“We put the person in the middle,” says Nils Behnke, CEO of St. Anthony Foundation. “At the very core of what we do here, there’s this strong mutuality. It’s this human interaction that we have with others that really lets us better understand who we are.”

Here lies the key to the Community Partnership Program (CPP) that’s growing collaborations between Stanford and community clinics across the Bay Area: Stanford doctors and researchers have cutting-edge medical experience, equipment, resources, and connections. Community clinics — whether federally qualified health centers that serve patients on Medicaid or Medi-Cal, or free clinics that serve patients without any insurance — have experience serving vulnerable communities, a place in the community fabric, and talented, tenacious specialists and volunteers. 

The city bustles not long after 7:00 a.m. as Larry Kwan, MD, walks from the Powell Street BART station past the intersection of Golden Gate Avenue and Market Street in San Francisco. He goes by the hundred-year-old theaters kitty-corner from the Thai and Vietnamese restaurants that will open their kitchens in a few hours to serve noodles, soup, and sandwiches. Passersby head to businesses, transit stops, and the mosque up the street.

But this is a community snapshot most people don’t see when they look at the Tenderloin.

“You read a lot in the papers about the doom and gloom: ‘the whole thing is going under,’” says Kwan, who is clinical assistant professor of primary care and population health. Every day he passes people taking drugs and living on the sidewalk, elements that make it into the popular narrative people tell of the neighborhood.

“And then you see the kids,” he says with a smile, mentioning the happy children who walk with their parents to a Catholic school on the same block as St. Anthony’s Medical Clinic, where Kwan works. It’s easy to paint the Tenderloin with a broad brush: a symbol of homelessness and substance use. But that vision overlooks many beautiful aspects of the neighborhood’s community.

“In the dining hall, you got all these homeless guys sitting next to a group of 70-year-old Cantonese-speaking Chinese women — it’s this weird mix, and in the clinic it’s the same thing,” Kwan laughs.

As a part of their mission to feed, clothe, and offer help navigating basic civic services for anyone in need, St. Anthony’s focuses not just on treating immediate needs but on renewing a sense of humanity in the way they connect with their visitors.

“We put the person in the middle,” says Nils Behnke, CEO of St. Anthony Foundation. “At the very core of what we do here, there’s this strong mutuality. It’s this human interaction that we have with others that really lets us better understand who we are.”

Here lies the key to the Community Partnership Program (CPP) that’s growing collaborations between Stanford and community clinics across the Bay Area: Stanford doctors and researchers have cutting-edge medical experience, equipment, resources, and connections. Community clinics — whether federally qualified health centers that serve patients on Medicaid or Medi-Cal, or free clinics that serve patients without any insurance — have experience serving vulnerable communities, a place in the community fabric, and talented, tenacious specialists and volunteers. 

Bringing these together helps Stanford doctors give back to underserved communities and helps clinics expand their impact “beyond our four walls,” as Behnke puts it.

“It’s a good find for both us and Stanford,” says Massy Safai, MD, member of the Board of Directors of Samaritan House, which provides free health care in San Mateo County and serves vulnerable populations, including undocumented immigrants and low-income households. When Samaritan House was in search of a new medical director, Stanford’s interest in providing health care to vulnerable populations created a win-win arrangement whereby Baldeep Singh, MD, clinical professor of primary care and population health, stepped in to help fill their needs. “All of a sudden our medical director was leaving, and we needed someone very experienced to come in,” Safai recounts. “Dr. Singh has a lot of experience with vulnerable patients, and he was able to get us connections with pharmacies to get a lot of insulin and other medications for very, very cheap. All of these things count.”

However, Samaritan House and other community clinics aren’t passive partners in these arrangements, and their relationship with Stanford isn’t a one-way street. Six years ago, the primary care and population health division asked faculty how they might refocus their mission.

“Up there, right next to faculty wellness, was community engagement. So, we piloted a community partnership program, making that mission explicit,” says Jonathan Shaw, MD, clinical professor of primary care and population health. Shaw developed the CPP for the past five years from one division to the whole Department of Medicine.

The CPP provides an avenue for Stanford residents, researchers, and faculty to bring their talents back to settings they come from. The program relies on direct partnership with these community clinics because the work is so wide-ranging and the patient populations are so underserved by our current healthcare systems.

“The clinics are quite different and specifically mission driven, serving a specific community and group of populations,” says Shaw, who works every week at Ravenswood Family Health Center in San Mateo County. “There’s a uniting mission around the populations served. All of these clinics are trying to have culturally appropriate, culturally humble provisions of care.”

Without this culturally-appropriate care, community clinics wouldn’t be able to help many of these patients at all. Patients from racial minority populations might have deep-seated, understandable mistrust of the healthcare system, and undocumented patients often have severe hesitation about accepting help from any institution they think might share their information with deportation officers.

“Those patients are very distrustful, as you might imagine,” Singh says. “But they have a long history with these clinics. They’ve known them for years. The staff are all from the community. They know they can trust these clinics.”

Through unflagging work and support, community clinics build trust with underserved communities that larger institutions like Stanford lack. For decades, universities and medical programs have made it easy to train for practice medicine in big care centers that are less accessible to people of color, immigrants, those with lower income, and the unhoused. Many aspiring doctors come from underserved populations like these that don’t fit this prevalent healthcare model.

“We attract amazing, diverse students and residents,” says David Chang, MD, clinical professor of primary care and population health and current director of the CPP. Chang also serves as a part-time health officer for San Mateo County. “But when we don’t provide them opportunities to get plugged into a community-based research project as easily as they would for basic science, we’re not equipping them for becoming leaders in these underserved settings.”

“Community engagement really is the flip side of diversity, equity, and inclusion (DEI) work,” Chang emphasizes. “Both are needed to support our students, our trainees, our faculty.”

Community partnerships like this help support the most vulnerable people most left out of health care today. By reconnecting with each other, the Stanford Department of Medicine and community clinic partners strengthen the resilience of these clinics so that they may continue to provide outstanding care in the future. In the process, Stanford is serving their mission of supporting the community, while extending opportunities for medical education and leadership.

“I love the idea of connecting Stanford’s excellence to the social model of these communities and bringing that into how we serve these vulnerable populations,” Kwan says, smiling. “Everybody has competing priorities. How do we help them flourish? Thrive?”