- [Narrator] Funding for this program was provided by.

- [Announcer] Chattanooga Funeral Home Crematory And Florist dedicated to helping you celebrate your life or the life of a loved one for over 85 years.

Chattanooga Funeral Home believes that each funeral should be as unique and memorable as the life being honored.

- [Narrator] This program is also made possible by support from viewers like you, thank you.

- [Alison] This week, I sit down with a woman who has turned her lifelong passion for Latino culture into a career, helping underserved communities.

- Of course, there was a lot of insecurity along the way in starting and wondering if we knew how to do it all.

But I think that continually being patient driven, patient centered and making decisions according to what's the best thing for the patient, that was always our beacon and has always been our bacon.

And so even in the insecurity and the fear of failure and the patients aren't showing up, you rest well knowing that you're doing the right thing.

- [Alison] Join me as I talk with founder and medical director of Clinica Medicos, Dr. Kelly Rodney Arnold, coming up next on the "The A-list" (upbeat music) Dr. Kelly, Rodney Arnold is a fourth generation physician who has spent her career building bridges between the health care system and underserved communities.

In 2015, she founded Clinica Medicos with a mission to make quality care accessible to Chattanooga's growing Latino population, regardless of insurance status, documentation or language.

Over the past six years, Kelly and her team have served more than 22,000 patients and Clinica Medicos has become an indelible fixture in the Chattanooga community.

I had a chance to sit down with Kelly to learn all about her passion for providing urban mission medicine where it is needed most.

Kelly, welcome to "The A-list" - Thanks, Alison.

- And I am so excited to get to know your story and your background, but let's start today before we go backwards, because anybody who has gone to or been the recipient and beneficiary of Clinica Medicos knows what a true gift it is to the city.

And I've heard the expression, urban mission medicine and I hope I got that right.

And I want to know contextually what that means.

- Contextually, it means that as physicians who founded this medical practice, 2015 that we saw a real need to blend our skills on the mission field, so the skills that we have as physicians without borders going anywhere, trying to pitch in and do whatever we can for the patient and meld those into what we saw was a need inside of an urban landscape.

So urban medicine, certainly inside of high density cities that have academic centers looks a lot different than medicine does on the mission field.

But we've come to the conclusion that you really need both, especially when you're talking about underserved communities.

- And I know your clinic specifically serving the underserved Latino community.

And I think a lot of people ask me when they found out I was interviewing you and I'm sure ask you, are you Latina?

- I am not Latina.

I am Italian.

And a lot of the story of Clinica Medicos has been born out of our Italian roots.

My grandfather, who came to Ellis Island my mother growing up in Brooklyn, in an immigrant community their transition to learning English, all speaking in a broken form in the household and my Papa Rock Rock Overgero Thomasino Eduardo learning English and really adapting to the culture and priding himself as an immigrant yet at the same time giving a lot of credit to those who helped him along.

And that was really an indelible story in my life, my Papa Rock and his love of being immigrant.

And at the same time, his love of this country and the looking at how he progressed from a young Italian boy who didn't know English to joining the military, becoming a dentist and oral surgeon and having such pride in his path was something that I really felt indebted to provide as an opportunity for other people who had that same dream and path.

- So your medical profession is certainly in your blood and in your roots.

- Yes.

- But when you were growing up in California, that wasn't necessarily the path you expected to take.

What interests you, what gave you joy when you were in LA and then eventually moved to Memphis?

- I am a learner at heart.

I am interested in all things, cultures, languages, basically everything ranging from science to math, to art.

And so I've always had multiple interests in a lot of things and medicine, I think it was hard for me to adopt that as my ultimate pathway, because it just seemed such a part of our family history, being a fourth generation physician that I wanted to sort of carve my own path.

I thought, what do, what am I originally what has been bestowed upon me?

What is in my veins and who am I originally?

And so I looked into a lot of different things from being a Spanish teacher.

I was a Spanish substitute.

I was a medical assistant and spent years really trying to carve out what that was ultimately to find that my passion which I think was bred out of growing up in Southern California for the Latino community and for language could be married to my love of science and the nobility I found in being a physician and helping people.

