Clinic goes mobile to reach underserved youth

Mar 18, 2013

What’s the quickest way to a child’s heart? How about a Harry Potter movie? The staff at the Bay Area’s Teen Health Van know their patients are no exception.

Katie Baker, the van’s newest physician’s assistant, says showing movies makes the patients feel “more comfortable” when waiting for treatment. The mobile clinic’s waiting room is the size of a cubicle. The movie drowns out any sounds coming from nearby exam rooms, helping preserve patient privacy.Patients range in age from 10 to 25 years old. Half are homeless. Most lack health insurance.

“The kids that we see typically have not had regular health care,”says Dr. Seth Ammerman, a practicing pediatrician and medical director of the Teen Health Van. Ammerman says most of the patients have had sporadic physical examinations, if at all. “What we do is provide comprehensive medical care,” Ammerman explains.

With funding from grants under the Lucille Packard Children’s Hospital, Ammerman and his team launched the Teen Health Van program in 1987. It’s a one-stop mobile shop that travels to every nook and cranny of the Bay Area’s underserved neighborhoods.

Rosa Maldonado, another physician’s assistant, receives incoming patients.

“Any pain today, hun?” she asks a young girl as she types on a laptop next to a sink.

“No,” responds the patient.

Today the van is parked outside the Indochinese Housing Development in San Francisco’s Tenderloin.  Melissa Nguyen, 21, is up next for her monthly check up.

“There are days I don’t feel good,” says Nguyen, “having head aches and sleepless nights.” Nguyen, who lacks health insurance, has been coming to the Teen Health Van for three years. Though she initially came complaining of headaches, she says that coming to the van has transformed her into a happier person overall.“Before, I kept to myself and,  when I don’t feel good, I’d just be in my box, no one entering it,” Nguyen explains. “And after I came onto this van, I felt much better and more out of the box.”

Nguyen says the van’s counselor has made a huge difference. “They’ve been there and they actually understand us – and they are willing to help us, one by one, one step at a time,” says Nguyen.

Patricia Soto-Minder, the van’s social worker, says she is on the look out for certain psychosocial problems. She says she performs an assessment on each patient to find out if the patient is homeless or if the patient has any mental health issues.

Soto-minder says a lot of teens who come into the Teen Health Van feel isolated. Many have bounced between various foster homes and housing developments. Her role is to bridge the gap between patients and those around them who can help. “When we meet them, we are able to assess them and provide those resources that are not in place,” she explains.The van has a comprehensive team that can provide virtually any kind of care. There’s a doctor, a nurse practitioner, a social worker, and a physician’s assistant. There’s even a resident dietitian and fitness instructor.

What they don’t have, says Dr. Seth Ammerman, they team up with neighborhood organizations to provide. The Boys and Girls Club offers afterschool arts and crafts down the street.The Tenderloin Children’s Playground hosts a kitchen for cooking classes, a gym, and a veggie garden. All are part of a wellness program designed to keep kids coming back. Ammerman has noticed that, when teens “start taking responsibility for their health, that it actually spills over into other areas of their life.”

Sally Martinez, a mother of six, says her family has been coming to the health van for eight years. She says her family is stuck in limbo; they don’t qualify for federal aid, but can’t afford private health insurance. “It’s just me and my husband working,” says Martinez. “But we have six kids, so it’s hard.”

Three of the six children are in college. The van has relieved some of the financial pressure and is now an important part of the Martinez’ lives.“They know all the kids names,” Martinez explains. She even has the doctor’s number saved in her cell phone.

“Sometimes people are shocked at that. ‘Oh, you’re giving teens your cell phone,’” says Ammerman, laughing. “But it’s really interesting because it helps build trust with the kids and it’s a bonding thing. It’s extremely rare that they don’t call me with an appropriate question.”

Maybe it’s the cell phone number. Maybe it’s just that these underserved patients know that someone somewhere knows what they are going through. Whatever it is, the Teen Health Van and its staff have given them a place to come home to. 

This story originally aired on March 14, 2012.