Navigating the Transition from a Free Clinic to a Community Health Clinic

This blog was written by Clay Resweber ’18, 2018-2019 Davidson Impact Fellow for the Charlotte Community Health Clinic (CCHC).

This might seem obvious, but one of the best parts of being a Davidson Impact Fellow is having the opportunity to integrate yourself into an organization and participate in its operation. In my experience at Charlotte Community Health Clinic (CCHC), I feel like my fellow coworkers and leadership team have taken many steps towards teaching me about the mission of the clinic, our operating procedures, and the history of our organization. The clinic’s mission and operations are on the minds of our staff every day as we find ways to better treat and relate to our patients, but one aspect that often gets lost in the daily routine is the story of where are our clinic came from. This history is interesting in itself, and helps to explain the obstacles that our clinic faces today.

In the world of healthcare, there are a few different types of practices that are designed to cover different populations of people. On one end of the spectrum you have private practices, clinics run by physicians which have a lot of freedom in deciding what procedures they treat, who they want to see, and what insurance types they will accept. Hospitals also exist towards this end of the spectrum, but often have restrictions and guidelines on how they can operate that provides them less freedom than a private practice would. On the other end of the spectrum exist free clinics, which, from my understanding, exist due to the virtues of volunteers and are designed to treat uninsured patients. The nature of their target population means that the clinic will not be fully reimbursed for the services they offer their patients, which restricts the types of procedures they can provide, their hours of operation, the number of patients they can see, and a multitude of other factors of which I am unaware. These types of clinics exist because of the stewardship and service of dedicated staff and providers, which often reflects in the quality of care and atmosphere found within them.

Somewhere in between a free clinic and a hospital or private practice is the world of federally qualified health centers (FQHC), often referred to as community health clinics. FQHC’s first appeared in America in the 1960s and were inspired by the health clinics of South Africa, which experienced more effective outreach and treatment by integrating themselves into the communities they served. It took a while for a system inspired by these South African clinics to take off in the US, but eventually, under the governance of the Health Resources and Services Administration (HRSA) within the Department of Health and Human Services, the government set up a program to follow the example of our South African counterparts. These FQHC’s receive grants from HRSA to help fund the cost of their operations. Further, HRSA offers many other grants for specific programs that FQHC’s can apply for based on their specific services and patient populations. Since they are designed to integrate themselves within the communities they serve, FQHC’s can and do serve patients of any payer type, including uninsured patients, Medicaid patients, Medicare patients, and 3rd party insurance patients. Uninsured patients are responsible for a copay based off of their federal poverty level (FPL) designation to provide them with some investment in their healthcare. The grants that FQHC’s receive from HRSA are designed to offset the cost of these patients, but it is important to emphasize that community health clinics in America are able to provide primary care and references to specialty care to patients of all payer types.

What makes CCHC’s situation unique is that before becoming an FQHC 2 years ago, they operated as a free clinic for over a decade. This means that the clinic had a large population of uninsured patients using their services, used volunteer providers that completed services as they could, and had no federal reporting requirements. Since community health clinics have to report to the federal government and offer a wider range of services than a free clinic, the transition caused a large turnover in providers and staff which has now stabilized. However, one aspect of the change that we still grapple with today is in the payer mix of our patient population. Although we receive grants, both from federal and private sources, to help offset the cost of serving our uninsured patients, FQHC’s need to have a diverse payer mix including Medicaid, Medicare, and privately insured patients in order to be sustainable. Due to our history as a free clinic, we maintained a large percentage of uninsured patients that persists years after the switch.

Although all of us here at CCHC are happy to serve all types of patients, the fact remains that in order to remain sustainable and grow as an organization, we must find ways to attract other types of payers. Doing so has proved to be challenging, but we have undertaken many initiatives that will hopefully help us accomplish our objective of diversification. Learning about these projects has provided an interesting opportunity to learn which populations usually have different types of insurance, which paints a telling image of the American healthcare map. We have partnered with the local Men’s Shelter and Urban Ministries to place one of our nurses in Charlotte’s homeless shelters and provide us intimate access with the city’s homeless population, who often have Medicaid coverage. CCHC has also pursued partnerships with different elderly organizations in an attempt to reach a population of people that are provided with Medicare coverage. Initiatives to establish our clinic in schools allow us to attract more school-aged children, who enjoy Medicaid coverage under CHIP. Meanwhile, our uninsured patients are largely Hispanic adults, but represent a diverse population of Charlotte citizens.

