Dr. Joseph Panerio-Langer

The Kraft Practitioner Program

The Kraft Practitioner Program is a two-year program aimed at better enabling community health centers to recruit and retain talented physicians and masters-prepared nurses by providing leadership development, mentorship and structured learning opportunities for top-performing community health center clinicians.

A highlight of the Kraft Practitioner experience is the independent project that each clinician pursues over the program’s two years. Support from the Kraft Center enables Kraft Practitioners to step away from their clinical responsibilities for one day each week to dig into projects that both interest the Kraft Practitioner and address the health needs of the community.

The latest in our series of Kraft Practitioner Spotlights features Dr. Joseph Panerio-Langer and his work at Brockton Neighborhood Health Center.

Meet Dr. Panerio-Langer and Brockton Neighborhood Health Center

One of Dr. Joseph Panerio-Langer’s most striking impressions when he interviewed at Brockton Neighborhood Health Center (BNHC) was how connected the health center seemed to be to the local community.

It’s a big reason he took a job there four years ago. And now, as part of his role as a Kraft Practitioner, this internist is working hard to find new ways to leverage community-level knowledge in service of the nearly 25,000 community residents for whom the health center provides care.

“Our staff members come from our community,” he explained in describing his efforts to restructure BNHC’s adult medicine department into three team-based “pods” that will be capable of better assessing and meeting the needs of individual patients. “So they often pick up on things that the doctors and nurse practitioners just miss.”

Indeed, BNHC is notable not just for the diversity of its patient base, but also for its incredible success in engaging local community members as health center employees -- to the great benefit of those employees and the health center alike.

“It’s not the job skills per se, but rather the language skills and the ties to community that we really need here at Brockton,” emphasized Sue Joss, who as BNHC’s Executive Director for the past eighteen years, has gotten to know the Brockton community extremely well.

Dr. Panerio-Langer at BNHC

Importantly, BNHC has been able to secure a series of “job creation” federal grants from the Office of Community Services (OCS) within the Department of Health and Human Services (DHHS) that have made it possible for the health center to create successive waves of full-time, entry level, living wage positions, even during economic downturns. On-site job education and training programs have followed, enabling those new employees from the Brockton community to build job skills and climb the career ladder within the health center.

And two more federal grants recently supported the addition of a 6,100-sq. ft. Urgent Care Center (in July 2010) and a 24,400-sq. ft., four-floor building above the Urgent Care Center (in September 2012) – thus opening a door to even more employment opportunities for local community members.

The benefit hasn’t stopped there. External consultants and evaluators have calculated the economic multiplier effect of BNHC’s job creation and capital expansion efforts and estimated that they have generated an additional 450 indirect jobs for downtown Brockton. A recent report commissioned by Brockton’s local redevelopment agency even went so far as to describe BNHC as the city’s “economic home run.”

For his part, Dr. Panerio-Langer wasn’t aware of the health center’s broader economic impacts when he first arrived at BNHC fresh from his residency in Seattle – but he was certainly glad that so many of the staff came from the Brockton community.

“They taught me a lot about working with these populations,” said the Minnesota native, who quickly found himself confronted with a panel of patients struggling with the challenges of poverty and from such diverse ethnicities and cultures as Cape Verdean, Haitian Creole, Haitian Brazilian and Portuguese. “And they were so welcoming,” he added.

Dr. Panerio-Langer at BNHC

A Project to Improve Patient Care

The quality improvement project he decided to pursue as part of the Kraft Practitioner Program focuses on creating three patient care teams within BNHC’s adult medicine department to streamline and improve the care provided to patients. Each team, or “pod,” is comprised of physicians, nurse practitioners, nurses, medical assistants, behavioral health social workers and secretaries – and while the endeavor’s most immediate goal is to address management issues and begin taking advantage of the health center’s new space, its longer-term aim is to bring together the various viewpoints represented within these groups to better identify community-level issues and social problems that may be affecting a patient’s health.

Dr. Panerio-Langer’s involvement in the Kraft Practitioner Program is what has made such a thoughtful approach to BNHC’s reorganization of its adult medicine department possible. He said that the day per week that Kraft frees him up from clinical responsibilities has been invaluable in that it has enabled him to step back and really look at what is going on within the clinic and the community overall -- and then (as he describes it) to “act as a tool for change.”

“Joe is the perfect person to lead this project because he thinks in such a process-oriented way,” confirmed Ms. Joss. “We think he’s a superstar,” she added, noting that the health center had just promoted him to Assistant Medical Director.

It is still early days, but Dr. Panerio-Langer said that the biggest challenge with his project so far has been coming up with definitions for each of the roles within the new patient care teams.

“We could have just put people in the new space, but what really makes the teams is the relationships,” he elaborated. “So we’re listening to feedback from staff on what’s needed, and that’s what we’re trying to develop.”

Read more “Profiles in Compassion” on Kraft Practitioners Maggie Beiser and Aisling Lydeard and Kraft Fellow Dr. Ian Huntington.

Topics: Community Partnerships, Integrated Care, Scholarship, Community Health Centers

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