She'll pull a Sori on him: Accompaniment by community health workers

Dr. Heidi Behforouz's story on Sori and Maria:
Sori is one of my PACT [Prevention and Access to Care and Treatment] community health workers. Sori told the story of Maria. A young woman with significant mental illness, and a cocaine user, Maria was referred to PACT with her immune system ravaged by uncontrolled HIV. For four years, Sori rode life's ups and downs with Maria, always encouraging, never forcing. Yet she was never able to help Maria consistently take her medications. Then one day, something clicked. Maria began taking her pills. She's now getting stronger and has voluntarily taken on the role of accompanying her boyfriend, showing up in his room with a cup of coffee in one hand and his psych pills in another, telling him that if he doesn't get up and take his meds, she is going to "pull a Sori on him."

With the power of such accompaniment, we have documented significant clinical improvement in the majority of our patients, and reduced preventable hospitalizations by 40%. We have been creating – to borrow a phrase – patient-centered medical homes.

Much of the care is being delivered by paraprofessionals who have not been extensively schooled in the biomedical model and don't practice office-based care. Their schooling and expertise is in the art and science of "accompaniment" – you walk with the patient, not behind or in front of her, lending solidarity, a shoulder, a sounding board, a word of counsel or caution. Empowering, not enabling. Together facing and managing challenges that neither you nor they can fix – poverty, racism, illiteracy, social isolation – so that you can help them swallow their pills every day, get to their appointments on time, and renew their Medicaid applications.

Advice to people with chronic illness: Find a Sori.

Read another story about patient partnership. Thanks to Dr. Heidi Behforouz for her source story in today's Boston Globe.