Dr. Megan Sandel and Boston Medical Center

We started the morning with a trip to Boston Medical Center to meet with Dr. Megan Sandel and learn more about her work there as a pediatrician and physician advocate for the underserved patients in Boston.  Dr. Sandel talked about several social determinants of health such as income, housing, insurance, etc, and also discussed how these issues affect the health of individuals as well as the hospitals and clinics that serve them. In our conversation with her we were able to learn a little about the financial infrastructure of "essential" hospitals like BMC that serve disproportionately poor patients.  We talked about the challenges they face to provide quality care to their patients while keeping costs low, and how they plan to adapt and innovate with the implementation of the Affordable Care Act.

 

We were also interested to hear more about the National Center for Medical-Legal Partnership and Dr. Sandel's role as the the Medical Director.  Many of the underserved patients coming to BMC are confronted with a variety of social barriers that prevent them from leading healthy lifestyles.  Dr. Sandel is particularly interested in housing issues and related several cases in which inadequate housing influenced the health of her patients. In one example, a child suffered from chronic asthma in large part due to mold growing in the child's house. This child has legal rights that could help address the asthma problem at its cause.  Other low income patients with chronic conditions are protected by the law to not be evicted in the winter months. With the Medical-Legal Partnership, Dr. Sandel hopes to provide these types of patients, and others, with access to legal help. The Medical-Legal Partnership seeks to promote teamwork between the health care providers and lawyers to address the health needs of patients not only in the hospital, but in the community and home as well.  We were very excited to talk and learn from Dr. Sandel about social interventions and policy changes at local and national levels that have the potential to positively affect urban populations.  Dr. Sandel encouraged us as future physicians to be advocates for our patients, especially those who are underserved, and she emphasized that physicians should be leaders in the community to promote change.