This month’s PA Profile highlights Corinne T. Feldman, MMS, PA-C, Clinical Assistant Professor of Family Medicine in the Primary Care Physician Assistant Program at the Keck School of Medicine of USC. PA Feldman also is director of the Street Medicine track for the USC Family Medicine residency. She has provided primary care for people experiencing unsheltered homelessness since 2007 and contributed to the development of shelter and street-based care in Lehigh Valley, Pennsylvania, and in Los Angeles. She currently sees patients at USC Street Medicine.
Corinne is cofounder of the International Street Medicine Institute Educator Coalition and is an advisor to the International Street Medicine Institute Student Coalition, both of which establish standards on street medicine education.
Q: What unique programs or projects have you started or participated in to advance patients’ health?
PA Feldman: During my PA education, I was exposed to homeless health care at a critical time in my professional identity development. After graduation from Midwestern University, my husband (who was a PA student at the time) and I cofounded the DeSales University Free Clinic at the Allentown Rescue Mission in 2007, which provided free primary care for people experiencing sheltered homelessness. This experience led to the development of multiple shelter-based clinics in our area. Over time, we became curious about who was not in the waiting room and realized that there was a world of people who were living unsheltered in our area who received little to no health care. This led to the development of a street medicine program in the Lehigh Valley area of Pennsylvania. Street medicine provides primary care to people experiencing unsheltered homelessness in the places they call home such as sidewalks, parks, or underpasses. It is based on the principle that you must “Go to the People” and is primarily done through walking rounds. In 2018, our work in street medicine took us 3000 miles across the country to Los Angeles where we have worked to create the Street Medicine program at the Keck School of Medicine of USC.
In addition to the direct delivery of care to our neighbors living outside, I have spent more than 10 years teaching students about homelessness, health inequity, and reality-based medicine. If we want to change the way medicine is practiced, we have to rethink the way medicine is taught and change the proximity of students to the problems we hope they will help us solve. Most recently, I have been the principal investigator for a $1.5M Health Resources and Services Administration (HRSA) grant that has allowed for the creation and implementation of street medicine curriculum, including street medicine clinical rotations in the USC Primary Care Physician Assistant Program.
Q: What aspects of your profession are most rewarding?
There are moments during patient interactions when both the patient and I feel fully seen and heard for who we really are. In addition to street medicine, I have practiced in the areas of trauma surgery, HIV/AIDs, and nursing home-based geriatric care. In each area, my patients were likely hoping to never need someone like me in their life. I aim to practice medicine with the humility that I cannot change many aspects of a patient’s current or prior history but that we both bring assets to the table that can work symbiotically to change trajectory. These moments of understanding are the hallmark of a genuine and honest interaction and I find that to be the most rewarding aspect of being a physician assistant. I have found that patients rescue me far more frequently than I ever rescue them.
Q: How do you avoid burnout?
I am a firm believer in the power of being a witness to the reality of a patient’s experience with illness, health, or social inequity. I have found that narrative medicine and the act of reflective writing have helped me process the experiences I have been privileged to witness. Further, the development of narrative competence through writing has helped me be a better listener and observer of my patients and, in turn, has enhanced the meaningful care I am able to offer.
Q: What do you know now that you wish you knew coming out of PA school?
I wish I knew how well my education was preparing me for the flexibility, humility, and leadership that I would rely on throughout my career and that there is no singular path for any of us. We are all on a journey that is unique to us and that comparison only limits your potential.