Transcription of Dr. Renee Fay-LeBlanc for the show Hometown Proud #261
Lisa Belisle: It’s always very fun to have people in the studio with me whose names and reputation succeeds them, in a good way. This individual is a board certified physician. This is Dr. Renee Fay-Leblanc who attended medical school at the University of Vermont and completed her residency in internal medicine at New York University.
Renee has been working in the Portland area for the last 10 years and as the Chief Medical Officer at Greater Portland Health since 2014. Renee loves providing vital primary care services to the community in Portland where she was born and raised. She now lives in Portland with her husband and two sons. Thanks so much for coming in today.
Renee: Thank you for having me.
Lisa Belisle: I really do love the story of being born and raised and educated, going away for your education, doing a little doctoring elsewhere, and then being back here again and helping out the people in the city. That’s a great story, and it doesn’t always happen.
Renee: Yeah, and I think it was not a story that was planned out that way. I left for college and didn’t expect to move back to Maine. Then was premed in college, mostly because I liked science and wanted to be a biology major. Being premed was pretty similar to that.
After Holy Cross, where I went to college, I actually spent a year abroad in Guyana, South America with a Watson Fellowship. Was supposed to be learning about traditional healing there, but that’s a very long story. It was a great experience.
Then from there actually went out to Oakland, California where I worked as a medical assistant for a couple of years before going to medical school. Then when I went to medical school, I decided I wanted to be closer to my family, so went to the University of Vermont. Then my husband was getting an MFA in poetry at the same time that I was going to do my residency. It was either Iowa or Manhattan.
That’s how we ended up in New York City. Then ended up spending four years in New York City. I completed my residency there. He completed his MFA. Had our first child and quickly decided that our 400 square foot, third floor walk-up wasn’t going to do it for us. We really moved back to Maine to be closer to family. It wasn’t until we got here that we really understood … I mean, I had been gone for almost 20 years … that there’s a really good writing and arts community here for my husband.
Also, it’s a great place to raise our kids. The medical community here, I just think that it’s filled with really smart, compassionate people. It was a nice place to call home. We sort of circled back. It’s been 10 years now that we circled back. I think my husband and I both feel really lucky that we did. My job right now at Greater Portland Health is extremely fulfilling for me. It’s very much a place that wants to make our community better.
I think it’s uncommon that people get that opportunity to really do something that they love, that they feel is making a difference in the place where they grew up, and where they’re raising their kids. I feel really fortunate about the whole thing, and none of it was planned.
Lisa Belisle: Unless there is some bigger something that maybe was …
Renee: Maybe, maybe. You know, it’s so interesting to think back about decisions that you’ve made or things that have happened, and years later you think, “Huh. That really brought me to a place that, you know, I never imagined it would.” Yeah, so it’s been good.
Lisa Belisle: Tell me about Greater Portland Health that is a public health program and also a clinical program for the City of Portland.
Renee: Greater Portland Health was previously called the Portland Community Health Center. We just changed our name. We are a federally qualified health center, which means that we are supported through grant funding from the federal government to take care of people regardless of their ability to pay. Which is very important to me.
The health center started in 2009. It actually was a group of community members who really wanted to bring a health center to main, who put together a proposal that was initially denied. Then when Obama took office, he granted 100 health centers who had been denied, he granted them grants to become health centers. The Portland Community Health Center was one of those places.
It started out as a joint venture with the City of Portland. Over time, the goal was to be an independent nonprofit, which is what we are now. We’re governed by a community board that needs to be at least 50% patients. They really set the direction and the tone of the health center. The health center has grown very rapidly over the last seven years, from one site and a couple of hundred patients to now we have five different sites, 6500 patients, and are continuing to grow rapidly.
We’ve got several new programs that we’re working on right now. For a variety of reasons, healthcare has changed a lot. As a federally qualified health center, we had the opportunity and have been writing a lot of grants, trying to keep as many services as possible in Portland. We also have an interesting sort of environment here.