Having worked in the clinic for 6 months, learning about these initiatives and operations has made a huge impact on informing me about America’s healthcare situation. The government programs we have in place show some of our most vulnerable populations, many of which all of us have some connection to, and the lengths that our representatives have taken to provide for them. Our uninsured patients show another part of the picture, of those who are vulnerable and do not receive assistance. Figuring out how to reach each of these very different groups of people is a unique challenge, but one that lies close to the heart of a clinic such as CCHC, which is dedicated to serving people in a city such as Charlotte. I quickly realized that understanding the vision and initiatives at CCHC requires an understanding of our history and free clinic roots, which has been fun and interesting to learn about in itself. Using these lessons to connect CCHC to the larger picture of American healthcare has been a real privilege, one that I hope to take with me in a career as a healthcare provider.

You Majored in What!?

Read about CCD Student Associate Stephen Shank, and how he decided what to major in.

It took me a while to figure out what I wanted to major in.  The one thing I was always certain about was that my career would be in the business field.  Well, after taking Econ 101 in my freshman fall, it was clear I didn’t want to major in economics.  I had never been that great math and 4 years of it seemed like too great a feat.  So then I found myself feeling lost at a school with no general business program.  During my sophomore year, I began to find other areas of study that I was interested in.  I took a number of political science courses and found that I enjoyed learning about political strategies and government operations.  I decided political science was my best option for a major and now, as a junior, I still think I made the right decision.  It took three years at Davidson, but I now know I want to pursue a career that doesn’t align with my major.  I still want to go into business, and more specifically, the marketing and communications field. 

When people hear what my major is, they always ask if I’m going to pursue politics or go to law school.  I’ve found that your major doesn’t determine or prevent you from a certain career.  What’s important are the connections you make and the experiences you gain.  This past summer, I was able to land a communications internship where I gained valuable skills in the industry.  I also got involved with the communications aspects of projects and fundraising events on Davidson’s campus.  These experiences started to help me build my resume to appeal to future employers.  On top of these experiences, I am continuing to reach out and build relationships with Davidson alumni and other professionals in the area to learn what other skills I need to develop.  At a liberal arts school like Davidson, don’t freak out if your major doesn’t closely relate to the career path you’re pursuing.  Find ways to gain experience around campus or the community and don’t be afraid to reach out to people who can share their knowledge.

God Save The Queen…and My Summer

Read about CCD Student Associate George Hatalowich , and his summer experience abroad. 

During my sophomore’s spring semester, I had absolutely no clue what I wanted to do for the upcoming summer.  The pervious summer, I interned at Verigent, a telecommunication staffing firm in Huntersville and it was a great experience; however, I knew I wanted to try something new and exciting.   Prior to the 2018 summer, all I knew was that I was an economics major and history minor and that I wanted to explore different opportunities in these field.  As I began talking to former teammates, two of them suggested taking a three-week summer class at the London School of Economics.  Immediately, I considered this opportunity.  As a student-athlete at Davidson, I’m basically obligated to spend both semesters on campus and would never get a chance to study aboard.  Well, the summer session at LSE was my opportunity and I took it.  Myself and two other Davidson students took an economic class called Financial Markets and the Global Economy: the History of Bubbles, Crashes and Inflations. The smaller group classes, discussions, and lectures were on par with a Davidson class, just in London! The work and exams were manageable and a great way to test the information covered over the class’ three-week span.  Now, to the real fun stuff. Outside of the class, I had the opportunity to travel a great deal in Europe. Prior to the trip, we knew we wanted to travel so we gave ourselves roughly a week and half before our three-week class in London and a week after to explore Europe.  In total, I traveled to six different cities in five countries (Barcelona, Rome, Florence, Munich, London, Dublin).  The traveling was absolutely incredible, and I made memories that I will carry with me for the rest of my life.  The opportunity to study and travel at the London School of Economics my sophomore year summer was easily one of the best decisions I have ever made.   

