“Almost every week, I see someone in my primary care Penn practice who I met at the mobile unit. It's really exciting to see how direct community engagement—meeting people literally in their neighborhood—can lead to long-term relationships where we're addressing addiction care as well as primary care,” says Dr. Judy Chertok, physician with Prevention Point Philadelphia’s (PPP’s) mobile unit, Wellness on Wheels (WOW).
Dr. Chertok, who works with Prevention Point one day a week, is Associate Professor of Family Medicine and Community Health in the Department of Family Medicine and Community Health at UPenn and holds several leadership positions across the Penn medical school and health system. After finishing her training in 2010, Dr. Chertok began her career in general family medicine. She started to focus on addiction medicine in 2017 as she began observing the devastating impact of opioid use, particularly fentanyl, among her primary care patients.
“I became one of the early primary care doctors at Penn figuring out how to integrate care for people with opioid use disorder into primary care,” she says. “Working with the PPP team allowed me to further accelerate changes in my own practice.” In a community-based setting like PPP, she explains, providers can learn from patients and each other to evolve their practice to meet the needs of the community in real time.
Wellness on Wheels
From the beginning in 2020, Dr. Chertok has been one of the medical providers for WOW, a collaboration between PPP, Penn, and the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS). The bus, which stays three to six months in one site, serves areas across the city by providing outreach, education, resources, drug treatment, and medical care.
A team of providers, case managers, and certified recovery specialists works with patients to address medical, health insurance, housing, and identification needs. What does each individual need from a long-term provider? Examples might be integration with primary or mental health care.
"Whatever happens with your medications, whatever happens with your addiction care, I'm committed to being your doctor."
“We individualize our referral plan with each patient. We figure out what the hyper-local providers are in that neighborhood,” Dr. Chertok explains. “Then we get them started and stabilized on medication for opioid use disorder (MOUD).”
The WOW team facilitates every next step for a patient—finding a provider, scheduling appointments, providing transportation. This kind of individualized support has proven successful in keeping patients engaged in care.
“A couple of years into the project, we did a research study looking at our connections to care from the unit finding they not only went to the first external visit, but they went to at least two. That is a pretty high rate of linkage for such a low-barrier program,” Dr. Chertok remarks.
Pathways to long-term care
There are countless examples of patients who have found success connecting to long-term medical care through the mobile unit, particularly at Penn and PPP.
Dr. Chertok recalls a patient first encountered in 2020. At first, the gentleman stopped by to talk. Then, he took some Narcan. Week by week, he engaged more and more with the PPP team. Ultimately, he started drug treatment at WOW and transitioned to Dr. Chertok’s Penn practice for ongoing care. He had a recurrence of substance use but then reengaged with treatment through the mobile unit.
As his addiction care needs changed, the team helped him transition to a methadone program while still engaging in the rest of his medical care.
“I always tell our patients: we're stuck in this together. Whatever happens with your medications, whatever happens with your addiction care, I'm committed to being your doctor,” Dr. Chertok says.
Five years later, “He's still my patient. I saw him last week. He has had a lot of medical challenges but remains in our care.”
WOW is currently on N. Front and E. Tusculum Streets on Wednesdays from 12:00 to 4:00 p.m. Check our website for contact information and location updates.