One thing is that we didn’t expand Maine Care. We’re the only state in New England that did not do that. That has really hurt our citizens. The other thing is that we have a lot of people who come to Portland to get away from violence in other places, so a lot of people here seeking asylum who don’t have access to services. A lot of those patients come to get their care at the health center.
We also are a regular primary care practice, and so we see people with any kind of health insurance. People sometimes tell me, “Well, you know, I don’t want to go to the health center because I don’t want to take somebody’s spot.” It’s actually the opposite. It really helps us if we have patients who have insurance. We bill their insurance, and it helps us pay for those patients who can’t pay.
We have a variety of different patients. We see kids and adults. We have an integrated behavioral health model. We have teams that include physicians, nurse practitioners, physician assistants, licensed clinical social workers, nurses. We’re in the process of bringing in some more psychiatry. In the process of developing an infectious disease team. We’re also transitioning the health care centers in the schools. We’ll also be running those starting in the fall.
There’s a lot happening at the health center. It’s really growing. It’s a very vibrant place. In addition to the medical and behavioral health services, we have community health workers who help people with where to get food, housing, transportation. We have financial counselors who try to help people get insurance if they can, and then put on our slide if they can’t.
We really try to wrap services around people. It’s not just their physical health that we’re worried about, but their living conditions, their working conditions, their mental health, kind of all together.
Lisa Belisle: What does it mean to be a federally qualified health center?
Renee: Federally qualified health centers, there are 19 requirements that are set up by the federal government. They are things like you have to have a board that’s a community board that’s more than 50% patients. Only a certain percentage, I think it’s 10% of the board or less has to be in the healthcare, can be in the healthcare field. They don’t want the board filled with healthcare CEOs basically. They want it to be community members.
You have to have a sliding scale fee. For patients, depending on where they are in the poverty line, you have to reduce the fee. Some people pay $10. Some people may pay $20. Some people may pay nothing. You have to have that in place and have to see people regardless of their ability to pay.
You need to have a pretty rigorous quality improvement program and be able to show the government what you’re doing for quality improvement, what you’re doing for peer review. We also, as a federally qualified health center, have something called FTCA deeming, which means that we get our malpractice insurance through the federal government. Because of that, they want to make sure that we’re doing due diligence with the care that we provide.
The other 19 requirements, I don’t remember them all, but they’re in a similar vein. There are financial requirements. There are governance requirements. There are clinical requirements. You have to meet all of those 19 requirements in order to stay a federally qualified health center. You need to show that there’s a need in the community in order to stay a health center.
Then, in addition to following all of those rules, you need to keep your grants up-to-date. It’s a lot of grant writing. Basically then that means that the federal government will give us grant money that we can use to pay for some of the services that we offer, especially because right now at the health center, more than 50% of our patients really don’t have any ability to pay. It’s a lot of people who don’t have access to care otherwise.
Lisa Belisle: My understanding of federally qualified health centers is that they often in rural areas. In the state of Maine, we don’t have that many urban areas, but this must be somewhat of a unique situation, to have this right in Portland.
Renee: In large cities, there are lots of health centers actually. The health centers in Maine, you’re absolutely right, most of them are rural health centers. Portland is an outlier. It’s really the only one that is not rural. In places like Boston and the Bay Area and New York, Washington DC, Chicago, all have a lot of inner city health care centers as well.
There are, I want to say, around 1200 federally qualified health centers across the country. It’s a mixture of rural and urban. I think for us at Greater Portland Health, we are part of the Maine Primary Care Association, and so we really work a lot with the other health centers. Some of the things that we deal with are the same, whether you’re rural or urban. Some of the things that we deal with are a little bit different.
Primarily for us is the patient population and the diversity that we have, and the language and cultural diversity that we have, which really the other health centers in the state don’t have as much of that. There are other health centers in the country that certainly do.
Lisa Belisle: When you say “the diversity of the population,” do you mean new Mainers who have come from other parts of the world?