And so ultimately a lot of combined interests were wedded under becoming a family physician who had a real leaning towards this community.

- What drew you to that community though?

What, was there a person, was there an incident or was it maybe just the love of the culture and the language?

- Yeah, I mean growing up, there was the familiarity.

So I had heard the language for so long from really being a toddler all the way through my teenage years.

And that's my parents starting a clinic similar to this on the north side of Memphis that started out helping the Latino culture.

And it really being a table conversation in our family to then having this wanderlust and wanting to be inside of those cultures and taking every advantage I could to study abroad and be uncomfortable.

And whether that was spending a summer in Mexico, living in Argentina, or then inscribing into a national health system study through Emory in Cuba, I was always trying to plant myself inside of what was a genuine pull and a genuine attraction for the people, for the language, for the community, for the sense of family.

And so part of it was a familiarity and part of it was just as I started to explore who I was and what really gave me fire, I was constantly led down that path.

- Is it possible for you to trace sort of the Genesis of where the medical career and your love for the Spanish culture and desire to help certain vulnerable populations intersect?

Like did you see that need and then say the best way I can fill it is going to medical school now or did you go to medical school and say, oh wow, the greatest bucket I can fill is within this population?

- No it was the former, after undergraduate, I really wasn't sure which path I would take.

Do I want to teach Spanish?

Do I want to involve myself in sciences?

Do I want to be a science teacher?

Do I want to take the, MCAT go to medical school?

And so I tried to find jobs inside of those sectors to have experience on the ground.

So that was translating in a hospital, that was becoming a medical assistant inside of a clinic that was largely Latino based.

And that was becoming a substitute Spanish teacher.

And so I was doing all of these odd jobs, living at home and I, at that moment, and this is early twenties, through that year of experience thought my greatest impact is going to be to help people through medicine and still take this cultural compassion and bring that into the science of how we practice.

And that, that was a pivotal moment for me.

And I've never really steered or veered from that focus in how I want to be a physician.

And it's led me into a lot of other opportunities where now I look at myself in a different context outside of the physician behind the door, who is going through the patient's schedule one by one to somebody who is looking now with 20 years of experience at systems and how can we really tie culture and medicine into people's lives, which it's not just that medical visit that that patient needs addressing.

It's a large landscape inside of somebody's life who's vulnerable, who's underserved that needs addressing.

And so solving problems through that now has become my next line of work inside of a similar focus.

(gentle music) - After moving to Chattanooga, Kelly began her work in the academic field, providing guidance for budding physicians as a professor of family medicine but it soon became clear that there was a need to amplify students' experiences outside of a hospital or residency program, and in 2015, she found a way to marry that need with her passion for providing care for the underserved, by opening the doors of a new kind of comprehensive clinic in Chattanooga.

What were the values that drove you for that opening?

Like what did you hope to pass on, not only to the residents, but to your team that started which was a really a fraction of what you are today, but what did you try to pass on to them that wasn't in the textbook, that wasn't in their training, to say this is what we're going to be, not just what we're going to do?

- Yeah, and this is when we started with five people.

None of us had any experience inside of running a medical practice.

None of us had a business degree, this was purely out of the naivete of youth and passion and that risk taking because to not do it felt like a bigger failure than to to fall on our faces trying.

But it took me a while to be able to answer this question, probably a year into it, maybe a year and a half.

And I thought we're really outside of our mission statement, which is to provide comprehensive care for the underserved uninsured, Latino community of Chattanooga, we are addressing what it takes to serve underserved communities.

And so the four pillars, I think that we are built on and what we try to bring our team into and to educate residents about are culture, so cultural competency, what does it mean to provide excellent care for somebody even when you have philosophical cultural differences about what good outcomes are.

Right, so a woman who comes to our clinic pregnant at 32 weeks for the first time thinks often that she's done a good thing by showing up prenatal care because in her community or in her Pueblo, in her country, women don't have prenatal care.

So she's advancing herself and feels proud of that.

