When choosing a medical mission, continuity of care matters. Here’s why.

Brenda Pecotte de Gonzalez, MPH, OMS IV, is deeply interested in global health outreach; she spent a month last spring rotating at DOCARE International‘s permanent clinic in San Andrés Iztapa, Guatemala. When considering medical mission opportunities, Pecotte de Gonzalez looks for one important criterion: Does the program have an ongoing community presence?

Pecotte de Gonzalez, who attends the A. T. Still University—School of Osteopathic Medicine in Arizona (ATSU-SOMA) in Mesa, believes medical missions with a continuity of care component are the most helpful way for U.S. health care professionals to care for patients in developing countries. “Short-term missions work really well for acute conditions, but treating chronic conditions requires some continuity,” she says.

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In the world of global outreach, health care professionals are paying more attention to what type of trips offer the best way to bring care to underserved patients in other counties. Pecotte de Gonzalez and DOCARE International President Kelli Glaser, DO, say medical missions that provide continuity of care are the best option—here’s why, and here’s how to find trips that do that.

Local partners

Short-term medical missions can offer powerful benefits for patients with acute conditions, even if the mission doesn’t have an ongoing community presence. However, such visits aren’t ideally suited to every patient scenario. “You don’t want to go into a village, do surgeries and then have no follow-up care available—what if a patient develops an infection?” Dr. Glaser says.

Other types of care could also result in unforeseen consequences, Dr. Glaser notes. For example, if physicians visit a remote area and give a diabetic patient a month’s supply of medication, he may not be able to refill the prescription once the medical mission has left town. “By starting and then stopping medication, that patient could end up feeling even sicker, so the mission could have unintentionally done more harm than good,” Dr. Glaser says.

Ideally, Dr. Glaser and Pecotte de Gonzalez agree, visiting physicians and medical students should conduct outreach in partnership with health care professionals who are based in the area. “I learned a lot about the importance of continuity of care by rotating at DOCARE’s permanent clinic in San Andrés Iztapa, which is run by a Guatemalan doctor and nurse,” Pecotte de Gonzalez explains.

Local physicians speak the language, are familiar with cultural attitudes on health and understand the community’s challenges, all of which can help earn patients’ trust. Without this kind of collaboration, Pecotte de Gonzalez says, medical mission groups’ impact is bound to be limited: “If there’s no local component, how much difference can you really make?”

Looking at the big picture

For Dr. Glaser, pairing medical missions with continuity of care is deeply osteopathic—and that holistic approach is one that should extend beyond individual patients. “When we think about medical missions, the bigger question is, how can we work with local nonprofits and help shape government policy to impact overall general health?” she says.

For Pecotte de Gonzalez, considering the big picture should also include an honest assessment of why you’re interested in global health outreach. “Are you participating to make yourself feel good or because you like to travel?” she says. “The best way to have a positive impact is being ready to work alongside your community partners, offering what you can.”

DOCARE opportunities

DOCARE now has three permanently staffed clinics in the following locations:

• San Andrés Itzapa, Guatemala.
• Tecpán Guatemala, Guatemala.
• Chacraseca, Nigaragua.

For more information about opportunities at these clinics, email DOCARE at [email protected].