Renee: Yeah. Depending on the time period, it’s different folks. For us, a lot of the patients who are from the Middle East, Afghanistan, Iraq, have been here for a while. The people that we’re seeing mostly that are new are coming from Africa, so Burundi, Angola, the DRC is where we’re seeing the majority of the newest patients.
We certain have a lot of Somali speaking patients. There are some that are new, but a lot of them have now been here for a little while. The patients that are new, new, most of them speak multiple languages, but a lot of them we communicate with them using French. In Angola, they usually speak Portuguese. After English, I think French is the second most common language in the health center right now. It’s African French. It’s not people from France.
Lisa Belisle: That’s so interesting because I remember when I was taking French growing up. My family was French. I believe your family is also, right?
Renee: That’s right.
Lisa Belisle: It’s a French Canadian, and sometimes it’s more of a Parisian French that we’re taught in schools. Here you are using some French, but it’s not the same French.
Renee: Yeah. We do get by okay with the French. It seems like there’s not a lot lost in translation there. It’s the Portuguese that’s spoken in Angola which is very different. It can take a while to find an interpreter that actually speaks the right Portuguese to communicate with those patients. That is a little trickier. The French seems to be a little bit easier.
Lisa Belisle: I know that in addition to having interpreters, you also will sometimes use interpreter phones. You’ll actually have conversations over the phone lines. That’s an interesting experience as well.
Renee: Yeah, you know, it’s so interesting. We actually use the phones most of the time. What we have found is that the communities are pretty small, and that patients don’t want an interpreter to show up that they might know in another capacity. It makes them very uncomfortable. That’s not always the case. Some people really want that live interpreter, and they’ll want a specific person to come and interpret for them, which is fine.
Otherwise, we do use the telephone a lot. It is kind of an interesting interaction. Some of the telephone interpreters are wonderful. Some of them are not. Then, you know, I’ve done this before, where the patient sort of looks at me like, “This is not working,” so we hang up and call someone else. Yeah, so we use the phone interpreters quite a bit.
The other thing that we do is we hire people who can speak multiple languages whenever possible. Most of our front desk staff speak multiple languages. We have providers and nurses and medical assistants who speak multiple languages. Within the health center, we try to have that capacity in case we need to call someone, that sort of thing.
Lisa Belisle: You went to King Middle School.
Renee: I did.
Lisa Belisle: Where one of your sons is now going. You graduated from Portland High School.
Renee: I did.
Lisa Belisle: Did you ever think, as you were growing up, that you would find yourself back in a situation where you were caring for Portland patients, but that they might not be the same types or Portland patients you might expect?
Renee: When I was at Portland High, Portland was a resettlement area back then. There were kids back then coming from Afghanistan, and also a lot of kids from Southeast Asia. I think even back then Portland was becoming more diverse. I experienced more diversity at my Portland High School than I did when I went to college, which was not very diverse.
I didn’t think I would come back to Portland. I hadn’t planned that far ahead. When we were in New York, one of the things we really liked was the diversity. We really wanted to be in a place where our kids could grow up with some diversity. So, you know, I’m sort of pleasantly surprised by what’s happened in Portland in that I really think there’s a lot of strength that comes from diversity.
My kids right now are at Ocean Ave. My son just finished Ocean Ave and will be at King next year. They have quite a bit of diversity in their classrooms, which I really like. I think that, depending on what, the decisions that Portland makes, there’s a way to turn this diversity into something that can keep us very strong.
Especially because a lot of the new Mainers that are here seeking asylum are very well educated. They speak multiple languages. They were professionals in their communities. Right now, it’s really difficult for them to work and get jobs. When they do, it’s usually not in their fields. It’s usually low level service jobs. You know, house cleaning, working at hotels, things like that.
There’s a lot of potential, I think, in the community to really utilize the skills of the new folks that are coming. I don’t know if that answered your question. I think I got a little sidetracked.
