March 1997

Pediatric Links with the Community Training Doctors to Serve the Neediest Children

"Pediatric Links with the Community" (PLC) is a new program at the Children's Hospital at Strong that trains pediatric medical residents in the special health needs of poor children. Fifty resident physicians in this program will provide supervised medical support to children in health centers in some of the area's poorest neighborhoods, including the Corpus Christi Medical Outreach Clinic, the Foster Care Clinic, and the Migrant Families Clinic in Sodus.

The PLC program has been developed by Drs. Laura Jean Shipley, Michelle Jones and Jeffrey Kaczorowski, in conjunction with the Pediatric Residency Training Program and pediatric residents at the University of Rochester School of Medicine and Dentistry.

"We have three major goals for PLC," said Dr. Shipley. "One is to enhance medical care and health education for poor children. A second is to give residents the opportunity to learn firsthand about poverty's effects on children's health. The third is to nurture future pediatricians' provision of health care and advocacy for poor children."

Poverty has long been linked to serious medical problems in children, Shipley said. These problems range from significantly greater risk of injury and death from violence, assault and accidents, to growth and developmental delays, to increased disabilities due to chronic diseases such as asthma, allergies, and lead poisoning. Consequently, impoverished children need more care. But due to other intervening factors of poverty, they are less likely to get that care.

In addition to assisting center staff in caring for children, medical students will lead discussions on health-related topics for families at the centers, and participate in community health agency activities, including those of the Community Health Nursing Service and the Lead Inspection Team.

It's because of the unique medical needs of poor children that special training for future pediatricians is required. The highly-regarded Pathways to a Coordinated System of Health Care and Human Services for Children and Families in Rochester, published jointly by the University of Rochester School of Medicine and Dentistry Department of Pediatrics (of which the Children's Hospital at Strong is a part) and the Monroe County Department of Health in 1994, listed the training and recruitment of physicians to care for impoverished children as one of its top three goals in improving health care for Rochester's children.

"We have the pleasure of bringing together two extraordinary resources for children in Rochester," said Dr. Jones. "One is the enduring commitment of our community health agencies to caring for the poor children, and the other is the excellence and concern of our pediatric residents." A pilot program implemented during the 1994-95 academic year by Drs. Jones and Kaczorowski received excellent evaluations from both medical students and the community health centers. Based on this success, they joined with Dr. Shipley and sought funding from local sources to expand the PLC program. To date, funding from the Monroe County Department of Health, the Glen and Maude Wyman-Potter Foundation and the Harold and Joan Feinbloom Foundation of the Rochester Area Foundation has helped bring more agencies and more residents into the program.

If you are interested in making a difference for poor children and supporting PLC, please call the Children's' Hospital at Strong's Office of Development and Community Affairs at (716) 273-5948.

Jeff Kaczorowski, M.D.:
General Pediatrics, Specialized Care

Jeff Kaczorowski, M.D. believes that helping to develop the Pediatric Links with the Community (PLC) program got him back to the reason he wanted to become a pediatrician in the first place: working with kids in the community.

"Being a medical student, and a resident, is a great experience," said Dr. Kaczorowski, a second-year Fellow in General Pediatrics at the Children's Hospital at Strong. "But actually getting out and caring for the kids gives you such a wonderful feeling, and reminds you of how you got here.""

Kaczorowski worked with Michelle S. Jones, M.D. on the PLC program when they were co-chief residents in pediatrics at Rochester General Hospital. They approached community agencies with the idea of organizing medical residents to assist the agencies in providing medical care to their clients, which they hoped would give residents a new understanding of the effects of poverty on children's health and a continuing interest in advocacy for poor children.

Kaczorowski's interest throughout his medical training, all of which was done at the University of Rochester School of Medicine and Dentistry, has been in birth defects, the leading cause of childhood morbidity and mortality. An innovative approach to his Haggerty Fellowship, to which he credits Dr. Michael Weitzman, Chair of Community Pediatrics, has allowed him to work in general pediatrics while also working in a variety of subspecialties, including genetics and cardiology.

The combination of interests, unfortunately, makes sense: poor children are far more likely to experience birth defects and complicated health problems. Kaczorowski's research focuses on patients with very complex cases of congenital heart disease and their neurological development. "The real problem with poverty," Kazorowski said, "is that are many issues and no good answers. We hope that putting bright, well-trained people in this environment will help us find some answers. PLC is a way to get these people thinking about children and in poverty, which we hope they'll continue to do throughout their careers."

Jeff Kaczorowski's work has helped change the curriculum for medical residents at the Children's Hospital at Strong. With his combination of caring and scholarship, we're confident that he'll continue to be a leader in the fight to keep children's health issues, especially those of poor children, in the forefront of the community's conscience