Many people who live outdoors, unsheltered, are also — unsurprisingly — sick.
People experiencing homelessness are more likely to suffer from chronic illnesses like diabetes and heart disease, according to the Centers for Disease Control and Prevention, but getting help for those conditions is not easy when you’re also dealing with a lack of housing, money and food.
Doctors at Baylor University Medical Center have joined other physicians around the country by bringing medical treatment directly to the forests and underpasses where their patients live.
One of the Street Medicine program's leaders, Dr. John Garrett, says Dallas has never had a team like this before.
He joined NTX Now hosts Ron Corning and Miranda Suarez to reflect on the team's progress about a year and a half since its inception. According to Garrett, the program has led to a 77% reduction in hospital stays for its patients.
This interview has been edited for length and clarity. You can hear the full conversation by clicking the 'listen' button above.
What is street medicine?
Just like an elderly patient who couldn't leave their home may have a home health care visit by a primary care doctor, we do the same thing.
We become that patient's primary care doctor, but instead of going into their house, we're going underneath the bridge.
Of course, me writing a prescription doesn't do them any good, because then they'd have go to the pharmacy and get it filled, which can be technically and financially challenging sometimes. So, we actually bring all our medicines with us, and we will write the prescription, we will dispense the medication right there so that they have it and we know that they're able to take it.
Breaking a cycle
I'm an emergency medicine physician, and we see a good amount of unsheltered and sheltered homeless folks in the emergency department at Baylor University Medical Center. About 10% of our patients — 30 or 40 patients a day — are homeless.
We would see the same patients over and over again, and these were not people who were there because they sprained their ankle or they had a laceration or something. These are people who had real, chronic, severe medical diseases. They had bad liver failure and cirrhosis. They had heart failure, so they couldn't walk 50 feet before having to stop and take a breath.
They would come in because they couldn't breathe. I'd take care of them in the emergency department. Sometimes I could get them feeling better enough to go back home, and I'd write them a prescription to go home and go back out onto the street. Sometimes they were too sick, and I would have to admit them to the hospital.
Then, ultimately, the patient would end back up out on the street again in the same situation, and we would rinse and repeat over and over and over again.
After looking at that for a decade, there was this call: We've got to do something more, because what we're doing is not working.
What success looks like
One of the first patients that we had was a guy who had liver failure. He had fluid in his belly that would get infected. He was at the emergency department and admitted to the hospital every month for a year.
Then we got him enrolled in the program, and he went 12 months without being admitted to the hospital. That's a success story.
Those individual stories, I think, capture with much better accuracy what we're doing, than the metadata of a 77% reduction [in hospitalizations].
Miranda Suarez and Ron Corning are the hosts of KERA's NTX Now. Got a tip? Email Miranda at msuarez@kera.org or Ron at rcorning@kera.org.
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