Five Questions With: Dr. Emily Harrison

Dr. Emily Harrison joined Thundermist Health Center as a family medicine physician this spring. A longtime Rhode Islander, Harrison previously served as medical director of the family medicine practice at Care New England Medical Group Women’s Care Inc., as medical staff president at the former Memorial Hospital of Rhode Island and on Care New England Health System’s board of directors.

PBN: You’ve been medical director of the family medicine practice at Care New England Medical Group Women’s Care Inc., and you’ve also held several other leadership positions at CNE. What went in to your decision to move to Thundermist?

HARRISON: When I started medical school, our dean, who was a wonderful man named John Fryemoyer, stood up in front of my class on the first day and said, “Never forget the three most important things about being a doctor: it’s the patient, it’s the patient, it’s the patient.” I have never forgotten that. What that has meant for me as a primary care doctor caring for the underserved is that we have an obligation to deliver high-quality care to everyone, and that can only be done if health care organizations have a commitment to help all patients surmount barriers to care. Right now, in Rhode Island that means being part of a Federally Qualified Health Center.

I am really excited to be in a setting where we offer behavioral health, dental care, social services and care for the trans community, to name just some of Thundermist’s programs. We have a food pantry. We have a community garden. We have smoking-cessation programs. We have an amazing team [that shares] the mission of providing health care – in its broadest sense – to anyone who needs it. It’s a very exciting and fulfilling place to be a family doctor. I feel that I am doing the work Dean Fryemoyer called on us to do 20 years ago.

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PBN: Was it difficult to make a career change in the medical field in the midst of a pandemic?

HARRISON: Of course! Things were changing so rapidly in terms of our understanding of the virus, what was required of us as providers and how to do our jobs, and I couldn’t even find the break room. I think the hardest part was not having as much contact with new colleagues as I would have liked because we switched to working from home so rapidly.

One of the things I love about my work is that it’s all relationships, all day, whether that means greeting people at the front desk when I get there in the morning, planning for the day with my medical assistant, or having multiple patient encounters, not to mention seeing other providers. So not having that contact with people was really hard.

Fortunately, Thundermist is a very nimble organization and was able to make changes quickly and in a way that minimized stress for staff and providers, which I really appreciated.

PBN: What are you seeing at Thundermist so far? Is the practice able to reach deep into communities where medical care may be hard to access for some residents?

HARRISON: Oh, absolutely. Just as an example, we have a Community Health Team [that has] had some recent successes in getting a number of patients into subsidized housing who were either homeless or in unstable housing situations.

It’s humbling to me how difficult it is to access care when a person’s living situation is unstable. All their money and time goes into figuring out where they are going to stay and everything else falls by the wayside. Then you have unaddressed health issues and that’s a slippery slope.

On the other hand, if someone relates to a primary care provider whose team can also help with housing and food, that goes a long way to keeping them stable and healthy.

Our CHT is also doing great work with people who have recently been incarcerated, connecting them with community programs … [that] work with people who have recently left prison. Again, it’s humbling – people leave prison and they have no income, no health insurance and may not have the skills to figure out how to apply for things [such as] SNAP [Supplemental Nutrition Assistance Program] and health insurance.

These are just two examples of communities that Thundermist is reaching [that] otherwise would not have help in accessing services and health care.

PBN: What are your thoughts on the role of primary care doctors during the COVID-19 health crisis, and as Rhode Island’s infections continue to drop, do you foresee lasting change in the way that family medicine is practiced?

HARRISON: Primary care doctors have been able to serve a variety of roles during the pandemic, from staffing respiratory clinics to our regular inpatient work to continuing to care for patients in the outpatient setting. I think one of the most important things we’ve been able to do is to keep patients out of the emergency department by continuing to provide primary care in creative ways – for example, treating common conditions over the phone or being willing to refill diabetic medications even if we haven’t seen the patient in a while.

I think we all hope that we will be able to continue to treat patients via telephone or video going forward. It is such a huge improvement in access, that it is bound to lead to improved health access.

PBN: Part of your medical work includes volunteering in Honduras. How is that country faring during the COVID-19 pandemic, and do you have any plans to return soon?

HARRISON: I always have plans to return as soon as I can. Right now, unfortunately, Honduras has closed its borders to travelers from other countries and I don’t see that changing soon. We canceled our June trip and I would be surprised if we are able to send our October trip as planned. I’m hoping that our February 2021 trip will be able to go.

We’ve had to be creative about how we continue our programs on the ground because we have people depending on us for supplemental food and for chronic disease management. Fortunately, we have great staff in Honduras who have worked really hard to keep our programs going. Many key businesses, [such as] grocery stores and pharmacies, are closed, so supplies are hard to get. Our staff, like everyone in Honduras, [is] only allowed to travel outside of their homes once a week, so they have had to work around that in order to purchase food and medicine and then get them delivered to people in our village.

As for how the country is faring, news other than official government reports is quite limited. However, it’s like any poor country: people live in dense situations with many people in one house or apartment; they rely on day labor for income, so the idea of staying home for weeks at a time in quarantine is not realistic; and their health care infrastructure is desperately underfunded and under-resourced. What we hear from our village is that people are scared to report symptoms and scared to go out. I am most worried about inadequate food supply, in the short term; and the potential for high death rates if we do get cases of COVID-19 in our village.

Elizabeth Graham is a PBN contributing writer.

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