Attention Rising Sophomores Who Need Research Experience But Can’t Get Any because They Have None

Read about CCD Student Associate Haleena Phillips, and her experience with RISE
(Research in Science Experience) Program

Are you a rising sophomore who is interested in the sciences? Do you struggle finding research opportunities because they want you to have prior experience but nobody gives you a chance because you have none? Are you tired of my questions? If you answered yes to any of these options, continue reading this post!

            As ironic as it sounds, I’ve been through that exact moment when I applied for a research position at a different college but got rejected because I didn’t have any previous exposure to a lab. As upset as I was, I had to laugh as I realized  that I cannot obtain an experience when internships require prior involvement with a lab. Somebody had to give me a chance and that is exactly when I found out about Davidson’s RISE (Research in Science Experience) Program. A 4- week immersive program that explores biological research methods, from “literature searching and review, to hypothesis formulation and testing, to data analysis and presentation.” The program is mostly intended for underrepresented students but anyone can apply. In addition to the application, a letter of recommendation and a resume was required. The Center for Career Development  assisted me in crafting the perfect resume in order to be accepted into the program. I received a $2,500 stipend and additional grant money to stay on campus. I had such an amazing time over the 4 weeks executing a project in the lab. Also, staying at Davidson without the workload of a semester with your friends is the BEST. I was able to make my own schedule as I became established in the lab and was able to have that research experience under my belt as a freshman. When I returned back to campus in the fall as a sophomore, I presented at my first research symposium and I felt like I finally had  my life together in this hectic Davidson climate.

 My First Research Symposium!

For more information on RISE, please contact Mark Barsoum (mabarsoum@davidson.edu)

The Center for Career Development Would Like to Welcome…….

The Center for Career Development is excited to welcome two new members to the team. We are kicking off 2019 with Raquel Dailey, Assistant Director of International Career Development and Dalton Langdon, Career Adviser. Dalton, a native from North Carolina joins us upon completing his Master’s in Higher Education from the University of North Carolina Wilmington. Raquel, while also a North Carolina native, has traveled from afar to join the team, after her time spent in Belgium with James Madison University’s College of Business study abroad program.

Connecticut native Raquel Dailey earned her Masters in Higher Education and Student Affairs from Virginia Tech, a Masters in Teaching English to non-native Speakers from Shenandoah University, and a BA in Psychology and Spanish from Hampton University. Raquel has over a decade of experience working in higher education and is returning to Charlotte after seven years of living abroad. She most recently served as Program Coordinator for James Madison University’s College of Business, coordinating their Belgian study abroad program. Raquel also served previously as a Residence Education Coordinator at UNC Charlotte. In Raquel’s role here at Davidson she will be serving as the Assistant Director of International Career Development, focusing on serving our international student population. “Helping students discover and apply their passion to a profession where they can positively impact society is vital to the student experience”, says Raquel. “I am excited to be able to enhance career opportunities for international students and align them with a greater network of employers”. 

A North Carolina native from the Raleigh area, Dalton Langdon earned his Master of Higher Education from the University of North Carolina Wilmington and his BA in Economics and International Studies from North Carolina State University. Dalton recently graduated with his master’s degree, during his graduate program he worked in the Career Center at UNCW as their Certified Internship Program Coordinator. Through his graduate assistantship, Dalton was able to work one-on-one with undergraduate students to help them develop professionally throughout their internship process. He is excited to join the Career Development team at Davidson College and continue the process of advising students and help them achieve their full professional potential. In his free time Dalton enjoys hiking with his dog and is ready to checkout some of the nature trails in the area!

We are excited to welcome Raquel and Dalton, as they are huge assets to the team and to the students of Davidson College. They are greatly looking forward to working with Davidson College students through advising, employer programming and professional development. 

Embrace the Task, No Matter the Scale

This blog was written by Meredith Hess ’18, 2018-2019 Davidson Impact Fellow for the Habitat for Humanity International.

If I have learned one thing about Habitat for Humanity since starting my fellowship here in July, it is that there is always more to learn. Sometimes, that can feel daunting. Habitat for Humanity operates in over sixty countries, all fifty United States, the District of Columbia, and Puerto Rico. Our programmatic approach varies based on country and community context (as all development should), and we recognize that there is no one-size fits all solution to providing safe affordable housing. It is impossible for one person, let alone someone like myself who has only been with the organization for five months, to know and understand all that happens within the organization. Our network extends farther than I am sure I will ever fully know.

