House calls for patients without a home

Overlooking the beach at Palisades Park, Dorothy will quickly tell you stories about growing up in rural Canada, dancing with boys to big band music, and how she isn’t giving up on her search for her next husband. But she is not quick to trust doctors to provide much-needed medical care.

Homeless and elderly, she doesn’t remember going to the hospital last month, where her hair was shaved because she had a severe case of lice. And she is reluctant to have the bandages rewrapped on her leg, which is gradually healing from a severe infection.

Dr. Coley King, Venice Family Clinic’s Director of Homeless Services, changes her bandages, checks her blood pressure, and encourages her to connect with Venice Family Clinic’s partners. Three days a week, he hits the pavement with homelessness outreach groups including the People Concern, Safe Place for Youth, and St. Joseph Center.

“When I treat a patient on the street, the first thing I want to know is how at risk they are—at that moment—of dying on the street,” he says. “I’m triaging them in my mind: are we on alert to get them to a hospital that day?”

Homeless patients often have compounding health issues like untreated mental health conditions, addictions, and severe emotional trauma.

“Often, we’re building trust with people who don’t trust anyone,” says Katie Holz, a case manager on the People Concern’s street outreach team. “Dr. King has a special way of swooping in and treating people who really need medical attention but are very reluctant to ask for it.”

Dr. King’s friendly persistence has made an impact on homeless patients from Marina Del Rey to Malibu for more than 12 years, as the Venice Family Clinic Street Outreach program has expanded to better meet the needs of Los Angeles’ growing and underserved homeless population.

“Homeless patients have many barriers to health care,” Dr. King says. “They have emotional trauma that makes it difficult to trust authority figures. They have trouble travelling with all their possessions to faraway appointments. They don’t have access to a shower or clean clothing, and they may feel unwelcome because of their hygiene. Our clinics are incredibly homeless-friendly.”

Venice Family Clinic’s range of services also makes comprehensive treatment easier—while treating patients on the street, Dr. King can refer patients to addiction counseling, social workers, ophthalmologists, dentists, nurses, and more. This helps stabilize patients’ physical and mental health, while case managers help put them on the path to getting housed.

This year, a grant from the United Way of Greater Los Angeles will also help Dr. King show others how to bring his effective approach to other parts of LA County.

“It’s not easy to figure out how to get someone in the right position to be housed in the way they need to be housed to be healthy long-term—that pathway is dynamic,” Dr. King says. “It’s always changing and always challenging. However, we can we can train more care providers  to treat this unique population with the compassionate, high-quality clinical care they deserve.”

*Patient name was changed to protect anonymity.