The sunny waiting room in suburban Maryland holds widely assorted patients: a slender man in gold-cloth African garb; some women wearing hijab head coverings, others without. In the hallway lined with treatment rooms, a young woman in shorts sits next to a man donning a baseball cap. Here at the Muslim Community Center Medical Clinic, regardless of attire or religion, all patients will receive care.
[See: Which Medical Screenings Should You Have in 2017?]
A bit farther north, a New York City hospital has found that wide-open doors aren’t always enough. So Maimonides Medical Center is sending physicians into Brooklyn neighborhoods to reach women whose religious or cultural beliefs prevent them from seeking health care. For the first time in their lives, some will receive heart-disease and breast-cancer screening — permissible only from same-sex doctors.
For both centers, inclusion and service to the wider community are core values. Without these and other like-minded U.S. health facilities, more people would go without care.
Accessible to All
Like its adult patients, the majority of the MCC Medical Clinic staff members are non-Muslim, even though the clinic is housed within an Islamic center in Silver Spring, Maryland. About 80 percent of patients receiving primary care there are uninsured. Many are drawn there by word of mouth.
In the busy clinic, dental exam chairs are occupied. A metal tray holds packages of discounted dentures, labeled with the names of patients who can finally afford proper teeth. Awaiting use, an echocardiogram device sits in the hallway, and will enable patients to receive complete heart workups, explains cardiologist Dr. Asif Qadri, the clinic’s founder and medical director.
Across the hall, an OB-GYN exam room is staffed by a female physician whom patients will feel comfortable seeing. Weekly dermatology and a variety of specialty clinics are also offered.
In another room, a patient reads down the eye chart. If she needs eyeglasses, an impressive array of choices is available on-site. One of two shuttlebuses sits in the parking lot, ready to pick up patients on its route for free to take them the clinic and back.
From its humble 2003 inception with 53 yearly patient encounters in what was then its only exam room, the clinic staff anticipates 18,000 patient visits in 2017. Whether patients are Muslim, Coptic Christian, Buddhist, Jewish, agnostic or other, the clinic offers compassionate care irrespective of their beliefs or lifestyle, says executive director Dr. Rashid Chotani. They don’t necessarily have to live in state, either.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
Celeste, a human rights advocate, was living in New York City when she developed an urgent, complicated dental problem. Lacking insurance, she couldn’t find local providers who might let her pay for care in cash installments, rather than plunking down a credit card she didn’t have. (Celeste is not the young woman’s real name, which she prefers to keep private.)
A friend-of-a-friend suggested that Celeste contact the Maryland clinic. One phone call later, she was on her way. There, in the open waiting area, Celeste says she observed patients of different ethnic groups and economic backgrounds “being cared for kindly and with great consideration,” as was she. “The fact that a very thoughtful doctor has a big clinic and is opening the doors to people outside the community — that’s a beautiful thing,” she says.
Many patients who come to the clinic had never received preventive care in their country of origin, Chotani says. Some had never seen a doctor at all. Some present with “sky-high” blood pressure that’s never been diagnosed, much less treated.
The center recently started accepting patients with insurance. Most patients are charged a modest copay. Still, some can’t afford any amount whatsoever. The motto is: “If you cannot pay, we will find a way,” says Zaffer Mirza, chairman of the board of trustees of the Muslim Community Center.
Several funding streams keep the clinic running. Charity starts with donations from the center’s congregation. Partnerships and grants through state and county agencies, health care companies, nonprofit foundations, the National Institutes of Health and others are also vital to its survival. In return, the clinic serves an educational role that includes primary care rotations for nurse practitioners and medical students from several major area universities.
“If individuals still feel in the United States that Muslims are not contributing to the fabric of this nation, I invite them to come to our clinic to see what we are doing,” Chotani says.
Welcoming Women
Most patients, whatever their culture or religion, value modesty and privacy. For some Muslim or Orthodox Jewish women, it’s even more essential to respect those priorities. The Heart to Heart Program at Maimonides Medical Center is doing just that.
With its Brooklyn location, Maimonides is adapting to changing area dynamics. The large, nearby Muslim population presents specific issues that the program works with community leaders and liaisons to understand and address.
Because of the nature of heart exams and the relatively low female-to-male ratio of cardiologists in the U.S., preventive heart care in particular for women in these populations might seem out of reach. Maimonides outreach events adapt to cultural and faith-based sensitivities while introducing women to providers of their own sex on their own turf.
Women may have more confidence asking questions among other women, says cardiologist Dr. Inna Nelipovich, director of the Heart to Heart Program. Education is the primary goal of these events but they also serve as screening opportunities. It’s a chance to offer heart tests like echocardiograms and to check attendees’ blood pressure and cholesterol levels.
The heart program has “blossomed'” into prevention for other conditions, including breast cancer, Nelipovich says. Breast surgeons, OB-GYN doctors, vascular surgeons and others may join in to speak about screening for cancer or vascular disease.
“Not all Muslim women are allowed to attend certain gatherings because of restrictions,” Nelipovich says. “They may not be able to speak freely about certain concerns, such as breast cancer screenings and things like that. So we assess what they need and adjust our events to what they want.” While Q&A sessions aren’t geared to individual medical advice, women have the opportunity to make appointments or receive health providers’ contact numbers to follow up when they feel ready.
“Even getting the word out that there are female providers — even something as simple as a woman’s name with the physician on the door — sometimes goes a long way,” Nelipovich says, “Being able to provide this opportunity to the community is good. Because they know there are people who speak their language; there are people of the same gender who will be happy and willing to take care of their needs.” A Chinese-community outreach program is now in the works, she notes.
[See: 17 Ways Heart Health Varies in Women and Men.]
Once open, the door can stay open. Some patients first came to see Nelipovich precisely because she is a female provider. “They had very specific modesty requests and couldn’t be seen by a male cardiologist,” she says. “For a couple of these patients, we did change the course of their disease. They’re still my patients that I follow regularly.”
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Delivering Health Care Across Cultural Divides originally appeared on usnews.com