Because our network is far-reaching, and my team works across various domains, there are days where my work feels spasmodic, and my tasks vary a great deal. For example, a few weeks ago my work load for the day included working on documentation for a grant application for an allotment of over $12 million USD, and working on formatting a PowerPoint presentation graphic for our updated WASH (Water, Sanitation, and Hygiene) strategy. Both tasks needed to get done, and both were within my domain by virtue of my position on the Global Programs Design and Implementation team. I couldn’t help but laugh thinking about how different these tasks were. It can be easy to lose sight of your purpose in an organization or your role on a team when your tasks feel disjointed and disconnected from other components of the organization. What I have learned, from watching my colleagues and talking with my mentors, is that it is powerful and necessary to take ownership of a task, no matter the scale.

Being entrusted with any task, whether it seems big or small in the grand scheme of things, provides an opportunity to demonstrate your flexibility, competency, and management capabilities. I have felt incredibly privileged here at Habitat for Humanity International, being given the chance to represent the organization at various conferences and meetings, both local and out-of-state. I am sure that in part I have been given the opportunities I have because I have embraced and executed smaller tasks with the same sense of responsibility as I have larger tasks. This is an incredibly important lesson to for anyone to learn in their first-year post-grad: embrace the task, no matter the scale. No work is beneath you when you are working towards a common goal with others, for others.

Reflections on the Professional Sphere

This blog was written by Helen Mun ’18, 2018-2019 Davidson Impact Fellow for the Georgia Justice Project.

As of November 2018, I am five months into my fellowship and seven months post-graduation, and I am still growing into the new world of professionalism. After riding many highs and lows in my role at Georgia Justice Project, I now find myself reflecting on how far I have come in my first professional job after graduating from Davidson.

Georgia Justice Project is a legal non-profit organization, and our building is divided into what we call “the legal side” and “the social services side.” My workspace is on the legal side, among the offices of all of our attorneys. Everyone is busy and stressed, which is characteristic of the legal profession and of the non-profit environment, as we try to serve as many indigent clients as we can with our limited time and resources. The office environment is also relatively fast-paced and can sometimes be chaotic as new issues arise or clients drop in unannounced.

My first few weeks were dedicated to learning about Georgia’s criminal justice system and laws, the client base that Georgia Justice Project serves, and the various positions and roles of our twenty or so staff members, which include lawyers and paralegals, social workers, development staff, and others. I spent my first few weeks reading reports, listening attentively in meetings, asking plenty of questions, managing multiple projects, making mistakes and learning from them. I often felt overwhelmed by the steep learning curve, but I made steady progress and received support from the people around me. In October, I asked my direct supervisor and Legal Director of the organization for a three-month evaluation and was pleasantly surprised to hear her glowing positive feedback.

The recognition of my efforts to learn quickly and the initiative I took in certain projects buoyed me, and that newfound confidence helped me to become more proactive and independent in my roles on the policy team and on the legal team. My supervisor began to entrust me with additional responsibilities, and although I was excited at the prospect of contributing more, self-doubt and feelings of imposter syndrome began to settle in. I questioned whether I was qualified, whether I belonged in this space, and began to overthink even the small, relatively inconsequential decisions that I made on a daily basis.

I recently spoke with a trusted mentor and friend of mine about my struggles to adjust into this professional sphere. She shared with me that, although she has been in the workforce for many years, she sometimes feels similarly and constantly reminds herself that she earned her seat at the table. At her encouragement, I reflected on all the personal and professional milestones I have accomplished and all the changes and challenges I have faced in 2018. It is a long list, but after remembering all of these things, I realized just how well I have been doing at a new job in an intensive and fast-paced environment. I am proud of how much I have learned and adapted in my new role, and I encourage all who are enduring similar challenges to celebrate your accomplishments, take your mistakes in stride as learning opportunities, and to sit at the table like you belong there.

Looking for an Internship

Read about CCD Student Associate Anna French, and her advice on searching for an internship!

Internships. We hear about them all the time as students, from not only our parents but also our peers. It seems like all our fellow students around us have one or are waiting to hear back regarding their acceptances. If you have not started looking for an internship yet, do not worry. You have plenty of time. The best time to apply for internships as a student who is busy with school and extracurricular activities is winter break. Why? You no longer have schoolwork to bog down your afternoons and most of your extracurricular’s are probably on campus, giving you additional free time. If you return home to your family during winter break you also have the support and knowledge of those you love and trust.

