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ABSTRACT
Homelessness is among the most important problems in social medicine. While traditional studies provide useful answers (albeit for increasingly narrow phenomena), unique perspectives and first-person accounts hold potential to influence broader thinking about the field. Here, we provide a first-person account from physician-activist David Buck, a health policy expert and founder of Healthcare for the Homeless-Houston, on what it takes to tackle the homelessness epidemic, fix the broken aid industry, and challenge the status quo.
Acknowledgements
The authors acknowledge Dr. Dana Clark for contributing to the interview guide.
Disclosure statement
NP and MF serve on the Board of Directors of HOMES Clinic, which provides free healthcare services to people experiencing homelessness. DSB is the founder of Healthcare for the Homeless-Houston and HOMES Clinic in 1999 and founded / serves as board chair of Patient Care Intervention Center.
Notes
1 In an earlier draft of this work, an anonymous reviewer suggested that, “researchers are inherently part of the research itself … a bit more about all of the people involved in the project would be in line with qualitative forms of inquiry.” Therefore, supplementary info on all authors can be found in Notes on contributors.
2 Medical College Admissions Test.
3 Sophie’s Choice is a film set in the Holocaust. A mother in a concentration camp is given an impossible choice: to decide which one of her daughters will be executed and which will get to live.
5 Houston Outreach for Medical, Education, and Social Services (HOMES) Clinic is the only student-managed free clinic in Houston and serves people experiencing homelessness (Clark et al., Citation2003): www.homes-clinic.org.
6 “The Flexner Report of 1910 transformed … medical education in America with … the establishment of the biomedical model as the gold standard of medical training” (Duffy, Citation2009).
7 Rudolf Virchow was a renowned German physician, anthropologist, and politician. While perhaps best known as the namesake of Virchow’s Triad, his investigation of the 1847 typhus epidemic is often credited as the origin of public health in Germany. He once famously said: “Medicine is a social science, and politics is nothing but medicine on a large scale” (Silver, Citation1987).
8 Phrase borrowed from Samuel Beckett’s Worstword Ho (Beckett, Citation2014).
Additional information
Funding
Notes on contributors
Nicholas Peoples
Nicholas Peoples is a 2nd year medical student at Baylor College of Medicine and the Executive Director of HOMES Clinic, which provides free healthcare services to people experiencing homelessness. Prior to medical school, he spent four years overseas working for various global health programs. These included a mental health NGO in Nepal, a pediatric HIV/AIDS clinic in Malawi, and, while earning his MSc in Global Health from Duke University, an academic research group focused on rural primary care in China. Unexpectedly, these opportunities also exposed him to the ugly politics of international development – namely, that charitable organizations are often forced to compete with each other, rather than co-operate, because they are vying for the same sources of funding. This generated an intense interest not only in the medical and social problems that the poorest patients face, but in the fault lines that run throughout our own (sometimes misguided) efforts to serve them. That interest was the impetus for this manuscript.
Mary Fang
Mary Fang is a 4th year medical student at Baylor College of Medicine and has served as the Associate Director of Operations at HOMES Clinic since her first days as a physician-in-training. She has also volunteered at Star of Hope (pre-Covid), where she served meals to women and children experiencing homelessness, and at New Hope Housing (during Covid), where she provided health education to women experiencing housing instability in weekly one-on-one sessions. These experiences have prompted her to lead numerous efforts to integrate medical and social services. Most recently, she co-created a program that trains medical students to volunteer as adjuvant social workers, enriching their ability to identify and address psychosocial concerns. Her interest in bridging patients with housing insecurity into longitudinal social services was a major stimulus for this manuscript.
David S. Buck
David S. Buck is the Associate Dean for Community Health and Clinical Professor at the University of Houston’s College of Medicine and holds adjunct faculty appointments as Professor at University of Texas and Rice University. From working in Calcutta, India, with Mother Teresa, to establishing impactful organizations across Houston, Dr. Buck has spent over 35 years reshaping how communities care for the underserved. In 1999, he founded and served as Chair and President of Healthcare for the Homeless–Houston, and his empathic and entrepreneurial spirit propelled him into pivotal roles as a co-founder and chair with Doctors for Change (2006–8), and the founder & chair of the Houston-Galveston Albert Schweitzer Fellowship Program (2007–16). His strides to improve healthcare expanded through his position on the founding board and later as Chair of the International Street Medicine Institute (2010–12), and on the Consumer Operated and Oriented Plan Advisory Board, at the request of the U.S. Secretary of Health and Human Services (2010–12). He is an innovator and thought leader, with over 25 published articles and book chapters on improving the care of persons experiencing homelessness through health services research. Currently, he serves as founder and board chair of Patient Care Intervention Center, a nonprofit that leverages community-wide care coordination and technology to deliver resources to patients with complex social and medical needs.