Growing up around healthcare professionals, Ethan Hume, one of Waymark’s Washington state-based Community Health Workers (CHWs), always knew he wanted to serve patients in one capacity or another. But it wasn’t until his college years, as he began studying to be a clinician, that he realized his passion lay outside the doctor’s office – instead, he was interested in going out into the community and making an impact on populations who traditionally didn’t receive adequate or consistent access to care.
In his role as a CHW, Ethan acts as an empowerer and, later, as a cheerleader; his goals are to ensure every patient he serves feels equipped to advocate for themselves and access the care they need to live full, healthy lives. Below, he digs into his mindset around the work he does in service to patients and shares a patient story that underscores the power of advocacy and whole-person care.
In your words, what is a community health worker, and how do you support and enable patients and primary care providers (PCPs) in your role?
A community health worker is a guide or companion helping a patient navigate through a healthcare system. My goal at the end of my time with a patient, however long that is, is to help them to feel confident understanding their own health care choices, making appointments and advocating for themselves at the doctor’s office. My favorite part of our patient journey, and when I know a patient is ready to graduate, is when I find myself sitting back and playing the healthcare cheerleader while they’re doing everything on their own. That’s a super exciting time and it’s super rewarding for both the CHW and the patient to see how far you’ve come.
Why is it important for community-based teams to include CHWs? How do you work alongside other roles, like pharmacists, pharmacy technicians, care coordinators, and therapists?
I’m taking a class in health policy right now (as a University of Washington Masters of Public Health student) and this is something we just talked about: the idea that a PCP can’t do everything on their own and we need to think of preventive health through a “team-focused” lens. Care teams like Waymark’s are unique in that they help extend care from a PCP’s office into the community.
For me, as a CHW, it’s important that I can meet patients where they are; I can engage with them more authentically when they see that I’m a real, live person who’s taking the time to be there with them. I can then work with our pharmacy team to identify the real reasons that medication adherence is hard, and find strategies that work for the patient’s lifestyle in the patient’s home to solve that. It’s so nice for patients to have a dedicated pharmacy team that’s so personalized.
On the behavioral health side, I can’t say enough how top-notch our therapists are, and how they’re really, really important to our model. They do so much when it comes to helping patients who are in a variety of spots in their lives and just need someone to talk to. My patients and I will collaborate with them really closely on developing strategies to tackle even non-mental health related issues, since the therapists get to know their patients so well they often have great insights on what might work for a particular person best.
And then of course holding everything together are our care coordinators. Nobody here could do our job without them. These are people actively seeking out and finding the people in our community who would benefit the most from engaging with us, they keep primary care teams in the know about everything going on, and while they’re doing all this, they also know all the different idiosyncrasies of the insurance system and how to troubleshoot it to drive results for our patients. They are incredible!
Can you share an example of how you recently helped a patient in the community?
I have a patient who has really been struggling to get a knee surgery for the last 2-3 years, and in the meantime she’s pretty much unable to walk very far on those knees, which comes with a whole lot of other struggles. However, in order to get this surgery, she was told she needed to stop smoking and lose about 20 pounds. She and I worked with her primary care and Waymark’s own pharmacy team to 1) consolidate all of her existing medications to be from the same pharmacy and develop a good system for taking them, and 2) to help support her through that tobacco cessation and weight loss pathway. She actually found out at the doctor this week that she’s been approved to get that surgery! That’s a big victory, and we’re all super excited for her.
Finally, why Waymark? What about our model and approaches stood out to you?
I originally studied public health in college; during that time, I thought “Oh, I want to be a clinician,” and I did the whole pre-med thing while working in emergency medicine. I was on ambulances, I worked for a little bit in a children’s ER, and I did some in-home acute care as well. And what I came out of those experiences realizing is that I was far more interested in strengthening and improving the systems we have in this country at a higher level that was still incredibly impactful.
Waymark is all about that, which is what led me to apply for my current role. Our leaders and our data team are putting out publication after publication, and Waymark was founded with this collection of really seminal papers in mind that made it clear how important a robust community-based workforce is to making the American healthcare system work. And that, to me, is exciting: being a part of something that isn’t just “Ooh this is a fun, flashy idea we want to try,” but is based on real evidence, which shows in our outcomes. Waymark is a really exciting and important part of ensuring this system works for everyone, especially for patients receiving Medicaid. We’re also constantly putting out resources to that effect; Sanjay’s new book is a great read that digs into Medicaid and how it can and should be improved, and that’s just the most recent example!
