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Helping hands: James Withers, M.D. , and fourth-year medical students Marianthe Manak tend to the needs of a homeless man. |
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In the early 1990s, James Withers, M.D., an internal medicine physician at The Mercy Hospital of Pittsburgh, read a book, 52 Ways to Help the Homeless. Dr. Withers felt a connection with the book because as a child he had accompanied his father, also a physician, on house calls to the poor in Latin America.
His resulting inspiration? To provide free health care to the homeless population of Pittsburgh. "My kids thought I was insane," says Dr. Withers, who is also a full-time faculty member at Mercy's Department of Medicine.
Dr. Withers dressed like a homeless person, complete with tussled hair, partnered with a man who was once homeless, and made night rounds in Pittsburgh's alleys and underpasses several nights a week to treat the city's homeless. "None of them had primary care, and they were all profoundly grateful that someone was willing to acknowledge they existed," the now 45-year-old physician says.
After several months of street rounds, he saw the possibility of starting a more formalized network. "I made myself available as a consulting service to other physicians who had dealt with the homeless," Dr. Withers says. His secretary transferred from the Department of Medicine and joined with him in forming Operation Safety Net (OSN), a medical outreach program under Mercy's auspices that they incorporated as a non-profit organization in January 1993. Since then, the network has developed into a program that provides primary care through "street teams" - consisting of clinician volunteers, former homeless people, medical students, and residents - and an RV that has been converted into a mobile medical clinic.
In the last ten years, Dr. Withers and OSN have received more than 35 awards and grants, including a prestigious $120,000 Community Health Leadership Program award from the Robert Wood Johnson Foundation late last year. The network gets about a third of its funding from state, federal, and private sources.
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'Safety Net': James Withers, M.D. (left), and a volunteer from Operation Safety Net tend to the medical needs of a homeless man on the Pittsburgh streets. Operation Safety Net offer a homeless man help and a handshake. |
OSN teams go out on street patrols four nights a week, from 7 p.m. to 11 p.m. Dr. Withers still accompanies the team on Mondays. Besides basic primary care, the teams screen for TB and test for HIV and hepatitis. In the cold months, much of their work consists of the obvious necessary support - passing out blankets to keep homeless people warm, coordinating efforts at shelters, and evaluating the medical needs of those who remain on the streets. This year's cold winter has not spared Pittsburgh; one homeless person actually lost a foot from frostbite, the first such event there in nine years, Dr. Withers says.
Tracking each person's case has often been a challenge, Dr. Withers says, but the program uses computerized wireless devices to make it easier to track individual case istories. "It's difficult sometimes. You meet someone named 'Spike,' who was 'Froggy' last week…then there's the no-name guy with the fish tattoo," he explains.
"The staff has had to deal with some pretty tough people," he adds. That's why he "dressed down" when originally heading out on the streets in 1992. Currently, two residents work in the network, while more than 60 medical students have passed through OSN over the years. "For me, it's more important to take people who are going to be leaders [in medicine] and give them an in-depth experience" in dealing with the underserved, says Dr. Withers.
OSN has had visits from a number of cities, medical schools, and hospitals both locally and nationally, including the University of Pittsburgh School of Medicine, Jefferson Medical College (which is affiliated with Mercy), Lake Erie College of Medicine, UC-San Diego, UC-San Francisco, and Baylor College of Medicine. Dr. Withers says he could ultimately envision linking with other institutions and creating a nationwide network.
As many as 90 percent of the nation's medical schools have specific programs to get students involved in helping the underserved, adds Thomas O'Toole, M.D., an assistant professor of medicine at Johns Hopkins School of Medicine in Baltimore, who coordinated a parallel program to OSN out of the University of Pittsburgh in the mid-1990s. "I think it's very important … in forging attitudes and in helping underserved communities," he says.
Those who work with the homeless and underserved "are really carrying a significant personal burden," adds Dr. O'Toole, who also runs a drug treatment program for Baltimore's homeless. "It's kind of a collective altruism that I don't think is always fully appreciated."
By Michael G. Malloy
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