This spring Philadelphia College of Osteopathic Medicine (PCOM) School of Pharmacy faculty members Candis McGraw-Senat, PharmD, BCACP, and Drew Cates, PharmD, AAHIVP, collaborated with healthcare professionals from the Strickland Family Medicine Center in Lawrenceville, Georgia, and Solid Rock International, based in Indianapolis, Indiana, to provide primary care services to patients in the communities of San Juan de la Maguana in the Dominican Republic. During this experience, the group stretched limited resources to provide medical services to more than 1,000 individuals in a week.
Dr. McGraw-Senat explained, “‘Barrios’ or neighborhood clinics were set up at local churches, schools and an orphanage. In the morning and early afternoon, patients would line up outside the pop-up clinic sites to receive small paper tickets which served as their medical records.”
She added, “One by one, patients were guided to four stations at the clinic, which were each operated by different healthcare providers who were aided by Dominican translators. At station one, patients were weighed. The patients’ vitals and chief complaints were taken by a nurse at station two. At station three, patients were seen by a physician or nurse practitioner where medical histories were taken and patients were evaluated. Then, providers devised care plans including medications to be dispensed by the pharmacists at station four.”
According to Dr. McGraw-Senat, the pharmacies were comprised of a wooden box filled with donated medications. The new ‘medical records’ indicated whether or not medications were to be dispensed for each patient.
“Given the limited medication supply which we had in stock in the box, the medications or equivalent alternatives were provided to patients in plastic medication bags with labels in Spanish to indicate the medication name, expiration date and directions for use,” she said.
At the pharmacists’ discretion and with the providers’ permission, changes in medication were made at the time of dispensing, according to the pharmacists. For all chronic medications, a 30 day supply was dispensed. All patients received multivitamins.
Dr. McGraw-Senat said she was challenged by the “Dominican way” of doing things. “Having a strong type A personality made it difficult at times. I wanted to execute patient care in a certain manner, which was not ideal for many reasons (e.g., limited resources, cultural differences),” she said. “However, overall this was a rewarding experience to learn about Dominican culture and an even greater learning experience to find that the ‘American way’ is not the only or best way of doing things.”
Dr. Cates said, “Similar to Dr. McGraw-Senat, I found the most challenging part of this experience to be overcoming my own strong type A personality, especially with the setup/organization of the medications in the pharmacy box. Overall, it was an excellent opportunity to see there are many ways of doing things to achieve a great patient experience.”
The most enjoyable part of the trip was getting to know the Dominican people, Dr. McGraw-Senat and Dr. Cates agreed. “They were so grateful to receive care, even if it was as simple as being provided with multivitamins,” Dr. McGraw-Senat said.
“The individuals of the Dominican were overwhelmingly appreciative of anything we did for them while welcoming us into their communities to share their culture,” Dr. Cates said. “They were also excited to learn more about the culture of the United States, especially music. Dr. McGraw-Senat and I were asked to play a lot of music from artists like Adele and Lady Gaga.”
This medical mission trip attracted Dr. McGraw-Senat for the second year in a row and Dr. Cates for the first time. In 2015, Dr. McGraw-Senat had also participated in a mission trip to Guatemala. As a result of their incredible experiences, both faculty members are signed up to return to the Dominican Republic in April 2019.
Dr. McGraw-Senat is laying the groundwork for students to participate in a similar experience. “My future plans are to create an elective rotation for our pharmacy students so they may gain cultural awareness and understanding of health and disease outside the United States,” she said.
PCOM Georgia has been serving students and the community for 20 years as a branch campus of Philadelphia College of Osteopathic Medicine (PCOM), a private, not-for-profit, accredited institution of higher education established in 1899. Located in Suwanee (Gwinnett County), PCOM Georgia offers doctoral degrees in osteopathic medicine, pharmacy and physical therapy. Graduate degrees are offered in biomedical sciences, medical laboratory science and physician assistant studies. The campus joins PCOM South Georgia in Moultrie in helping to meet the healthcare needs of the state. Emphasizing "a whole person" approach to care, PCOM Georgia focuses on educational excellence, interprofessional education and service to the community. For more information, visit pcom.edu or call 678-225-7500. The campus is also home to the Georgia Osteopathic Care Center, an osteopathic manipulative medicine clinic, which is open to the public by appointment. For more information, visit pcomgeorgiahealth.org.
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