And that is a victory, whereas our system might say, insufficient prenatal care I'm sorry, this is a liability but where do you find culturally a middle ground where you both feel like you can establish a safe outcome and relate to one another.

The second is economic transparency.

So we operate inside of a healthcare system in which everything is opacified.

How much does this cost?

Well, that question has become really important to patients and most of the healthcare community goes, I don't know but economic transparency and affordability is critical for our patients and for underserved communities largely uninsured or have a high deductible plan through an employer and still bear the brunt of the cost of medical care.

Thirdly, it's logistical ease.

How sensitive are we being to the fact inside of healthcare that patients lack transportation, that working families are not able to just put that two o'clock on a Thursday appointment on the calendar.

And they're just going to get off work without any punitive measures or without jeopardizing their job.

So we were full service walk in, anytime seven days a week to serve the patient schedule, not have the patient serve our schedule.

And then the fourth pillar was the language.

We need to be able to communicate directly and so much as lost through translator services.

And we are going to build that deliberately.

And those are really the four pillars of how we've built our microcosm inside of healthcare to address all the things that are not in the books.

There is no playbook and we came upon it through discovery.

I think we all knew we needed broad solutions but in retrospect, we said, these are probably the four fundamental things that nobody will teach you but that you need to know to deliver effective and compassionate care to people who otherwise can't find it anywhere else.

- When you first opened in 2015 was there any moment where you thought to yourself?

Oh no, what if nobody comes right?

- Like there were like a thousand.

- Yeah, we've invested all this and we have this whole theoretical notion of what people need and, and the trust.

I would imagine the trust factor is the most important and that something you don't just get, you have to build.

- Yeah it was, I knew that I wanted growth to be really deliberate.

And I had a lot of wise people around me who gave me advice such as be patient, do not have mission drift.

You know exactly why you're here.

Don't be enticed by putting out a new doctor in town ad in the newspaper in which you become inundated.

And then you're chasing somebody else's mission.

And so I was very deliberate and very grassroots about how we grew a trusted base.

And there were plenty of days of doubt.

And even speaking it into existence is as a scientist and somebody who really values the concrete, talking about something that wasn't actually happening, seemed like an abstraction and made me very, self-conscious like do they think I'm actually going to deliver here?

You know, what kind of doubts do people have?

And I still, I, to this day, six years later I keep large wall calendars that show how many patients we've had every day to see then this upward trajectory of how patients have come into the clinic.

And the first day we opened, actually, day we were slated to open somebody just knocked on the door.

And so we're all looking around at each other.

Like we have a patient.

We have a patient who's coming and it was this beautiful story because actually he had come from Florida and he was coming because he was out of his chemo.

He had a brain tumor and he was here with his family and he needed help.

So I called an oncologist buddy of mine, connected him to the tumor clinic.

He finished his chemotherapy and then two years later we delivered his second child.

So it started just these building blocks.

And there was one patient one day the next day there was two, three, four, and we felt busy.

You know, you're trying to figure it out.

So you have five patients you feel busy, and now we see exponentially more.

But of course there was a lot of insecurity along the way in starting and wondering if we knew how to do it all, but I think that continually being patient driven, patient centered, and making decisions according to what's the best thing for the patient, that was always our beacon and has always been our beacon.

And so even in the insecurity and the fear of failure and the patients aren't showing up, you rest well knowing that you're doing the right thing.

- Despite humble beginnings, Clinica Medicos has grown to become a critical resource for the Chattanooga community.

For patients, the clinic is literally lifesaving and that has never been more apparent than in the wake of COVID-19.

From the very beginning, Kelly and her team were at the forefront of protecting this vulnerable and at-risk population against the deadly virus.

But the healthcare needs of this growing community continue to evolve.

How do you keep yourself grounded in the success without getting sort of mired by the reality that the underserved population continues to grow, while your services remain not limited in scope, but you can only do what you can do.

And when you look back six years, do you see I'm sure you see the progress, but there's also gotta be this reality check of how can we expand?

How can we do more because that population is just continuing to be a larger presence within especially the Chattanooga community.