Speaking of family, your families are a prime source of advice. If you are trying to write a cover letter for your internship and can’t find time to swing by the Career Center before you go home try asking your parents, aunts, uncles, and older cousins. Most likely they’ve all written cover letters before, if not for an internship then for a job application. Additionally, your families and family friends act as your first tier of networking. If you are having a hard time finding the type of internship you want on Handshake, try asking those you are close to whether or not they know of anyone who would like to have, or are accepting applications for, interns. Usually someone will say they know of a company who is looking for interns. You can then go and research the position and the company to see whether or not you think you would like to apply there.

As for the application process, you should remember that different companies have different requirements. Some only require your resume. More often than not, though, you will have to provide a cover letter stating who you are, why you want to work there, and why you think that you’re a good fit for the internship position. The key to writing a successful cover letter is doing your research on the company. For example, take a look at the About and Mission pages on the company’s website. These should tell you what sort of environment, work ethic, and goals the company likes to promote and uphold. Tailor your cover letter to reflect these qualities by pulling key descriptor terms from these pages to put into your letter; doing so will show the employer you have vested interest in their work and truly want to work for them. However, do not lie or exaggerate your personality or your experiences. If you are not energetic and the company portrays itself as fast-paced, don’t tell them you are upbeat all the time. Focus on other qualities about the company that you appreciate and be yourself. After all, if you get accepted, your employers will quickly discover any discrepancies between your words and your behaviors, so it is best to avoid them in the first place.

Finally, waiting to hear back can be excruciating and if you get rejected, painful. I just want to remind you: there are many other applicants who are applying for internships, all of them qualified. Yes, you were rejected, but you weren’t the only one who was rejected; others were too. Also, there are many internships out there, and new ones are being posted all the time, so don’t give up hope if you weren’t accepted. Who knows, maybe that internship wasn’t meant for you and a better one will come your way and change your life.

Research during your Undergraduate Experience

Read about CCD Student Associate David Thole, and his 2018 summer research experience!

Ever since beginning high school, there was a word – an idea, almost an unachievable goal for how fantastic it seemed at the time – that always fluttered out in some fantasy world for me. Research. It’s something that many colleges preach as a competitive factor at their school – ‘students have the opportunity to participate in faculty-led research, or generate ideas of their own, and pursue them through different programs’ – and it’s hailed as an almost necessary experience in order to pursue higher education.

And, for good reason! Research is hard. Seriously hard, and it teaches you a lot about yourself and the topic you’re researching. This past year, I began to discover a love for the field of chemistry and started a conversation with one of my professors, Dr. Mitchell Anstey, about a research position during the summer. After writing a mock proposal, I was accepted onto his research team and participated in a ten-week faculty-led research experience over the summer. During the ten weeks, I continued working on a project that had already been started by another student, Claudia Hernandez, involving the molecular synthesis of a complex ligand that had potential for electrochemical implementation (pun intended, for the physicists and chemists reading this). There are, of course, some nitty gritty details regarding the chemistry of the project, but I don’t want to focus on that (you can swing by Wall 246 and see my poster if you’re interested though!). Rather, this summer was the first time where this previously unattainable and idealized experience was suddenly thrust in front of me. Through the experience, I learned a lot more than just chemistry and I also started to really understand why research experience was regarded so highly by potential employers and graduate schools.

Patience was the first trait that was tested during the summer. Patience is a virtue, they say. Well, when you spend two weeks (80 hours!) trying to find the right conditions to run a reaction, and you can’t seem to find anything that works, patience definitely isn’t the first thing that comes to mind. However, that’s the nature of research. Some things work, and some things are a complete bust. Kind of like life, right? I consider myself a pretty patient person, but kudos to my labmates this summer for tolerating my less-than-flowery word choice in situations where things didn’t quite go my way. If you get involved in a research project, failure and setbacks are inevitable, and people know that. This is one of the reasons why a research experience can be extremely valuable.

