Pediatrics in the Community: Commentary

Abstract

The previous two pieces were written by residents in the University of Rochester Pediatric Residency Program while participating in the“Pediatric Links with the Community” rotation.“Pediatric Links with the Community” (PLC) is an innovative program at the University of Rochester Department of Pediatrics designed to teach pediatric residents about the special health care needs of poor children. The goals of the PLC program are to: This year, 30 pediatric resident physicians will interact with approximately 4,000 impoverished children in the Rochester area in the 2-week rotation they spend in the PLC program. Next year, 100 medical students will participate as part of their third year pediatric clerkship.The effects of poverty on chidren’s health are profound and enduring. Currently, at least one in five children in the United States lives in a family whose income is below the federal poverty level. In the city of Rochester, NY, approximately 40% of children live in poverty. Recent studies have shown that compared with nonpoor children, poor children have: Yet, pediatric residents’ and medical students’ encounters with impoverished children traditionally have been limited to hospitalizations and hospital-based clinics.As part of the PLC program,pediatric residents provide supervised medical care to children at sites that include the Corpus Christi Medical Outreach Clinic for the homeless and underinsured, Migrant Families Clinic, and the Foster Care Clinic. Residents have health-related discussions and tutor parents and children at sites such as the Webster Avenue Family Resource Center and the Boys and Girls Club of Rochester. They participate in community health agency activities, including home visits with the Community Health Nursing Service and Early Intervention Team.The PLC program was developed by three former chief residents in the Department of Pediatrics—Michelle Jones, Jeffrey Kaczorowski, and Laura Jean Shipley, in conjunction with pediatric residents, the Pediatric Residency Training Program at the University of Rochester, the Monroe County Department of Health, and local community agencies. Through this collaboration, the PLC program hopes to help breach barriers to health care and education for impoverished children; foster a cooperative effort for poor children among health care providers, community service agencies, and local organizations; and strengthen commitment to poor families as health care systems evolve and government programs are curtailed.