Grantee Profile

UNITE Health Center: The Magic Touch

For Jenny Tsang, MD, coming to work at UNITE Health Center completed “a bit of a full circle.” The daughter of a Chinese garment worker, Dr. Tsang once accompanied her mother, a member of the Local 23-25 Union, to the clinic. “I used to come as her translator, and go through the process with her,” she says.

Dr. Jenny Tsang

Dr. Jenny Tsang teaches a UNITE Health Center patient
how to perform a breast self exam using a model.
The health center offers several types of breast
health education programs. Photos by Julia Connors.

Years later, after attending medical school in Mexico, Dr. Tsang is now fulfilling a required service year at UNITE before beginning her residency. “I’m working with the same population that my mom was a part of and it’s a population I’m really familiar with. I feel like it’s part of my home.”

As Dr. Tsang can attest, things have changed a bit at UNITE Health Center since her mother was a patient. For one, you no longer have to furnish your own translator.

Founded in 1914 as a tuberculosis clinic for the International Ladies Garment Workers’ Union, the center has since become a full-service health clinic boasting 54 exam rooms, 12 full-time primary care providers and 24 medical assistants and primary care associates. Nearly 95% of the staff is bilingual, an essential feat since many of the center’s patients speak a language other than English—most commonly Spanish, Chinese or French Creole.

After several union mergers, UNITE now serves members of the UNITE HERE Union, which represents 50,000 garment, laundry, restaurant, hotel and drug store workers, and 40,000 retirees. Most patients travel from the outer boroughs to visit UNITE. “These members are very low-wage workers,” says Audrey Lum, Chief of Clinical Services. “They make $8,000 or $12,000 a year, so we wouldn’t find them living in this area.” They come for high quality health care. “And we speak their language so they feel comfortable. It’s their health center. We promote it that way,” she says. Housed in a chic office building in Manhattan’s Chelsea neighborhood, the sophistication and comfort of the clinic’s facilities rival those of many upscale providers.

Because it is difficult for most of the clinic’s patients to take time off work for medical appointments, UNITE is committed to providing efficient office visits packed with as many in-house services as possible. Its methods for delivering effective clinical services have been touted in the American Journal of Industrial Medicine and in a case study by The Commonwealth Fund.

UNITE Health Center's radiology floor

UNITE Health Center's radiology floor offers women a
comfortable and brightly decorated seating area while
they wait for mammography. The center has two
mammography machines.

A grant recipient of the Komen Greater NYC Screening, Treatment and Education Program (STEP) since 2004, UNITE offers a variety of on- and off-site breast health services at companies whose workers are Union members. When a patient comes in for any reason, electronic medical records allow the provider to quickly determine whether it is time for her annual mammogram. “We’ve made it really easy for them to get screening,” Lum says. If a patient requires a mammogram, she has the opportunity to have one done that same day at the clinic—with or without an appointment. This efficiency contrasts that of many health centers where patients can wait for several weeks or months for a mammography appointment.

Even UNITE’s radiology floor is inviting, with its pink walls and watercolor posters advocating mammography. The department has two mammography machines, several contracted radiologists, and two full-time mammography technicians. Several days a week, a breast surgeon holds clinic where patients can get in the same day, if need be.

“You don’t have to go to five different places to get something done,” Dr. Tsang says. “We have primary care doctors. We have specialists. We have radiology. So, it’s one stop.” The program also offers in-house breast health education, conducted by Dr. Tsang while patients wait for their appointments.

“We do a very extensive follow-up,” Lum says. “Because we have electronic medical records and it’s pretty easy to run reports, we send out reminders once a year to those who haven’t had mammograms in the last eighteen months. We also do an extensive follow-up in terms of people who get abnormal mammography results.”

UNITE is also linked to the Columbia Breast Health Screening Partnership, which covers the cost of screening, diagnosis and treatment for underserved women in New York. In the event that a patient has lost her job and does not have adequate insurance but needs to have follow-up on an abnormal finding, she is referred to the Partnership.

“Our job is to demystify and facilitate mammography,” says Caroline Dorsen, a family nurse practitioner and the liaison between UNITE and the Partnership. “Many women have had a bad experience with a mammogram or with breast cancer, and it can be hard to walk through the door. We make every effort to make the experience as comfortable as possible.”

But providing in-house breast health services represents only half of UNITE’s battle against breast cancer. Dr. Tsang and José Rodriguez, Director of Marketing and Outreach, hit the road with the clinic’s education and outreach program, visiting the workplaces of Union members in the New York City area to spread the word about breast health, hypertension and nutrition.

Rodriguez works through Business Agents, members of the Union who coordinate with the administration of the company, to set up visits to various shops. “It’s a little bit difficult to get into these companies. They are very protective for various reasons,” Rodriguez says. “We are not allowed to stop production. So the training has to take place either during the lunch break or breaks that they have between shifts.”

The breast health presentations generally take place in Spanish, Chinese or English, depending on the audience. Some of the companies have lunch rooms where the presentations can be made. “You have to be very creative in order to get their attention because they only get 30 minutes to eat,” Rodriguez explains. Sessions include information on breast cancer, self-breast exam demonstrations and screening referrals.

Dr. Jenny Tsang educates a member of the UNITE HERE Union

Dr. Jenny Tsang educates a member of the UNITE
HERE Union in the waiting room on the UNITE Health
Center. UNITE sets up educational tables each in its
waiting area on various health topics.

But the workers aren’t always an easy crowd to reach. “Sometimes we don’t have the privilege to attend a lunch because they have to eat either in the parking lot or the yard,” Rodriguez says. In such instances, presentations take place during production hours. “When you go to a laundry, it’s so noisy. And the machines are running,” Rodriguez continues. “Of course it’s really a big effort to get to them because you are talking on a one-on-one basis and you don’t want to stop production. So they move to one side [of the machine], and you chase them. You have to be very creative.”

Among the workers, there is a wide range of education and interest level pertaining to health issues. If 10% of the people Rodriguez meets at a presentation are already aware of breast health concerns and the necessity for screening, he considers them ahead of the game as far as the industry is concerned. At some companies, only one or two workers may be aware of these issues prior to the presentation.

While Rodriguez and Dr. Tsang are constantly adding companies to the presentation list, there are several that they return to regularly. Different unions also have monthly meetings that are an ideal situation for educational sessions because hundreds of people are already assembled. “The more we do this, the more I see some retirees that go to the English sessions, they go to the Spanish sessions, and they come back for other topics,” Dr. Tsang says. “And it helps other people who have never been to these presentations to get more involved and also pay attention and come back for more…Things travel by word of mouth, so sometimes the information does get skewed. So if they come back to a presentation more than once, we can clarify that information.” Repeat participants can also be helpful in encouraging others to overcome cultural barriers associated with talking about female health issues or practicing a self-breast exam on a breast model.

As Rodriguez says, “You have to have the magic touch. Because if you don’t, you won’t get their attention.” In the nine decades since its inception, UNITE Health Center has taken this idea to heart by observing the needs of its population—and translating them across cultural, linguistic and economic barriers.

By Julia Connors
June/July 2005

For more information on these programs and services, please contact UNITE Health Center:

Audrey Lum
Chief of Clinical Services
212-812-3562
alum@uniteunion.org

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