Imagine walking into a doctor’s office where your personality, your wants, and your needs are showcased in every corner of the office. From the waiting room to your doctor, everything has been tailored to ensure you’re comfortable discussing your health needs. This is the experience Dr. Chinwe Efuribe created at Centered Youth Clinic and Consulting in Manor, Texas. Our partnership is truly special, and Dr. Efuribe has a passion that ties in with our mission and values here at Upstream.
This year we traveled down to Manor, Texas to see Dr. Efuribe’s clinic in person and learn a bit more about her story. We’re excited to share with you the video and conversation that came from our visit.
Tell me about your journey to become a pediatrician. What inspired you to pursue medicine and what led to your focus on adolescent health?
I come from a family of healthcare providers. My dad was a pharmacist and my mom was a registered nurse. So as a Nigerian, it’s mainly, “Oh, you’re going to be a doctor, lawyer, engineer, and all that.” So I was kind of predestined to some degree to consider medicine. But it wasn’t until I went to college. Adolescent medicine kind of came about at a point where I thought medicine was no longer for me. I have a very creative mind and there are parts of medicine that are very rote and rigid. And so I went through all the medical school training and then I chose pediatrics as my residency. After medical school and during my pediatrics residency, I felt like there was something missing.
I had a social worker, who was one of our preceptors and taught us about community medicine. She took us out to the community and we got to partner with an adolescent medicine provider at a school-based health center. And it wasn’t until I rotated with the social worker—driving through the neighborhoods, learning about the effects of social determinants, spending time in the school with the adolescent provider—that I learned about public health. I was like, ‘Wait a minute, I think I like this side of medicine,’ as opposed to being in the hospitals or being in clinics. So I shadowed the adolescent provider. Her office was at the school and she had peer health educators who she taught certain tips about sexual reproductive health services, and we, as residents, rotated with her so that the students could ask us questions.
In terms of healthcare provision, what are some of the unique challenges and rewards involved in working with adolescent populations?
Rewards—I could talk about those all day.
Adolescents really benefit from receiving care that speaks to them. I see that when young people come to a space that is ready for them and moving for them—they feel comfortable in that space. I’m always impressed whenever I see that they are seeking care when they need it. There was a study that I read during my residency that looked at barriers to adolescent healthcare services—what gets in the way of them actually getting care. And a lot of it was that they’re worried about what people might think of them or felt like they were asking dumb questions. But all in all, they want to get that information from the healthcare provider, so it’s just a matter of us providing the best space to do that and in a youth-friendly way.
What inspired you to open your clinic—what gaps in care or access were you trying to fill?
When I first came to Texas in 2016, I was still working within larger systems, and we would get feedback or reviews from young people saying that it was hard for them to be seen. Or by the time they get to see us as a provider, there were stories about how difficult it was for them to understand our services by phone, on the website, or even through communications prior to our meeting.
There was something about that path for them that was always really hard to navigate. So, for me, the first question to figure out was, how do we simplify access to care for adolescents and how do we message our services? How do we message the different types of confidential care and what it means to have confidential care in the clinical setting, for Title X and non-Title X?
The structure of established healthcare systems right now doesn’t allow for pediatric clinics to consider the adolescent. You go to a pediatric clinic and you see Spongebob, you see a little Dora the Explorer—the teen is trying to find their space [in that environment.] If you go to the family practice, it may be more universal, but it could just be more for adults. When young people come into a healthcare space, very few of them feel like they see themselves represented.
What led to your decision to partner with Upstream?
One of the participating program managers recommended Upstream because I had mentioned to her how, as an independent practice, I don’t have the capital to purchase a stockpile of LARCs to have on hand, and so I was a bit limited in what I could provide for my patients.
While the main request, when we first started, was LARC support, I think what I got was so much more beyond that. I can’t even begin to say how helpful it’s been for our practice. I’m bringing a lot of my academic, evidence-based practices of efficiency to a private independent practice model. And in most private practices, policies aren’t necessarily mainstay—like if there is a standard operating procedure, it’s not necessarily succinct and team-based. But with Upstream, we were able to do a lot of that [policy work] on the front-end and that’s just made a world of difference in how we approach all other things and processes.
Learn more about Dr. Efuribe’s Upstream experience in the video below: