Nightime Rounds with Health Care for the Homeless: The Night Center

This past Wednesday I had the opportunity to go out for rounds with Jim O'Connell, the founder and president of Boston Health Care for the Homeless. While Dr O'Connell is one of the most humble and down to earth people you could ever meet he's a big wig in the health care for the homeless world and an opportunity to shadow him for the evening was a big deal.

The evening began at The Boston Night Center, one of the many Pine Street Inn programs. The Night Center was a new concept for me, it's an overnight drop in center. The center serves meals, has a tv, and space hang out. An overnight drop in center is the lowest of low threshold services; residents are able to go in and out as they please, they're allowed to be inebriated, and they do not need to accept any services. Because it is not a shelter there are no beds but clients can sleep on the floor and, two nights a week, receive medical services.

Jim brought a backpack full of medical gadgets with him, which included a thermometer, a bracelet-type gadget that takes blood pressure, something that goes on your finger that does something too technical for me, and the classic stethoscope and prescription pad. We saw four different patients, wrote one prescription, scheduled two follow-up visits at the clinic, and gave one person a phone number to call for test results. This was in the span of about an hour in a bustling room full of people.

Somehow Dr O'Connell made the space his own as he listened about the fractured ankle that wouldn't heal because the client couldn't walk with a cast, "How am I supposed to get around? I'm homeless." Clients who are homeless aren't always the easiest people to get along with, often life has gotten the best of them and sometimes that leaves them bitter and snarky. But the snark didn't matter, Jim still listened carefully and examined his patients with the same care one would expect in a hospital room, not in a homeless shelter.

Health Care for the Homeless is not unique to Massachusetts, there is actually a National Health Care for the Homeless Council that stemmed out of a 19 site demonstration project that is now 95 organizations strong. Not all Health Care for the Homeless Services are delivered like what I witnessed tonight, or what I experienced with Jill earlier this fall. The shelter I volunteer in actually also has a health care for the homeless component; there is a clinic on site where health care services are delivered. This isn't quite as exciting as health care on the streets but it still is an important concept; clients are able to meet their health care providers where they already are. Wouldn't it be nice if our doctors held clinics in our workplaces? Homeless services are onto something!