North Carolina Schweitzer Fellow Rebecca Flint has been studying to become fluent in Spanish almost as hard as she’s been studying to become a pediatrician.
As an undergraduate student, Flint studied Spanish for the medical professions. Early in her studies at University of North Carolina School of Medicine, she volunteered at Samaritan Health Center in Durham, where she spent time interpreting to improve her Spanish while caring for the clinic’s large Hispanic clientele. As she prepared to move to Charlotte for her third year of medical school, Flint researched opportunities to serve the Hispanic community, including having her longitudinal clinics in facilities with high numbers of Spanish speaking patients. Flint’s boyfriend, whose first language is Spanish, has also been a patient teacher.
Why is this so important to Flint? Common sense, for one thing―according to U.S. Census data, North Carolina has the fastest growing Hispanic/Latino population in the country. Thirty-four percent of the state’s growing Hispanic/Latino population say they speak English poorly or not all; nearly 50 percent say they speak it less than very well. Flint has seen firsthand how this language barrier can negatively impact patient care, beginning with her volunteer job as an undergrad at UNC Medical Center’s Pediatric Playroom, where she encountered many Spanish-speaking patients.
“I realized that their care was not always as good as that of the other patients,” she recalled. “They didn’t know what meds they were taking, they didn’t know they could go to the playroom or do other things that just make life in the hospital better overall.”
Then, while working at UNC Family Medicine’s free clinic at Our Lady of Guadalupe Church in Charlotte taking patient medical histories from Spanish-speaking patients, Flint spotted a trend. “While many patients had poor health literacy, they also had a strong desire to get well and do what is asked of them by their doctors,” said Flint. “I knew their desire to get well was something that could be easily addressed through education on topics like medication compliance, health maintenance, diet, and exercise; but with so many patients and so little time, we just couldn’t do it.”
“The reason that these patients are often labeled ‘non-compliant’ is not because they intentionally disobey the orders of the doctors,” Flint added. “It’s that they don’t understand or are confused by the medical reasoning behind the doctor’s orders and are therefore unable to follow them correctly.”
With that reality in mind, Flint developed a program in partnership with Our Lady of Guadalupe Free Clinic to help uninsured Latinos manage their chronic diseases through healthy living counseling classes. Throughout the course of the six-week Stanford evidence-based workshops, “Tomando Control de su Salud”, participants will hear from trained health care leaders on topics including diet, nutrition and personal health. They will also work together to set personal goals, support each other, and share their experiences. Medical staff monitor progress through surveys and tests to assess progress, and provide further guidance for a 6 month period.
The joy participants felt at losing a pound or two by the end of the inaugural class was contagious, said Flint. “Listening to them sharing their goals for the next couple of months was inspirational. They were so confident and determined to accomplish the goals they had set for themselves, and even more excited to accomplish them so that they could set more.”
Among those directly impacted was a woman who was struggling with depression. Though quiet and reserved initially, Flint witnessed her transformation over the course of the class.
“She showed up smiling and interacting with all of the people she had built relationships with,” said Flint. “While giving medications and counseling on diet can help, for this woman I believe that progress needed to begin with her finding joy in life and the support to maintain it. Only after that could she really start improving her health.”
“I would not be able to do this project without the support of Brisa Hernandez who has helped me with planning and implementation every step of the way and Dr. Andy McWilliams who has offered guidance and support as patients challenge me with medical concerns that I am not qualified to care for on my own,” said Flint. “Also, the CHS Faith Health Ministry Nurses, Rita Dominguez and Vanessa Nuñez, are an invaluable part of our team leading the Tomando classes with such enthusiasm and passion”
Flint is already working on ways to continue the project beyond her Fellowship, having lined up two Spanish-speaking med students who began working alongside her in July.
“By working with them this year, they will be invested in the community and the transition of leadership next year will proceed seamlessly,” she said.
Flint said the most surprising element of her Fellowship experience was the ease with she was able to establish trusting relationships with her students, which allowed her to better serve them.
“I expected it to be a lot harder to gain their trust, but now when I call them they all seem so happy to hear from me,” she said. “They’d pull me aside at the end of class to ask me about medical concerns that they were uncomfortable sharing with the group. They would ask me how I’m doing and greet me with a kiss on the cheek, as is traditional in Spanish culture.”
After completing her Fellowship year, Flint looks forward to the joining the ranks of Schweitzer Fellows for Life and learning from like-minded people about how best meet the needs of the underserved.
“I hope to continue serving in this same capacity or greater as I progress through my career,” she said. “Having the support of the Schweitzer fellowship will allow me to have a group of colleagues to work with and develop ideas with in the future.”