Physician Founds Think Tank to Innovate Healthcare for Poor
Physician Rishi Manchanda’s epiphany – to develop a new think tank aimed at improving health care for the poor - came last summer as he was treating a patient complaining of severe headaches.
Manchanda was working at St. John's Well Child and Family Centers, one of the largest community health clinics for low-income families in South Central Los Angeles, which treats about 40,000 patients a year.
Twenty-eight percent of the residents of this area live below the poverty level; more than a third of South Central L.A.’s population lacks health insurance. Substandard housing, poor air quality and lack of access to fresh food are major contributors to the poor quality of health there, according to Manchanda.
The Queens, New York native asked his chronic headache patient questions about her housing – “substandard housing is a driver of illness in communities like South Central L.A.” he explained – and determined that the woman was living with mold, roaches and damp indoor conditions. He diagnosed migraines and allergic rhinitis, and treated her for the pain, along with providing information about housing assistance.
Manchanda’s patient came back several weeks later feeling better, but angry that none of the other doctors she had seen had asked about her housing conditions. The woman had been bounced around three other hospitals before she came to St. John’s.
“I explained that many physicians want to improve health where it begins but often lack the tools, training or incentive to do so,” Manchanda told India-West. “Too few clinicians are ever exposed to innovators who demonstrate how clinics can provide great care by tailoring healthcare to the social needs of the community. I mulled it over and decided to create HealthBegins to meet this need,” he said.
On Feb. 9, HealthBegins will launch a new social networking platform where clinicians, public health experts and community leaders can exchange ideas on improving health care for neglected communities.
HealthBegins will attempt to create what Manchanda calls a healthcare transformation, developing tools, training and technology to help physicians determine the deficiencies in their patients’ lives that contribute to their illnesses. Manchanda believes his initiative is timely, as more people gain access to healthcare under the national Affordable Care Act. “The healthcare system urgently requires new effective models to train and engage health professionals who can provide quality care and help improve health where it begins,” he stated.
His collaborators on the new initiative are Oakland, Calif.,-based doctors Laura Gottlieb and Ricky Choi.
The 36-year-old Tufts alumnus created a program in social medicine and health equity at St. John’s, where he worked for three years before quitting last September to start HealthBegins.
At the clinic, Manchanda examined 18 to 20 patients a day, treating adults and children for asthma, hypertension, heart disease and diabetes, among other illnesses. He also developed advocacy programs with community organizers that attempted to address the root conditions that caused such diseases.
"It is not smart to take a cockroach out of an ear and just send that child home," Manchanda told a group of reporters visiting St. John’s last January.
“I truly enjoyed the work I was doing in South Central L.A., but grew increasingly weary of a health care system that often sends the sickest people back to the conditions that made them sick in the first place,” Manchanda told India-West.
The Indian American has also resurrected RxDemocracy, an initiative he founded in 2008, to register low-income and marginalized people as voters. The project is already underway in two Boston hospitals, and at Montefiore Medical Center in New York. In California, the organization is targeting eight hospitals throughout the state.
Each of the hospitals will put up a non-partisan poster about voter registration at their clinic and then will set up voter registration events. In 2008, RxDemocracy registered 26,000 new voters.