Profile-Taking healthcare beyond medicine

Credit:www.sechc.org

It took me a few minutes to realise that the life-size sticker on the door of the Boston South End Community Health Center was Dr Robyn Riseberg herself. The photograph of the blonde and blue-eyed doctor showed her cradling an infant in her arms. I later learnt that the baby was her second daughter, and the picture was taken four years ago. Now in her late thirties, Dr Riseberg is more than a poster on a door. She has made it her life’s mission to work as a pediatrician with children and families of underserved populations, but her idea of holistic health care goes way beyond treating an illness alone.

A half hour after we were expected to meet at the clinic, Dr Riseberg limped her way into the hospital and proceeded to the practitioner’s office, her eyes scouring the crowd of mothers and babies in the pediatrics’ waiting room.  She wore high-heeled boots which gracefully set off her petite frame, but did little to disguise her limp. She had clearly still not recovered from running the Boston Marathon two days earlier. As board member for Casa Myrna- a non-profit dealing with issues of domestic violence, Dr Riseberg had run to raise funds for the organization.  “We raised over $23,000!” she filled me in as I followed her into the room where her first patient waited with his mother. It was not until two hours later that she paid attention to me again during a quick break in between patients.

“And how are things at home?” she asked the mother of her first patient, and the parents of all the other patients that followed. Based on the answer, Dr Riseberg would then proceed to tactfully investigate the domestic situation of the family checking for the availability of utilities like heat and electricity, and keeping her eyes and ears open to symptoms of domestic strife. When she felt confident, she would abandon her interrogation and carry on with the medical examination. This curiosity is typical of ‘physician champions’, a term used to represent doctors who pioneer the Medical –Legal partnership in their respective health care centers. Dr Robyn Riseberg is one such champion at the South-End Community Health Center, which caters to Latino and migrant communities in South Boston.

The Medical-Legal Partnership is a distinguished service initiated in the Boston Medical Centre in 1993. It creates a relationship between doctors and lawyers to help identify and mitigate social problems which have consequences on the health of poor families in urban areas. For instance, recurring asthma in a child can often be traced back to a moldy or rodent-infested apartment. The family of the child, either too poor to sue the landlord or too new to the country to know their rights, would not approach lawyers themselves to help with the issue. An insightful ‘physician champion’ often helps identify the problem and then puts the family in touch with lawyers who are part of the partnership. The process is entirely free for the family, as private law firms justify these expenses as part of their pro bono social commitments.

Introduced to it during her residency at Boston Combined Residency Program at Boston Medical Center and Children’s Hospital , Dr Riseberg was immediately attracted to the mission of the Medical-Legal Partnership. “It went along with my idea of medicine,” she said. Hired as Health Center Director, she perceives herself as a “relationship manager” who bridges the gap between doctors and lawyers. Since her introduction to the partnership in 2006, Dr Riseberg has helped expand the program to six other health-care centers in Boston.

The process was not easy and she constantly faced resistance by doctors and health care workers who felt that they did not have the time or skill to delve further into medical problems. Dr Robyn Riseberg believes that most of the illnesses brought to clinics are symptoms of a larger social issue. The real medical issue is sometimes hidden, and proper health care needs to dig deep into the family’s social and living conditions. With poverty, domestic violence and ignorance widespread in poor and migrant populations, legal assistance has been the answer to many a medical problem. In one instance she helped the grandmother, and only care-giver, of a mentally-retarded boy gain legal guardianship of the child before his 18th birthday. Her colleague, Dr Jack Maypole, described Dr Riseberg as a “tireless advocate”. “She will bear steel fangs if you come in the way of her and a patient,” he added.

Dr Riseberg holds training programs for doctors and lawyers to help them identify social issues, and approach them sensitively with patients. In the process she works as a mediator bringing legal perspectives to doctors and medical insight to lawyers. “Lawyers and doctors make strange bedfellows,” said JoHanna Flacks, Pro Bono Director of the Medical-Legal Partnership, “Dr Riseberg keeps us honest.”

Dr Robyn Riseberg was first exposed to less-privileged communities on a backpacking trip to Asia and South America, after completing her undergraduate degree in Sports Psychology. Travelling through India and China, she realized how far removed her own life was from these populations. On her return, she decided to study medicine and joined the Bryn Mawr Pre Med School and from there she graduated to the University of Massachusetts Medical School. Her studies and research through pre-med and med school always focused on challenging social issues. At Bryn Mawr, she singularly carried out a prison survey of incarcerated HIV positive male prisoners. Later, she conducted her final project on domestic violence at University of Massachusetts Medical School. Today, through her involvement with Casa Myrna, Dr Riseberg still campaigns against domestic violence in addition to her work as a medical practitioner.

With two young children and multiple passions, I was amazed at how Dr Robyn Riseberg manages to keep up. She admitted that she would have never been able to cope without the support and help of her husband and parents. At our second meeting over a quick cup of coffee, she repeatedly checked her watch to ensure she was not overstepping her next appointment. About ten minutes into our conversation, her phone vibrated impatiently inside her bag and I wondered which one of the many facets of her life was demanding her attention. As Dr Riseberg reached into her purse to find it, she laughed and said, “My life would have been a lot easier if I worked at GAP.”

Sources:

  • Robin Rich, Vice President, Casa Myrna
  • JoHanna Flacks, Pro Bono Director, Medical Legal Partnership, Boston
  • Jack Maypole, Pediatrician, South End Community Health Center


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