A Night at St. Anne’s: Filling the Gap in Worcester’s Healthcare System

Madeline Schwartz

Every other Tuesday, around 5:45 p.m., I hop in my car and make the seven-and-a-half-minute commute to St. Anne’s church on Route 9 right outside Worcester. I park around the periphery of a bustling parking lot, tucked away behind the church. Usually around 6:00 p.m. as I’m showing up for my case management shift, I hear the church bells ring. This familiar sound has signified a night I dedicate solely to sitting with and listening to patients from the greater Worcester community.

I was cloaked with my white coat within weeks of arriving at medical school, after I had completed a mere two exams out of the dozens I would be taking during my first year. I had little to no medical knowledge, yet this profession had already decided to dress my classmates and me with a symbol of power. As the initial months of first year wore on, the glory and pomp of the white coat wore off. I spent long nights in the library, learning the ins and outs of the human body. Never had I felt so disconnected to the reason why medicine called my name in the first place. I had half-heartedly signed up for an optional enrichment elective (OEE) titled “Case Management.” Having no idea what case management was, but knowing it sounded “less science-y” than the other classes I was taking, I decided to continue with it.

We learned how to sign patients up for MassHealth, connect them with primary care providers, and even offer resources such as housing support, legal counseling, free baby formula and supplies, and car seats-all the tasks that would traditionally be delegated to other members of the healthcare team. It felt rewarding and unique to be able to step out of the student-doctor position and into the case manager role.

Part of earning credit for the OEE was completing two volunteer case management shifts at the free clinics with current second-year student (M2) volunteers. My volunteer shifts were at St. Peter’s (the sibling clinic to St. Anne’s) with AJ, an M2. As I walked into the church building that evening, it was as if I had peered behind the curtain of UMass’s medical presence in Worcester. Children laughed on gym bleachers, mothers spoke with medical students earnestly, and veteran clinic liaisons joked and poked fun at each other, like a family reunion. Immediately I was hooked by this glorious underbelly of Worcester’s healthcare system. I applied to become a case management lead for the 2022 year, and in January I happily accepted the case management lead position at St. Anne’s. Now every other Tuesday, I make the familiar drive down Route 9 and practice my case management skills with community members.

Working at the free clinics has taught me many things as a medical student. I am extremely grateful for the opportunity to be a part of the well-oiled machine that is WFCC. My experience has been 30 percent frustration and 70 percent joy. I will begin by explaining the frustration so that we can end with joy.

During each shift at St. Anne’s, I am confronted with very familiar, almost identical problems and patient concerns. The most common is health insurance. We are lucky to live in a state that provides universal health insurance for residents, depending on citizenship status.

I have met countless patients that have recently immigrated to the United States, lost a job, or have received a devastating diagnosis who are blown away by the option of MassHealth. However, this joy only lasts a short while. Primary care physicians, especially those who speak other languages, who accept MassHealth, and provide culturally competent care, are in such high demand in the Worcester area. Wait times to see a pediatrician or family physician can be months--time that families and patients do not have in the midst of starting school or taking care of a pressing health need. While it is frustrating to operate in a healthcare system that fails to serve so many, I am thankful that WFCC exists so that these patients can see a provider in a pinch.

The joy is hard to miss. Case management at St. Anne’s is an opt-in service. This means I get to sit and observe the patient interactions that are taking place for a large proportion of the night. When I see my classmates--just first and second-year medical students--eloquently taking histories, providing compassionate and trustworthy care, and even making patients laugh and smile during difficult conversations, I could not be prouder to be in this profession. Similarly, I have been blown away by the resilience of patients that visit the free clinics.

Most patients diligently take notes, listen to the physician’s advice, and report their own concerns and hesitancies. When I speak with patients at case management, I often hear of the multitude of adversities they are facing; whether it is a difficult divorce, applying for a green card, finding employment, or figuring out how to feed four young children, I am stunned at their ability to advocate for themselves and ask for help.

Medicine is community, and WFCC shows up for the greater Worcester community each day of the week. I am proud to have served as the case management lead at St. Anne’s this past year, and I look forward to handing over the honor to the next, somewhat naive, first-year medical student. +

Madeline Schwartz is a second-year medical student at UMass Chan Medical School and is on the Population Based Urban and Rural Health (PURCH) track.