I finally get to meet some of the patients and help them more directly. I schedule their appointments and ensure that all of their paperwork has been completed before their visit starts. I have also learned a great deal about the clinic working at the front desk. The Free Clinic is unique from many other clinics, in that eligibility screening is an enormous prerequisite to care. Patients’ eligibility is verified regularly to ensure that they qualify for free care. I did not recognize how the clinic determined whether or not people qualified, and the importance of having these rules, until now.
In the second half of my internship, I hope to write up instructions so that the calculations can be replicated by the director or other staff in the future. I have started calculating the measures for past quarters to see if there have been any unexpected trends, and to check for consistency; a project which I would like to complete in the second half of my internship. I hope to take part in the quality program in other ways such as coming up with reactions to the calculated quality measures. I also hope to learn more about how to interact with patients in a professional yet empathetic manner as a front desk person. It is sometimes hard to balance these two things because there are limited appointment spaces and many patients that call are experiencing pain. I would like to attend more public outreach events to recruit more of the community that could be eligible for our services. I have enjoyed what I have learned so far at this internship, and look forward to the second half of it.