Health is More Than Just Medicine
Dr. Kameron Matthews, Chief Health Officer, Cityblock Health.
Destiny is often thought of as an invisible hand guiding us towards the inevitable. But I’ve found that destiny doesn’t do home visits. When something feels right, you have to go for it.
I joined Cityblock this month as Chief Health Officer, and it feels like the culmination of a decade in medicine, law and public policy, working for health equity through community-based care. I’ve served military veterans and their families at the Veterans Health Administration, treated incarcerated patients at the Cook County Jail and worked to deliver care to underserved populations in hospitals, clinics and other managed care environments. To me, the Cityblock mission of “meeting the patient where they are” is more than just a matter of geography, it’s a commitment to the whole-person approach to well-being. If we think of medicine as local, then health — the ultimate outcome of care — is personal. Coming to Cityblock is personal.
Like a lot of young people inspired to make medicine a career, in medical school I studied how to treat the symptom, and it was fascinating. But I became frustrated as I came to understand that treating the underlying causes of illness would be more effective — and humane — than allowing the symptom to occur and then responding. It was the equivalent of choosing between eating regularly and satisfying your appetite or starving and then being revived by an IV drip. The latter was the approach to healthcare I was learning. Over time, the closer I got to patients clinically, the more vivid the complex causes of poor health became. My real world observations of medical conditions and their effects on different populations made me aware of the relationship between race, ethnicity, gender, geography, education, economics and health, healthcare and the inequity of care.
This was made specific to me one late night, as I was providing treatment in the Cook County jail. A young man had been admitted, charged with using heroin, and I spent hours trying to help him through his withdrawal. As we spoke, our conversation revealed his behavioral health issues that were going untreated, issues that were manifesting themselves in the substance abuse that was profoundly affecting his health and life. Punishing his crime — the visible symptom — would do nothing to give him the care he needed.
Believing that healthcare needed to be transformed to address the inequity of care, I went to law school to have a voice in health policy. I learned the analytics of problem solving and sought transformation through greater access to care and modeling the whole-person approach. These ambitions were realized in my years at the VA. I saw real progress made among patient populations that had been underserved, in large part due to an organizational commitment to change, to do better, and to do so by embracing the reality that had awoken me in medical school — that the experiences of the whole person affecting their health and well-being also create the most direct opportunity to improve outcomes. Identifying the cause of the problem introduces a solution. It’s what must happen for all populations in order for our healthcare system to work.
Meeting the member where they are must be the model, as it was in the VA, for the vast populations in private health. I’ll work to take everything I’ve learned in managed care and public health, in leadership and administration, in policy and analytics and apply it to make a bigger difference.
The Cityblock model — the integration of clinical and social care, and the integration of physical and behavioral health — works for the individual. The challenge motivating me, and everyone in this growing organization, is scaling the model so that we can achieve the necessary transformation. Others have tried it and not succeeded. There’s a structural difficulty that has to be solved for, accounting for the variables of population and geography: the care is different in North Carolina than it is in NYC. It’s why healthcare has to be localized to serve the community and personalized to serve the individual. Cityblock’s focus on community health partners and community health workers is key.
Now, I want to enlarge what Cityblock is doing by integrating a medical model, nursing model and social justice work. Cityblock’s care will be differentiated by our ability to combine a value-based approach with data analytics and a clinical-social perspective. With so many resources and a strong record of experience, we will succeed at meeting the member where they are.
Originally published on LinkedIn on January 10, 2022