March 8, 2022
When physician assistant Negeen Farmand was asked to start doing street medicine four years ago by the community health center she works for, she was intimidated by the idea.
“I had been working inside a clinic since I graduated, just regular four-wall primary care. I had no experience at all in street medicine,” Farmand said. “I wanted to be mentored by the best, so I reached out to Venice Family Clinic’s Dr. Coley King and physician assistant Carrie Kowalski, who I saw as pioneers in street medicine on the West Coast.”
Over the course of a few days, Farmand shadowed King as he provided care to patients on the streets of Venice and Kowalski at a nearby homeless services center. Farmand saw first-hand how important building rapport with unhoused patients is in being able to successfully provide health care. It was during one of these experiences that she saw King administer a long-acting injectable anti-psychotic medication to one of his patients with schizophrenia.
“Dr. King mentored me on the benefits of these medications, how to start them and what side effects to monitor for. I still text him for advice sometimes. Last year, I gained the courage to finally start one of my patients on a long-acting injectable, and I have seen great changes in the severity of his psychosis, insight, judgment and ability to care for himself,” Farmand said.
“I really can’t thank Dr. King enough for the education and confidence he’s given me.”
From traditional in-clinic primary care to on-the-spot street medicine, Venice Family Clinic’s many programs offer numerous and varied opportunities for students; medical residents, or doctors in training; and other health care professionals to learn how to provide comprehensive care to patients who may not get care otherwise.
Nearly all of the Clinic’s programs host student interns or residents, including primary care, psychiatry, pharmacy, dental, vision, health education, and Children First Early Head Start. Students and residents come to the Clinic from many universities and health care organizations in all kinds of disciplines, from UCLA Master of Public Health students and Tulane University pre-med pediatrics students to West Los Angeles VA Medical Center psychiatry residents. UCLA pre-med students learn about harm reduction through syringe exchange at Common Ground, the Clinic’s HIV prevention program. And just about every week a resident or medical professional from another clinic observes our medication-assisted treatment group sessions held by our substance use treatment program, SUMMIT.
As part of Venice Family Clinic’s affiliation with UCLA, our Simms/Mann Health and Wellness Center serves as a continuity clinic for UCLA residents. Here residents provide primary care, under the supervision of their attending physicians, in an outpatient setting throughout the entirety of their three years of residency training. In this way, our patients receive care from the same clinicians for an extended period of time. This continuity of care also gives residents a chance to learn more about our patient population and the factors that impact their ability to get and stay healthy.
“Our patient population is complex and deals with a variety of socioeconomic issues,” said Dr. Cesar Barba, Venice Family Clinic’s associate medical director. “Exposing residents to health care disparities early in their medical careers is important because it helps them better understand the needs our patients have. At Venice Family Clinic, residents learn to practice whole-patient care because of all the services we offer and how we provide patients a great medical home.”
Those services include behavioral health therapy. Our Behavioral Health department hosts several students every year from master’s degree programs in social work and marriage and family therapy. These students spend an academic year with the Clinic performing their internships in a health care setting at our Simms/Mann location or in a school-based setting at our Sandy Segal Youth Health Center on the campuses of Culver City middle and high schools. In addition to shadowing the Clinic’s therapists and receiving weekly trainings in a variety of topics, interns get their own caseload of 10-12 patients, facilitate group therapy sessions and provide on-call behavioral health services, all under the supervision of the Clinic’s licensed professionals.
One of those interns is Tiffani Parks, a USC student earning a master’s degree in social work.
“I have learned so much being here, including how the intake process works in medical social work, how to diagnose patients, how to provide services via telehealth and make decisions in on-call situations,” Parks said. “And helping to connect patients to different resources through case management is something that I’ve found to be important for my patients’ livelihoods, especially because many are experiencing homelessness or have lost their jobs.”
Fulfilling a promise
Barba emphasized the importance of clinicians experiencing what it’s like to work at a community health center.
“For people who normally wouldn’t have this kind of experience, the hope is that they enjoy providing care to this population and want to continue helping these patients,” Barba said. “There is so much need in our communities.”
Several clinicians who are now on staff at Venice Family Clinic performed resident rotations here. One of those clinicians is Dr. Michelle Aguilar, who now leads our Pediatrics program.
“My continuity clinic at Simms/Mann was my favorite clinical experience as a UCLA pediatrics resident,” Aguilar said. “With the experience I had with various services available at Venice Family Clinic, I felt well-equipped to provide my patients with quality multidisciplinary care that would address their needs beyond their medical concerns. I was also inspired by the compassionate care the Clinic’s clinicians and staff provided. I learned so much more than primary care pediatrics through that experience.”
Aguilar wanted to join the Clinic’s Pediatrics team when she completed her residency, but there weren’t any openings at the time. So when an opportunity presented itself in 2018, she jumped at the chance. Her experience with the Clinic as a resident had motivated her to want to work in a community clinic ever since.
“The most memorable experiences I had were caring for the wonderful patients, many of whom were also children of immigrant parents, like I was,” she said. “Hearing my patients say, ‘I want to be a doctor like you,’ or ‘Quiero ser doctora,’ made me aware that I wasn’t just their pediatrician, I was also their role model.”