For the last four years I have been volunteering every Saturday at the Paul Hom Asian (Free) Clinic in Sacramento. This clinic is a combined clinic with the Hmong Lifting Underserved Barriers (HLUB) and the VN cares clinics. This free clinic specializes in serving underinsured patients with language barriers from China, Vietnam, Laos, Mongolia, Kazakhstan, Korea and Latin America and local Americans without health insurance. Patients at this clinic often have diabetes and chronic hepatitis B as both conditions are common in East Asia.
The patients are often surprised that as an anesthesiologist I provide primary care services at this free clinic. This is because there is a common misconception in our community that anesthesiologists are narrowly trained proceduralists that lack solid knowledge of general medicine. They are however not surprised when an anesthesiologist like me is able to successfully collect their blood when others before me were unable to obtain a blood sample from them!
I am frequently joined by fellow CSA member John Liu, MD, who works as an anesthesiologist at the Shriners Hospital for Children in Sacramento. I am truly amazed by Dr. Liu’s expertise in managing adult primary care problems given that in his regular job he works exclusively with children.
Anesthesiologists and other subspecialists should not be reluctant to offer much needed primary care services to the underinsured because experience shows that we are doing an amazing job in this role. The medical director of the Paul Hom Asian clinic is in fact a vascular surgeon, Ronald Jan, MD, from Mercy Hospital. He has provided high-quality primary care services to Sacramento’s underinsured community free of charge for over 20 years and mentored many other subspecialists like me to provide excellent primary care.
We do receive a lot of professional support from retired hepatologist Mary Pat Pauly, MD, who used to work for the Kaiser Permanente system as well as from dermatologists, ophthalmologists, and rehabilitation specialists that attend the clinic once a month to provide their expertise.
Working in primary care on the weekends has helped me understand common disease processes better when I work as an anesthesiologist. I can now clearly determine how well controlled a patient’s type 2 diabetes is under, and how much end organ damage has occurred because of this disease. My experience at the clinic also enabled me to recognize liver problems now that I may have missed previously.
As the medical director of the Hmong Lifting Underserved Barriers (HLUB) clinic, I am regularly meeting with the Hmong undergraduates and medical students who run the clinic to discuss clinic procedures and their outreach efforts. These efforts involve going to Asian shopping centers, and Asian cultural events to screen people for diabetes and hypertension. I have learned a lot about the Hmong people and the Hmong culture from the undergraduates and this has significantly broadened my perspective on life. I also enjoyed attending the Hmong New Year’s Celebration at the Cal Expo Center. The undergraduates are doing a terrific job translating for the patients who speak many different Asian languages and many different Chinese dialects. Significant logistic effort is needed to ensure that we always have an interpreter available to cover all the different languages. I have learned a little Mandarin Chinese and I can now clearly distinguish all the different east Asian languages from each other.
The dedication of the undergraduates and medical students to serve the disadvantaged members of their community and their hard work is inspirational and makes me confident in a better future for all of us. Many of the undergraduates have gone on to medical school, physician assistant programs, and other allied health fields. I am sure they will continue to provide the same excellent care in the future by drawing on the principles that they learned at this clinic.
Finally, I would like to emphasize that more anesthesiologists should consider volunteering at free clinics not only for philanthropic reasons, but also to demonstrate to the community that we are in fact real doctors with profound knowledge of general medicine.