Creating change

Where clinical practice and public health intersect

Here’s how three DOs in North Carolina, New Hampshire and West Virginia are improving public health in their communities.


Physicians play a powerful role in supporting and protecting public health, says Georges Benjamin, MD, the executive director of the American Public Health Association. Evaluating the impact of external and environmental factors on a patient’s health can be the first step toward making a positive change.

“Physicians should look at whether their patients live in communities that are not walkable or struggle to access affordable food, and ask themselves, ‘What can I do about it?'” Dr. Benjamin says. “There are actually several ways they can help, from educating patients to getting involved politically.”

Here’s how three DOs used their clinical experience as a jumping-off point to develop public health initiatives. Each worked with the target patients they were hoping to assist when developing their projects—a crucial step to achieving a successful outcome.

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“Before you design a solution for members of a target community, you need to partner with them to fully understand the obstacles they face,” says Cole Zanetti, DO, a family physician from Epsom, New Hampshire.

Diabetes club meetings

Dr. Zanetti used this approach to help establish a monthly club meeting bringing diabetes patients together to cook a healthy meal and share tips and advice on living with diabetes.

Over the past year, attendance at the monthly meetings has grown from 12 to nearly 40 patients and caregivers, and members have expanded their focus to include community outreach and patient advocacy. “They’re not just a support group anymore,” he says.

Dr. Zanetti’s practice even recently implemented a suggestion from the group to proactively invite patients’ significant others and caregivers to appointments so they can better understand their diabetic loved one’s care plan.

Health care for homeless individuals

During the second year of his family medicine residency at Duke University School of Medicine in Durham, North Carolina, Farhad Modarai, DO, began studying the health care needs of local homeless individuals as part of the program’s population health component.

Farhad Modarai, DO (right), speaks at the American Academy of Family Physicians conference.

Dr. Modarai worked with the local health care for the homeless council to address the need for a permanent medical respite facility: a group of small apartments where homeless individuals can stay for a period of weeks or months while they recover from hospitalization or a serious illness. The council was able to obtain funding from the local health department to create a pilot facility.

Dr. Modarai is now co-leading a comprehensive retrospective chart review of Durham’s homeless population over the past five years to explore the potential health and economic impacts of a permanent respite facility, which would help more individuals transition to permanent housing and reduce hospital and emergency room visits.

Comprehensive health care in West Virginia

When C. Donovan Beckett, DO, started a family medicine practice in his hometown of Williamson, West Virginia, he learned that his patients faced several barriers to good health. Many had trouble accessing mental health and dental care services. A lack of fresh fruits and vegetables made it difficult to prepare healthy meals.

Two years ago, Dr. Beckett converted his practice into the Williamson Health and Wellness Center, a federally qualified health center. The new center offers onsite dental care, optometry and behavioral medicine as well as family medicine and pediatric services. In addition, Dr. Beckett operates a community garden next door to the center, which has helped increase access to fresh produce.

“It’s a fully operational one-stop shop for our local residents,” Dr. Beckett says.

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