Obviously, another thing that research requires – and shows to higher institutions – is a supreme level of intellect that separates you from others, right? Wrong! Very wrong. I’ve said it before, and I maintain this perspective; I think anyone could’ve done exactly what I did this summer with similar results. In reality, what my research required – and what I think any research requires – is interest, a positive attitude, and a killer work ethic. You are the one in control of your project, so you decide how to use your time and what you accomplish is directly correlated to how much time you put into it. Now, I’m a big procrastinator, so research this summer was definitely a wake-up call. At times where I felt tired, or unsure of how to continue, what I had to do was push past that rather than let my fatigue or boredom control my decision. Because, face it, research can also be seriously boring. For the rest of our lives, we’re going to inevitably have times where we are at a fork in the road faced with decisions, and pushing through perceived discomfort will help us become stronger and more resilient people.

I just wanted to touch on one more aspect of research. Like I said earlier, there is such a huge emphasis on finding research opportunities – from your high school, from your undergraduate institution, and from institutions moving forward. However, from my experience this summer, I really don’t think that research should ever be this concept anyone holds on a pedestal and sees as a necessary requirement for continuing their educations or pursuing any dream (of course, if you want to do research for a living, it’s kind of important, but that’s a completely different story). I’m interested in PA school, and with that in mind, I think a clinical internship or some sort of medical experience would have been substantially more helpful towards my future career. Of course, I could’ve loved research and wanted to do it for the rest of my life. And research is such a crucial field for the betterment of society, which is another reason why it’s so highly regarded by higher institutions, so I am glad that I was able to learn more about myself and about research this past summer. However, I just want to affirm that you should never feel discouraged or disappointed if you are unable to get a research position during your undergraduate experience.

That being said, if you do want research, Davidson is an incredible place to get that process started! Study hard, latch onto something that seems super cool, go to office hours, and start that conversation with your professor. You should also never feel like you’re not good enough for research either, because I seriously believe that anyone can research and make some awesome discoveries. Also, research can be in any field, and there’s something so transformative about creating knowledge for yourself – and making a project personal – as opposed to just being fed information in a classroom setting. You’ll never know what you’ll discover when you take that extra step.

Changing Career Paths

Read about CCD Student Associate Charlee Rae Bender, and her 2018 summer experience!

It seems counterintuitive, but there is a certain peace that comes with uncertainty- especially in those moments where all the plans you set up for yourself change without warning.

This is a lesson I wasn’t forced to learn until this past summer living alone in New York City.

At the end of May, I had managed to secure an internship working for a Production and Public Relations firm located just north of the financial district in New York City. I didn’t know anyone, but I knew living on my own would not only provide valuable lessons in independence, but also meaningful work experience.

I landed in LaGuardia with Law School on my mind and Elle Woods as my professional role model. However, I found my plans and interests having radically shifted by the time I left.

Within a week, I was nestled in one of the skyscrapers of Times Square at 6:30 a.m. managing four phone lines, connecting our spokesperson to various news stations and figuring out how to put our camera’s picture up on satellite. The fast-paced energy on studio days was something I immediately loved. I was in awe of the caliber of work the studio managers, technical crew and camera men produced, while living a life untethered to a desk.

With each studio visit and every bit of exposure to the broadcasting and entertainment industry, I knew this was it. I had actual hands-on experience that confirmed my newfound passion and further encouraged me to pursue this path.

Each and every person with whom I worked had a different story and different journey to get to the same place. This meant that for the first time in my life, I had no exact steps I could follow that would bring me to my goal. It would take slow, incremental change and a lot of patience to build towards this new career path.

It wasn’t long before obstacles began to arise. How was I supposed to pursue journalism, broadcasting, production, directing and acting all at once? How would a Philosophy major get me there? What if I wanted to keep Law School as a viable option? These questions were paralyzing and halted any and all progress.

I needed to take a step back and re-focus my scope.

I was so narrowed in on what I envisioned ultimate success to be that I lost sight of what was in front of me. It was time to slow down and appreciate the opportunities as they came. I needed to trust and have faith in my own instincts when they told me this journey would slowly unfold as long as I was dedicated and committed to the pursuit.

If you take nothing else from this- please know that the plans to which you may have been committed are worth foregoing if you find yourself losing interest- even if the other option does not provide the same sense of security and requires working harder to get there. Davidson is type of place that allows for and supports this journey of slowly discerning passions and interests- so take advantage of the time and resources while they are available.