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MED

Clinic-Based Food Bank Supports Vulnerable Patients

Mar 27, 2019 09:00AM ● By Alyssa McGinnis

By Alex Strauss

Last year, a study conducted in Rapid City uncovered a shocking statistic: Some four thousand people in the neighborhood of the Family Medicine Residency Clinic are “food insecure”. It was a statistic the clinic could not ignore.

“Patients who are food insecure choose the foods they can afford in the moment,” says Dr. Bobbie Schneller, director of the residency program. “Unfortunately, these are often the foods that are least likely to be healthy.”

So last October, the clinic made a bold move and opened an in-house food pantry. Patients who answer yes to one of two screening questions can take home the food they want. The clinic’s dietitian is on hand to offer advice on choosing and preparing it healthfully.

“Our goal is to give them healthier options,” says Schneller.

Regional Health purchases much of the food at a discount through the Feeding South Dakota distribution center in Rapid City. Caregivers and others have donated cooking utensils, crock pots, and even a freezer for meat and produce. Since October, more than 2,500 pounds of food has been distributed to 48 families, including full Christmas meals for nine families.

“We used to think our patients were non-compliant,” says Mary Beth McClellan, Manager of Clinical Operations. “Now, we understand they were just unable. When they have the right tools, they are very concerned about their health and interested in ways to improve it.”

“Patients are often doing the best they can within their means. This is a mindset shift that needs to happen among providers nationwide,” says Dr. Schneller, who anticipates and eventual decline in obesity and diabetes. “We hope to be the start of something important.”

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Interview with Mary Beth McClennan, Manager of clinical operations and Bobbie Schneller, MD, program director for the Rapid City Hospital Family Medicine Residency program

MM: Almost one year ago, a study in our area showed in the neighborhood of this clinic, we had four thousand food insecure people. So Feeding South Dakota was trying to partner with different agencies to try to help folks. Our VP at the time said ‘wow I think the clinic would be a good place to house a food pantry.’

We opened on October 10. It is an open food pantry. Our patients can go in and choose the food that they want. The food pantry is open just to our patients. We are in a family medicine clinic. I have a clinical dietitian that helps. We are looking at healthier food options.

A lot of our patients are diabetic or have high blood pressure, so we can educate them with better food choices.

Dr. S: What we find is that patients who are food insecure who are relying on food stamps, etc., are going to choose the foods they can afford in that moment. Those are often the foods that are least likely to be healthy.

We are able to teach our patients to cook healthy foods. Some of them have never even used spices before.

In addition to Regional Health paying for the food, so many caregivers in the organization have donated so that we can provide those patients with what they need.

Feeding South Dakota has a huge distribution pantry right here in Rapid City. We can go online and purchase food from them. There are lots of things that they pass on at no charge. So we can buy things like canned tuna, canned veggies, and whole wheat pasta much cheaper.

MM: We have distributed almost 2500 pounds of food to 48 families. Our costs are reasonably low for what we’ve had to purchase. There have been a lot of Regional Health caregivers and private people who have come in and seen the posting in the clinic and thought this was great and donated. A physician donated a freezer so we can offer frozen meat and fruit. We have had donations of crock pots and cooking utensils. Some people don’t even have ways to cook. If you live in a hotel, it’s hard to cook healthy things in a microwave.

Every year Regional Health runs a trunk or treat event in the parking lot. We collected 300 pounds of food.

We were able to provide full Christmas meals including ham, potatoes, vegetables, and apple crisp. We also bought gifts cards for the families. That is our favorite thing to do here in the clinic. A lot of our patients are challenged economically. We have a ton of young children.

I put baskets together and distributed the baskets with everything in it they needed. Nine families benefited.

Dr. S: It just makes sense that providing food and giving them recipes that, over time, I anticipate that we are going to see obesity improve in their neighborhood, lower incidence of diabetics.

MM: I have a mom with a 2-year-old. The mom came in dehydrated and was looking terrible. She hadn’t eaten anything for more than 24 hours and was 30 weeks pregnant. Here, we re hydrated her and sent her home with food. We had an excellent outcome with that pregnancy.

Dr. S: It has been rewarding for all the caregivers. We are looking to improve patients’ health. This has been a roadblock for years. This has brought so much joy to both our caregivers and our patients. It has allowed us to serve not just our patients but the community.

MM: We used to think our patients were non-compliant. They were just unable. When they have the right tools, they are very concerned about their health and interested in ways to improve it.

Dr. S: Our job here is to do the right thing every day and that is what we are doing here with the food pantry.

The clinic program was located in this area specifically because it was under served. The first class started in 1996. We have graduated 117 physicians, about 40 percent of whom our practicing in SD. Many are working in under served areas. That has been our mission - trying to make our community better. This is just another way to do it.

We hope to be the start of something important. There are clinics in Boston and Philadelphia that are doing something similar.

Food is medicine for our patients.

MM: People have to answer positively to two screening questions. “We are worried that our food will run out or that the food we have will run out before we are going to be able to buy more.”

We ask the ages of people in the household and how many people are there. We ask them ‘do you feel that you eat healthy?’ Then we ask the number of fruits and vegetables they eat daily. Then we monitor what they take from the food pantry.

People really WANT to eat better. We just find that people with come in with a high BMI and then they go away and not doing anything we say.

Dr. S: As providers, sometimes we tend to wonder if people are even listening to us because they may not be implementing what we tell them. But what we sometimes fail to realize is that people may be doing the best they can within their means. They may just not have the means to be compliant. This is a mindset shift that needs to happen nationwide among providers.

MM: We are certified food handlers and we take that seriously. Feeding South Dakota has had lots of recommendations for us.