University of Kentucky
It’s a small-town clinic with just a few rooms, named for a physician from an era when house calls were common. What you’ll find inside, though, is remarkably progressive.
The Phyllis D. Corbitt Community Health Center in Wilmore, population 6,400, completely staffed by faculty of the University of Kentucky College of Nursing, is a lifeline for those struggling with depression or anxiety, and where LGBTQIA+ patients can find specialized care and an understanding ear.
The primary care center has come a long way from its opening in 2015.
“We started out as a limited-services clinic treating colds and sprains because at the time it was the quickest way we could get up and running,” said Sharon Lock, Ph.D., the center’s director and the nursing college's assistant dean of faculty practice. “We had a lot of help from people at UK HealthCare to figure out how to make that all happen. After about two years, it became clear, though, that if we were going to make it, we needed to offer primary care services, as well.”
Today, five faculty members, who are also advanced practice registered nurses (APRNs), work in the clinic at least one day a week, and each is typically matched with a nursing student.
Serving both a community and UK
The center first opened to provide an opportunity for faculty at the College of Nursing to practice, Lock says.
“At the time, I was the coordinator of the family and nurse practitioner track for UK, and it was extremely difficult to do clinical placements because you’d think you had a student placed and then something changed,” Lock says. “We wanted a facility where we knew we would have a place for students while also serving the community.”
“The opportunity just sort of fell into our laps,” said Amy DelRe, the center’s practice manager, who has worked for the College of Nursing since 2005. “Dr. Lock had wanted this for years, and one day we got a call from the owner of a building in Wilmore, who saw my name and phone number on the university’s website.”
The building needed extensive renovations, and DelRe notes it took two years of planning from the time they first saw it until they were able to open the clinic. But the rent was reasonable, there was a pharmacy next door, and the residents of Wilmore had been missing a convenient place to find care since Corbitt retired.
Several visits to the UK surplus warehouse later, the facility was ready to open in the summer of 2015, albeit on a shoestring budget. In 2018, the center began offering comprehensive health care for people of all ages, or “those taking their first breath until their last breath,” as DelRe says.
Seeing mental-health needs everywhere
As the center expanded the type of care it provided, the need for practitioners grew. In 2018, the staff expanded with the addition of Lori Fugate, D.N.P., an assistant professor at the College of Nursing.
Fugate has worked as a family and women’s health nurse practitioner for 15 years. While providing primary care services in Wilmore, she and Lock soon realized many patients needed a different type of care than she could provide.
“I returned as a student to the College of Nursing to earn my post-graduate psychiatric mental health nurse practitioner certificate program of study when I realized there was such a great need for behavioral health services — here, anywhere — and in a town this small, they would have a long wait to see a behavioral health specialist,” said Fugate.
While Fugate completed the 18-month program of study, Lock and DelRe negotiated to lease an apartment upstairs from the clinic for additional office space. On a typical Wednesday, Fugate now sees between eight and 10 behavioral health patients in the upstairs office, an atmosphere that is more casual and less clinical.
“With the right medication and the right dose, you can see improvement in six to eight weeks. It’s amazing to see. Now when I see the patient back and they’re doing better — oh, my gosh, I get goosebumps!” said Fugate.
Fugate says as the clinic continues to grow, she hopes it will eventually provide care for substance abuse.
An ally to a diverse community
The next step forward for the center came in 2020, with the arrival of Anthony Carney, D.N.P., an assistant professor and two-time graduate (bachelor's of nursing degree in 2014, doctorate of nursing practice in 2019) of the College of Nursing.
Carney says the clinic has allowed him to treat a group historically underserved by the medical community: LGBTQIA+, or lesbian, gay, bisexual, transgender, queer and asexual. The plus sign "represents members of the community who identify with a sexual orientation or gender identity that isn’t included within the LGBTQIA acronym," GoodRx explains. "It’s an inclusive way of representing gender and sexual identities that letters and words cannot yet fully describe."
Carney said, “There have been numerous health disparities with the LGBTQIA+ community in terms of mind, body and spirit. Screenings are delayed, usually because of fear or distrust, and there are increased rates of depression, anxiety and substance-use disorders.”
Carney has been focused on caring for a diverse population since college, when he was mentored by Dr. Keisa Fallin-Bennett, director of UK HealthCare’s Transform Health Services, a resource that meets the unique health needs of LGBTQIA+ individuals.
“The patients who come to me for Transform Health needs are incredibly excited to have health care that’s sensitive to their needs, especially patients who are there for gender care," says Carney. "It’s a big life decision to come out to your provider, to say you have issues with gender dysphoria or with your sexual orientation.”
Carney says he sees about one patient per week from the LGBTQIA+ population.
“This particular type of care is not that common outside of major metropolitan areas, so it’s very exciting to offer it in Wilmore," Carney said. "The entire staff is on board, which I love, and it’s been an overwhelmingly positive experience for everyone so far.”
Carney has helped work with undergraduate nursing students on special considerations for the LGBTQIA+ population, such as pronoun usage and screenings. He eventually would like to start training other providers across the state to offer inclusive care that is sensitive and comprehensive.
“Right now, I just look forward to coming into the clinic every Wednesday,” he said.
What's next in Wilmore
The center has continued to adapt according to the community’s needs. At the start of the Covid-19 pandemic, the clinic began offering telehealth visits for the first time.
“When COVID came, we were just hitting our stride. Now, though, we are back to pre-Covid levels of visits,” Lock said. "More than 1,600 visits were billed in 2020. The staff also now includes a registered nurse to assist with patients."
In 2021, the clinic made a significant investment in connecting to the same system for electronic health records used by UK HealthCare. For patients, it will mean access to information and a portal that’s easier to use.
Like Lock and the rest of the staff, Fugate says the clinic has been good for Wilmore and rewarding for everyone working at the clinic.
“Here in Jessamine County, we don’t have the public transportation you’d find elsewhere, so many of our patients actually walk here from their homes,” Fugate said. “They’re very thankful we’re here.”
from KENTUCKY HEALTH NEWS https://ift.tt/9LQyi8O
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