Prescription Assistance from a Public Health Perspective by Catherine Chadwick

The Philadelphia Department of Public Health City Health Centers are dedicated to helping medically underserved communities access comprehensive, high-quality health care. I am excited to be serving as the Prescription Assistance Patient Advocate at City Health Center #5 in North Central Philly. Patients are directed to my office when they’ve been prescribed a medication they can’t access through the Health Center pharmacy and can’t afford from an outside pharmacy. Often the patient is uninsured, although sometimes they have insurance but it doesn’t cover the medication or the co-pay is still too high. I search for assistance programs that the patient might be eligible for and help them through the application process, coordinating between the patient, their physician, and the pharmaceutical company providing the medication. When a patient is approved for an assistance program their medication is shipped to Health Center #5 and dispensed from my office.

I help patients access a wide variety of medications, but I do notice some of the same prescriptions over and over again. Medications for diabetes, asthma, and hypertension are especially common. These chronic illnesses disproportionately affect low-income communities of color, much like the community surrounding Health Center #5. As an advocate, I tend to focus on each patient’s individual situation, but it’s also important to take a step back and consider the larger context of the health outcomes I see every day. The reality is that most of my patients are at a social, economic, and/or environmental disadvantage because of their race, and this greatly impacts their health. Factors like education, employment, housing, food access, social support, incarceration, experiences of violence/ trauma, and others contribute to racial health disparities throughout the city of Philadelphia and across the United States. By considering this public health perspective I am reminded that my patients are so much more their prescriptions, and their health and well-being extends well beyond the healthcare they receive at Health Center #5.

I often think back to the training we received on trauma-informed care during NHC orientation. Many of the patients I work with at Health Center #5 have their own experiences of trauma, and there are ways for me to connect and engage so they feel more comfortable and heard. I always start by taking a moment to introduce myself and check-in with a patient before I look at their prescription. Then, instead of just printing out an application and showing them where to sign, I take the time to explain the option I think is best and give them a choice. I always ask my patients if they would like to follow through with the application and if they have any questions or concerns. When I make a patient feel more comfortable and in control it builds a sense of trust, and in turn they tend to be more open and honest with me. Building personal connections doesn't just help me better help my patients-- it brightens up my time at Health Center #5 and is the reason I love what I do.