Baltimore had me at “hello,” literally. I walked out of the airport, shocked I had to remove my winter coat to adjust to the 50 degree November weather, a stark change from the cold and snowy environment I just departed. The night before my Hopkins interview, a close friend from med school took me out for my first oysters, and with that Baltimore stole my heart. Yet although these differences from my hometown first attracted me to this city, I find its similarities to upstate New York most endearing. Just like home, Baltimore is a post-industrial city with a rich history and culture, as well as kind, hard-working residents that struggle to maintain their livelihood in a city affected by economic downturn. Baltimoreans never quit. Amidst the hurdles of everyday life, they remain strong and steadfast. Always believing in their city, their creativity persists, builds, and contributes partnership and community growth. In my fourth year of residency, my fellow Baltimoreans still teach and inspire me, and serving the East Baltimore community continues to be a joy and a privilege.
Witnessing the passion of this community makes it easy to endure the rigors of residency and plants the desire to contribute solutions for community problems. As a second year resident, I repeatedly saw patients determined to maintain their health, but who faced many barriers to care. Though funding for mental health and psychiatric care has increased, the need for services continues. Many of our psychiatric patients also suffer from medical comorbidities requiring complicated medication regimens and frequent appointments. The patients I worked with found coordinating outpatient services difficult, as they often had to travel across town between providers, navigate the insurance system, as well as convey a provider’s treatment plan from one network to another physician in a different hospital system. As many of our patients live from dollar to dollar, finding bus or cab fare further compounded these challenges, leading to missed appointments, decompensation, and ultimately more hospitalizations.
I developed an interest in integrated healthcare while in medical school, and I wanted to provide our patients with better continuity of care and ease of access to services by combining psychiatric and medical care together in the outpatient setting, starting at the resident level. With the guidance and encouragement from faculty members in the departments of psychiatry and internal medicine, I established a med-psych clinic in early 2016 in the Johns Hopkins Outpatient Center. Since its inception, the clinic has initiated and re-initiated dozens of patients who previously faced long wait times for appointments or were lost to care. Though still in its nascent stages, the med-psych clinic thus far proves to be a successful collaboration, and faculty and residents from both departments continue to work to making its presence permanent in training. As a resident, this opportunity has taught me a great deal about clinic management, partnership, and further barriers to care for our patients. Within the next year, I plan to study relapse and readmission rates of our clinic population, as well as patient, resident, and attending satisfaction with this partnership.
This project speaks to our department’s commitment to resident education. When I came to Johns Hopkins I knew that I would receive an excellent clinical training. The faculty’s encouragement of creativity, promotion of intellectual curiosity, and their desire to embolden each resident continues to astonish me. I am grateful to work with a supportive faculty, who encouraged me to pursue a passion project and guide me through this endeavor. This project provided a unique opportunity to gain leadership and management skills that speaks to our department’s commitment to resident education. It demonstrates how the Phipps Residency strives to prepare and motivate its residents to become superb clinicians and leaders, and confront the challenges facing psychiatry in the net century.
[Dr. Solazzo is a PGY4 resident and this year's Breakey Scholar. The Breakey Scholarship provides funds for conducting outcomes research in a community psychiatry setting and traveling to scientific meetings]