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From “Vague Notion” to Purposeful Plan for Healthcare

By Rachel Tullio

Ms. Tullio  is serving at ARTEZ (Allegheny River Towns Enterprise Zone) working on several community development projects.  Her position is part of a yearlong service leadership program, PULSE Pittsburgh. She graduated in May 2015 from the University of Notre Dame with a major in Pre-Professional Studies and minors in Anthropology and Poverty Studies.  She is also in the process of completing medical school interviews and will matriculate in the fall of 2016.

When I began my undergraduate career at Notre Dame, I had the vague notion that I wanted to work in the field of medicine, but it was only that. During my time at school I was hoping to find something that would provide me with more focus and direction for my future after college, and, amid the traditions of Notre Dame Football weekends, dorm communities, and a catholic education, I found what I was looking for in my Poverty Studies minor. It was unexpectedly my favorite part about being at Notre Dame.

"My goal today is to practice medicine as a primary care physician, caring for patients in a clinical setting and working to design or influence health care policy," Rachael Tullio (Notre Dame 2015).

“My goal today is to practice medicine as a primary care physician, caring for patients in a clinical setting and working to design or influence health care policy,” Rachael Tullio (Notre Dame 2015).

I found the Poverty Studies Interdisciplinary Minor (PSIM) after taking a course in medical anthropology. In class, we watched Unnatural Causes, a documentary that explains how environmental, social, and economic factors impact the health of various communities across our nation. I was surprised and fascinated by the statistics in the film, and wanted to learn more about those issues.

My professor directed me to the poverty studies minor and Professor Warlick, the director of minor. The next week I met with Professor Warlick and enrolled in the introductory class. From my first class to my last, I was taught about complex issues and was challenged to evaluate what we talked about (housing, education, women’s health, family structure) from multiple perspectives. I learned about the roles that national policy, federal and state funding, political motivation, and racial and demographic history play in creating both solutions and challenges to major issues. I was overwhelmed by the complexity inherent in finding solutions to these issues. But as we learned, I learned how to critique and analyze viewpoints effectively and develop my own opinions about how many social issues should be addressed. Through the knowledge I gained in my poverty studies minor, I felt prepared to tackle issues I felt passionate about, and feel confident now that I can make a difference for those who are most vulnerable and most in need of advocates and social change.

Today, the issue I am most passionate about is equitable access to medical care. I believe strongly in providing all individuals access to quality health care without regard to income and want to be a part of creating delivery systems and policies that help meet this goal. My classes at Notre Dame, personal research, and Shepherd Internship experience were most important in helping me shape these future goals and identify what I wanted to accomplish as a future physician.

I spent my summer as a Shepherd Intern in Hazard, Kentucky, a rural town located in the state’s coal region. There I worked at the Little Flower Clinic, helping to serve the health care needs of the residents. Our clinic focused on caring for low-income and homeless individuals. While at the clinic I shadowed many patient appointments, worked with case managers and administrators, and learned about rural healthcare needs from both patients and community leaders. I found that what I really enjoyed about primary care medicine was the opportunity to create long-term doctor-patient relationships and establish continuous dialogue. I felt rewarded most when I was able to share what I love, my knowledge of science and medicine, with patients and help them feel more comfortable and confident about their health status. I learned from patients about personal lifestyles, health needs, and community needs and I felt that, through medical practice, I could contribute to meeting those needs.

During my internship I also experienced Medicaid expansion at work as the Little Flower Clinic enrolled its patients in health insurance coverage through Kynect. I saw that Medicaid expansion benefited nearly all of the patients at the clinic. Insurance provided them with much relief from the stress of unexpected and unaffordable medical bills. Seeing the difference that the recent Affordable Care Act (ACA) legislation made for the residents of Hazard got me interested in studying health policy and insurance more closely. When I returned to Notre Dame after my summer I dedicated part of my poverty studies capstone to understanding the main principles of the ACA, and spent a semester studying health insurance structure with one of my poverty studies professors, Professor Betson.

My goal today is to practice medicine as a primary care physician, caring for patients in a clinical setting and working to design or influence health care policy. Without my minor in poverty studies and my summer as a Shepherd Intern, I would not feel as prepared and passionate about tackling issues facing the medical profession and its patients.

More generally, my education as a poverty studies minor has affected how I understand the world and the issues society faces today. Poverty studies has taught me to be more cognizant of the challenges and suffering that others may face and has encouraged me to always act in ways that can affect positive change for those in need of it. I now feel responsible and committed to this work, and feel that I can best do so by working in the field of medicine.


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