‘Meeting People Where They’re At’: Experiences of Family Physicians Engaging Women Who Use Illicit Drugs

Susan Woolhouse; Judith Belle Brown; Amardeep Thind

doi:10.1370/afm.1225

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A model for encounters with women who use illicit drugs
Diane Hatton

Published on: 03 June 2011

Published on: (3 June 2011)
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A model for encounters with women who use illicit drugs
Diane Hatton, San Diego, CA, USA
The findings presented by Woolhouse, Brown, and Thind (2011) mirror my own clinical and research experiences working with women who have histories of problematic substance use, homelessness and incarceration. I especially find the idea of “meeting people where they’re at” to summarize an effective strategy for working with members of this vulnerable population and their many health challenges. These physicians demonstrate...
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The findings presented by Woolhouse, Brown, and Thind (2011) mirror my own clinical and research experiences working with women who have histories of problematic substance use, homelessness and incarceration. I especially find the idea of “meeting people where they’re at” to summarize an effective strategy for working with members of this vulnerable population and their many health challenges. These physicians demonstrated sensitivity and acceptance of their clinical encounters that frequently included “drama” that became routine. The family physician participants, the authors argue, most likely share traits that distinguish them from others in more conventional practice, and women with histories of illicit drug use are able to establish relationships with them and return for care. The authors note the family physicians in this study found themselves isolated and marginalized from their peers as a consequence of caring for patients who were also isolated and marginalized.(Goffman (1963) has described a similar idea as “courtesy stigma.”) It is unfortunate that we continue to have health professionals who lack understanding of and appreciation for the skill required to care for women with the complex healthcare needs described in this article. In the US, many women with problematic substance use find themselves accessing care from less than empathetic providers in crowded emergency departments where they are often referred to as “frequent fliers” and find little continuity of care. The trust and presence found among the providers in this study present us with a model for encounters in the many settings where women struggle to meet their healthcare needs.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs: Prentice-Hall.
Woolhouse, S., Brown, J. B., & Thind, A. (2011). 'Meeting people where they're at': Experiences of family physicians engaging women who use illicit drugs. Annals of Family Medicine, 9(3), 244-249
Competing interests: None declared
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Competing Interests: None declared.