The eighth annual James S. Winshall Lectureship in General Internal Medicine was a homecoming of sorts for guest speaker Heidi Behforouz, MD, who attended Harvard Medical School (HMS), completed her residency and fellowship at BWH and later practiced in the Phyllis Jen Center and Division of Global Health Equity (DGHE).
Now an internist in Compton, Calif.; medical director of the LA County Department of Health Services’s Care Connections Program; and director of Innovations at Martin Luther King Outpatient Center in Los Angeles, Behforouz received a warm welcome back from a packed crowd of colleagues, former fellow trainees and others. (Behforouz remains affiliated with HMS and BWH’s DGHE.)
The lectureship is named in honor of James “Jamie” Winshall, MD, a beloved BWH primary care physician who died 10 years ago. Winshall’s wife, Gail Levine, MD, of the Department of Medicine, helps to organize the lecture each year.
“The reason we’re here today is Jamie’s impact as a primary care physician,” said Joel Katz, MD, director of the Internal Medicine Residency Program, during the Nov. 6 lecture. “He was an inventive community member, founder of the precursor to BWH’s hospitalist service and a gifted teacher and role-model. He had an eclectic taste in music, and I think we can all remember his cackle of a laugh.”
Behforouz, who worked with Winshall as an intern, has focused her career on the health issues of the urban poor. Committed to transforming primary care to better serve the needs of the most vulnerable patients, she founded Partners In Health’s Prevention and Access to Care and Treatment (PACT) project in Boston, which employs community health workers to advocate for the health and well-being of inner city residents infected with or at risk for HIV and other chronic diseases.
During the lecture, Behforouz discussed the unique role of community health workers in augmenting the patient-centered medical home model and reducing disparities and improving outcomes among the most high-risk patients. She drew upon recent patient cases and examples from the Mississippi Delta to Navajo Nation, where primary care resources tend to be more limited. She shared the story of one man who presented to her hospital in Compton with a simple sore throat, but was facing brain injury and alcohol use issues and had recently experienced a traumatic event with the police.
“The question is always: ‘What is a good primary care physician to do?’” said Behforouz. “There are so many forces that factor into health. If we don’t address the whole person, it is difficult for our patients to achieve health. We are spending increasing dollars and time on health care delivery, but are we addressing the root cause of this gentleman’s sore throat?”
This is where Behforouz believes community health workers come in, especially in resource-poor settings. Acting as guides, advocates and care facilitators, community health workers can increase patient engagement, provide social support and care planning, advocate for illness management support and much more.
Behforouz asked attendees to think about how the Brigham could be a pioneer in redefining health not only for patients here in Boston, but across the country and globe.
“How do all people reap the benefits of our advances?” she asked.