Primary Care in the West 7th Community — Tradition and Evolution
T
he Twin Cities is fortunate to have many strong Family Medicine residencies, and United Family Practice Residency (UFPR) is no exception. This 27-year-old residency program is steeped in rich St. Paul history, staffed by a faculty, about half of whom have been with the program for over 20 years, inspired by residents who are drawn to the program from all over the country, and housed in a Federally Qualified Health Center (FQHC). The unique local nature of UFPR is evident from the moment residency applicants set foot into the clinic. They are taken on a tour of the West 7th neighborhood and given a history lesson, because both the community we serve and the roots of our clinic define us. We descended from the Wilder Infirmary, which began providing free and low cost care in the 1930s at Miller Hospital. When Miller Hospital merged with St. Luke’s Hospital, the Wilder Infirmary became the Miller Outpatient (MOD) Clinic. United Family Practice Health Center evolved from MOD Clinic and Helping Hand Health Center, which was started by St. Luke’s Hospital and West 7th residents. Four of the physicians from the time of this merger continue to practice medicine at United Family Practice Health Center. Dr. Tim Rumsey could boast (but does not — we do) that he has in his panel patients he has seen for 40 years and he has also provided continuity of care to some of the most transient of patients — our homeless population. The clinic operated under United Hospital,
By Sue Inoue, MD MetroDoctors
within the Allina Health System, but has since become a FQHC, maintaining the 90-year commitment to promote access to comprehensive patient-centered primary health care for low income and medically underserved St. Paul residents. In keeping with the theme of continuity and longevity, the residency is led by its original director, Dr. Kathleen Macken. It is not unusual for a resident to attend a delivery with Dr. Macken and discover that she had been at the delivery of the laboring mother, as well as the father, multiple aunts, uncles and cousins. The strength of the relationships she has developed with her patients was illustrated when the residents asked her to see one of her patients in the ICU at United Hospital. She found a very tense situation as she approached the room. A couple of security guards and the chaplain were standing outside a patient room. Dr. Macken had been the patient’s physician through her pregnancies, attended her deliveries and provided primary care up until this admission. The patient’s children were now large men in their thirties and staff
The Journal of the Twin Cities Medical Society
felt threatened by them as discussions of their mother’s poor prognosis were not well received. There was visible relief on the faces of these men, when they saw her approach and they asked her if there was truly nothing more that could be done for their mother. She gently told them she agreed with the ICU staff. The patient’s sons were immediately satisfied and agreed to transition their mother to comfort cares. Due in large part to the strength of family practice physicians in providing prenatal care, Dr. Macken was asked to take over the directorship of a prenatal clinic, which had been started by a perinatologist, at Face to Face Clinic on the East Side in 1992. Faculty and residents care for pregnant and postpartum women here between the ages of 12 and 25 years of age. For many of the young mothers seen there, relationships forged with residents and staff are the first profound experiences with primary care. UFPR’s commitment to the community extends beyond providers providing excellent care. From its inception in 1992, UFPR has been committed to Community Oriented Primary Care (COPC) and each resident participates in a longitudinal project that partners with community members to assess and respond to the community’s needs. Projects have included community gardens, project coordination in local homeless running groups, establishment of a multi-disciplinary geriatric assessment clinic, engagement with Reach Out and Read, a national early literacy program, and electronic mapping of neighborhood assets. (Continued on page 20)
March/April 2020
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