- Right no, it's, I'm very grounded to how much team effort this requires excellent partners, excellent staff.

We went from five, there are probably 45 to 50 of us now.

We're larger.

- Every single one is bilingual?

- Yes, every single one, and most are a combination of first and second generation immigrants.

We are like a family there and I'm continually checking in with, what do we need?

What are we thinking?

Where are we going?

What feels good?

What's within our mission?

And there are times in which the growth feels right and feels patient driven versus feeling that we're going to expand just because we're successful.

Those are two different things.

And so on the heels of this pandemic, really we have reacted to the needs of our patients to go bigger, not smaller.

And that has felt all very genuine.

It's felt deliberate, and it feels similar to the way that we started.

And so we're going to go for it.

And that's going to mean more capacity for that growing population, but then really digging more into the needs of behavioral and mental health for our patients and filling that gap which is all really important to the health of a patient and to a family.

- So what have you taken away from the year of COVID?

I have no doubt it changed how you did the work you do but it had to reinforce at least a hundred fold the why of the work you did.

- For sure, it's been a year almost too tremendous to summarize in words for us.

And it's been the rollercoaster of heartbreak to witnessing staggering genius, to innovation, to a lot of compassion.

So many things that I think needed to be reinvigorated inside of the field of medicine and inside of physician's personal callings.

And why are you doing what you were doing?

And are you going to retreat or are you going to roll up your sleeves?

Are you a part of this?

Are you there for the patient?

And for our practice, it was full of inspiring reminders that we really love what we do.

And when things get hard, then we need to go harder into what we think patients need and to be there and be more available.

And the Clinica Medicos project only, I think took a larger look at who we are, why we're there, what is our mission?

And as a result, instead of closing I remember March 13, 2020, we all sat down as partners and said whatever this looks like, we're going to do it.

And at that point we had 15 tests that were available to us because you couldn't get swabs.

You couldn't get the transport medium.

We had them locked up because they were like gold to do a COVID test.

This is how it started out.

And we just did everything we could to be resourceful and build relationships.

And that evolved into then becoming a community fixture inside of testing vaccination and building our own site and building bridges with the department of health and the health department to try to be there in every moment for the patients through something that was really terrifying and confusing.

And that now has brought a lot of hope.

And so we've seen this arc from desperation, fear, isolation to now smiles and more confidence and to gratitude and to be a part of that has been an absolute honor.

And it's been a privilege.

And I think we're all, although not happy for the suffering, I'm happy for the experience and for the ways that we could be there for patients.

And there was just never a doubt about it.

That's just what we were going to do.

And we're going to continue.

Hopefully not through something as dramatic as 2020 but the needs are still there.

And we're seeing them as offshoots in other ways.

And like I mentioned, mental health, access to care.

And then now new connections with patients who only through COVID found out that we existed and say, oh, wow this is a nice medical home.

This is a relationship with a physician or provider.

I'm going to check this out.

And that feels, that feels nice.

- Is Papa rock still around?

- Papa Rock, he is not around, but the legend continues.

My youngest is named Rocco after him and he's not around, but I certainly carry his spirit in me, feels alive for sure.

And through my mother as well.

- Yeah I, I can't imagine a more important or sacred legacy than what you are to all of them.

- Thank you for that.

It's taken a lot of positive influences around me to really solidify a calling and to be able to carry it through.

And it's all still evolving and we'll see where it goes.

- Yeah, I can't wait to see the next chapter.

It's been so great so far.

- Thanks Alison, I appreciate it.

- Thank you, Kelly.

(upbeat music) (gentle music) - [Announcer] Get on demand access to even more of the shows you love with WTCI passport, an exclusive benefit for members of WTCI PBS.

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(upbeat music) - [Narrator] Funding for this program was provided by.

- [Announcer] Chattanooga funeral Home Crematory And Florist dedicated to helping you celebrate your life or the life of a loved one for over 85 years.

Chattanooga funeral home believes that each funeral should be as unique and memorable as the life being honored.

- [Narrator] This program is also made possible by support from viewers like you, thank you.