A Prescription for Health: Never Take No for an Answer

As Rebecca Onie works to recreate American healthcare, she doesn't worry about the gap between where we are and where we need to be. She thinks far beyond that point. What she finds exhilarating is the prospect of a healthcare system we have yet to imagine.

Onie is an attorney and the CEO of Health Leads, a national nonprofit that utilizes the volunteer energy of college students to help patients get the basic resources they need to stay healthy. Sometimes medicine simply isn't enough. Having things such as food, housing, transportation, and English language skills are also essential to good health.

But physicians can't prescribe for everything. They can't always see what lies outside the examination room door.

What happens before the patient sees the doctor has interested Onie since the mid ‘90s when she was a pre-law student at Harvard volunteering in the Housing Unit of Greater Boston Legal Services. It was there that she began to see the many underlying causes of illness. She says she became "fixated on this connection between health and poverty."

Onie was raised to think about the well-being of other people. Her parents, both teachers who once were involved in the Civil Rights movement, valued community service. But they placed even more emphasis on the kind of efforts that correct social injustices.

"There was definitely a lively conversation growing up in our house about politics,"" Onie says. "But it was much more around how you change the underlying inequities. Why do people need to access food through a soup kitchen? There was a focus around understanding the context in which those structural challenges arise rather than on addressing the results of those inequities."

Onie's solution to the injustices she witnessed at Greater Boston Legal was to create a novel approach to the healthcare system. In her sophomore year of college, she started Project HEALTH, which brought college students into the Boston Medical Center Pediatrics Department to help connect patients to people or resources they needed most.

It is the type of service our healthcare system does not provide. And it consists mostly of time-consuming and tedious tasks—making phone calls, sending e-mails, or doing Internet research—the little efforts that can make a huge difference in one person's life.

As it turns out, Project HEALTH wasn't just a college project.

Today, it is called Health Leads, and serves 7,000 families in urban clinics in Boston, Providence, New York City, Baltimore, D.C. and Chicago. And the organization is still manned by student volunteers who talk face-to-face with patients to identify the non-medical issues that affect health so powerfully.

Onie has one word for what it has taken to make Health Leads a viable part of our current healthcare system: tenacity. It is a quality that she looks for in college volunteers because she knows from personal experience that it brings results.

She explains: "My dad always used to ask me, ‘Can't you take no for an answer?' But not taking no for an answer has been the defining ingredient of how I approach my work." That approach includes asking question after question until she gets an answer and "attaching" herself to doctors in hospital corridors to find out exactly how the healthcare system is treating its patients.

"The impulse to ask a lot of questions is something that I've been rewarded for," she says. "It's the only posture that ever made sense for me to take. I'm here to learn. I'm here to listen."

The challenge for Onie is that, 15 years since Project HEALTH's inception, people now expect her to have the answers. "For years, I would say, I don't know anything about healthcare. I can't say that anymore. Now it's about my being emboldened to step proactively into the conversation."

But her appetite to learn hasn't diminished, Onie insists. She keeps that hungry edge—that tenacity—because she knows the challenges are so daunting.

"That could either be demoralizing or frustrating, but for me it's really liberating," she says. "We are empowered to take huge risks because the odds of our failing are so great. Every success is in some ways unexpected. The sense is that the overall challenge is great, but the intervening victories are that much more significant."

http://www.healthleadsusa.org/