Lisa Belisle: No, I think that’s a good answer, especially knowing that your experience of Portland growing up wasn’t actually as different as one might think. Even though we think of Maine was being a fairly Caucasian state, that wasn’t your experience of it, and not that long ago.
Renee: Yeah, I mean I think it’s certainly more diverse now than it was, but there was certainly diversity in the high school when I was there.
Lisa Belisle: One of the most interesting things about your home situation is that you’re married to a poet. I don’t know how many people can actually say that, but certainly the doctor/poet combination with the two young children … I think that Gibson was maybe our first guest, if not one of our first guests for this entire radio show, when he was still the director of The Telling Room. Tell me what that is like in your family.
Renee: It’s crazy, and it’s wonderful. When I was in residency and Gibson was in his MFA program, we were always trying to get poets and doctors together. It never worked out. It’s interesting. One of the reasons why I love what I do is that I listen to stories all day long. Patients come in and tell me these amazing things. I try to do what I can to try to problem solve and that kind of stuff with them. I really love that.
So much about medicine is relationship and story, and really that’s what Gibson does too. It’s not so different if you look at it that way. Our lives are a little bit of a juggling act in terms of the nuts and bolts of running a household. We do have a little bit of, you know, our home duties are a little different than other families that we know. It works for us.
Gibson has the ability to be more flexible with his time than I am. That’s helpful for our kids. I think we both try to talk to the kids like they understand what we do. They understand why we do it. They understand it’s really important to us, and that in our own ways we’re both giving back to our community.
I think Gibson’s poetry and the work that he does is all really based in this community and trying to bring arts and education and imagination to both kids and adults. Really seeing that those are ways that people, that telling your story is a really important part of your life. Understanding things, trying to write things down or say them out loud, however you want to express yourself.
His professional life is very much about trying to be a positive force in the community, just like mine is. I think my kids get that even when it’s annoying if we’re not doing what they want us to do at that moment.
The other thing is that it does take a village. We have an amazing amount of wonderful friends and neighbors and feel very supported by the community that we live in. Gibson actually, he’s a poet. He’s also a hockey player. He had an injury about a month ago where he had an open fracture of his humerus and required emergent orthopedic surgery and several days in the hospital.
It sort of turned upside down our … like, huh, we sort of had this work/life balance thing going until he couldn’t participate. A lot of people helped us out. The kids rose to the occasion, and we worked through it. I feel like every day is a little bit of an adventure.
Lisa Belisle: I hope that his broken arm continues to heal quickly, then that way-
Renee: Me too.
Lisa Belisle: It’s nice that he has a doctor to help him work through this transition.
Renee: I’m not sure he thinks that.
Lisa Belisle: Well, I have to admit, whenever people in my family are sick, I think that they would rather that I wasn’t a doctor. I don’t think I’m as nice as some of the nurses that I know. The nurses that I work with are so super warm and friendly and compassionate and caring. I’m thinking my kids would love it if I could be a little bit less clinical and a little bit more soft and fuzzy and warm.
Renee: Absolutely.
Lisa Belisle: I’m not saying you’re like that.
Renee: No, I’m certainly … no one gets much sympathy.
Lisa Belisle: It sounds like you give sympathy in a broader spectrum …
Renee: Yes.
Lisa Belisle: … in a larger way, so I wouldn’t discount that possibility. It’s really been lovely to speak with you today and to hear more about Greater Portland Health. I know that there’s some controversy swirling about in the community. I decided not to talk about that with you because, really, it sounds like you are doing great work. Your entire group is doing great work. You’re moving forward. You’re offering great healthcare.
I encourage people to learn more about Greater Portland Health. We’ve been speaking with board certified physician, Dr. Renee Fay-Leblanc, who was born and raised right here in Portland, where she still lives and now offers care to her patients. We’ll have information about Greater Portland Health on our Show Notes page at LoveMaineRadio.com.
Thanks so much for coming in today.
Renee: Thank you so much for having me.