Chronic Care team treats diabetes and other conditions

Michelle Shelly, M.D., has joined the staff of the Center for Healing & Hope, completing a team that specializes in providing care for people with diabetes and other chronic conditions.

The Center for Healing & Hope has focused on urgent care clinics for people without insurance or funds to pay for care since 1999, relying on volunteer physicians and nurses. The goal has been to address immediate needs and refer patients to medical practices in the community for ongoing care.

However, it has been difficult to find local physicians who can take new patients, Bryan Mierau, executive director of the Center, explained. This is a significant concern for patients newly diagnosed with a condition like diabetes—patients who need consistent, regular care for monitoring their health and making lifestyle changes.

The Center has experienced a growing percentage of patients who return for management of chronic conditions. From 2015 to 2017, the percentage of visits for management of chronic conditions increased from 11 percent to 23 percent.

The Center’s volunteer medical providers screen all patients for diabetes and do further tests when factors in their health indicate it may be present. In 2017, 298 patients were tested; 71 were diagnosed as pre-diabetic and 36 were diagnosed with diabetes. The previous year’s statistics were similar: out of 309 tested, 71 were identified as pre-diabetic and 21 were diagnosed as diabetic.

These numbers reflect what is reported on a much wider scale for patients in minority groups. For example, the Office of Disease Prevention and Health Promotion, in its Healthy People 2020 initiative, points out that on average, “Mexican Americans and Puerto Ricans are twice as likely to have the disease as non-Hispanic whites of similar age.” In addition, the Centers for Disease Control and Prevention estimates that half of the Latino people in the United States will develop diabetes, and that Latino people are 50 percent more likely to die from the disease than other white people are.

“Approximately 70 percent of our patients are Latino and almost all of our patients do not have insurance or a family doctor,” Mierau said. “This means we must make the need for care of these patients a priority in our mission of providing medical and advocacy services in our community.”

The Center began earlier this year to form a team who will work with patients newly diagnosed with diabetes. They have established an educational program to help these patients learn how to monitor their blood sugar levels and to make changes in diet and exercise. The Center received several grants to help fund this diabetic initiative, and staff is seeing early success in patients participating in routine monitoring and educational sessions.

Dr. Shelly brings to this team both a specialization in diabetes and a strong interest in providing services to people who are not able to afford medical care in other settings. “It’s critical to find ways to provide high quality care for people who don’t have insurance,” she said. “I’m a strong believer in preventive care. We use our resources much more wisely when we address conditions early, rather than waiting until they are serious and more expensive to treat.”

Having practiced as a physician in Goshen for 20 years, Dr. Shelly also brings to the Center’s work an understanding of barriers some patients in this community experience in seeking medical care. “I don’t think there is any other access point where a person without insurance and a primary care provider can walk in and get immediate care,” she said. She also affirms the Center’s faith-based approach to care for patients; “Seeing patients as a whole person and not just a physical body—caring for all needs, physical, emotional, mental and spiritual—is part of holistic care for me.”

Dr. Shelly joins an interdisciplinary team who collaborate to provide care for patients with chronic conditions. Gil Pérez, LPN, is the Center’s clinic manager and leader of the team. Barb Landes is a certified diabetic educator who meets with patients individually and in groups. Marbella Chavez, the Center’s patient advocate, is also a health care worker, keeping in regular contact with patients who have been newly diagnosed and patients with uncontrolled diabetes to encourage them to use the Center’s educational and medical services. This team constitutes a unified set of professionals who will work individually with patients each time they come to the Center, providing consistent care and counsel.

The Center will continue to rely on volunteers for regular clinic sessions, Tuesday and Thursday evenings and Friday mornings. Dr. Shelly may work in these clinics sessions as needed but will concentrate her work on the patients referred to her by the volunteer physicians and nurse practitioners. In addition, patients from her previous practice may come to the Center on Mondays and Wednesdays when she is available to meet with them.

About Dr. Michelle ShellyDr.  Michelle Shelly

Michelle Shelly, M.D., is a board certified family medicine physician. Managing diabetes is a special interest of hers and she has received certification in the provision of quality diabetes care by the National Committee for Quality Assurance (NCQA).

With an undergraduate degree in physical therapy, Shelly completed medical school at the University of Colorado Health Sciences Center and family practice residency training at St. Francis Hospital in Beech Grove, Ind. In the northern Indiana area, she has worked with Maple City Health Care Center, Elkhart County Corrections Center and Goshen Physicians.

Dr. Shelly is fluent in Spanish and has experience in providing medical care in numerous impoverished settings outside of the U.S.