Dr. Edwin Chapman
Medical Director, Medical Homes Development Group
1. You head the Medical Home Development Group in Washington D.C. and are on the front lines fighting the opioid epidemic. Tell us about that.
A. I have practiced medicine in Washington, DC for the past 40 years after completing undergraduate training, medical school, and post graduate training in internal medicine and cardiology at Howard University. I always wanted to have an office in the city close to where the people most in need of services actually live, and therefore set up an office in northeast Washington in 1980. I shared offices with Dr. Carlton Phelps until his untimely death in 2008. Dr. Phelps was an extraordinary individual who worked part-time for many years with the prison population at Lorton Reformatory, until its closure, and the mentally challenged at St. Elizabeth’s Hospital until his death. I took a lead from him and thought I could serve in a similar capacity by helping to keep individuals out of institutional settings as much as possible and received that opportunity in 2000 when another friend, Dr. Larry DeNeal, suggested that I serve as the medical director for a proposed methadone clinic for which he was writing a grant. I spent the best 12 years of my medical career learning the travels and untold stories of the many in our community who have suffered thru what we now commonly refer to as “toxic stress” or the “pair of ACEs” (Adverse Childhood Experiences and Adverse Community Environments). The experience in the methadone clinic environment taught me much about the many additional needs of our patient population in terms of social support and what we should be doing to improve care outside of the hospital, physician’s office, or substance treatment environment.
I began treating patients for opioid addiction in my private office in 2006 using buprenorphine medication assisted treatment (MAT) in a pilot demonstration project supported by the D.C. Superior Court. I began looking at ways to transition the lessons learned from the methadone clinic in to augmenting care in a private office setting noting that many such patients suffer from associated under-treated mental health issues, un-addressed physical health problems, and disproportionate infectious disease burdens such as HIV and hepatitis C. It was not until 2013, upon my return to the adjunct faculty at Howard University in collaboration with the Department of Behavioral Health and Psychiatry, that potential new and improved treatment models could be fashioned. This realization was augmented by the recent implementation of the Affordable Care Act and a call for “Accountable Health Communities.” This radical change in previously siloed medical practice stressed the importance of “integrated care,” primary care with a behavioral health focus and substance abuse treatment, and the so called “social determinants of health.”
The Medical Home Development Group was born out of the necessity to transform my solo practice into a broad-based service that could support the high needs of patients and families impacted simultaneously by all of the aforementioned. That transformation was created by a team of experts with national experience in practice integration, collaborative care techniques, and medical technology. That transformation created a metamorphosis from a single site adult care practice to a multisite family care focusing on complex medical, mental health, substance abuse, and social service needs. Medical Home Development Group is an independent practice association (IPA) composed of internists, pediatricians, psychiatrists, psychologists, social workers, nurse practitioners, and soon to be hired peer navigators. Our motto is “Best of Care Close to Home!”
2. How did you know you wanted to be a doctor when you were young?
A: My parents were both educators with strong backgrounds in community service and civil rights. As the first executive director of the Urban League in Gary, Indiana, my father entered a firestorm of racial discord and a school strike in 1945 in which white students refused to go to school with “Negroes.” After helping to fashion a creative solution to that issue, he was asked by Black doctors in Gary to help them gain access to hospital privileges and practice access. At that time, fewer than five white hospitals in the entire nation allowed qualified Black physicians entry. However, through the persuasive efforts of the National Urban League, both hospitals in Gary began accepting Black physicians in 1947, which was a full one and one-half to two decades ahead of the rest of the nation. I always remember my father talking about the medical profession in favorable terms and I think it was his way of influencing my older brother, Joseph Jr., and I to become physicians.
3. You recently spoke at our kick-off event for One America West Virginia, a new coalition that is bringing people together across divides to address the opioid crisis. Can you tell us about your thoughts about the program?
A: The One America Movement D.C./West Virginia concept immediately struck a cord with me when it was described as a way of bringing diverse populations of people together working around a common theme, while at the same time getting those disparate groups or “tribes” to see and know one another as not being so very different in our aspirations and goals in life. The concept was then beautifully explained in pastoral terms in an op-ed piece written by an evangelical pastor from West Virginia and a rabbi from northwest Washington. They summarized our current siloed political atmosphere as “motivate misattribution,” illustrating the near insanity of not working together as human beings to solve mutual problems, all while concurrently occupying the same space in the same nation.
We thank One America on a daily basis for the singular opportunity to have been invited to West Virginia into a warm and welcoming atmosphere filled with purity of heart. Martinsburg solidified in my mind that selflessness and love of all humanity is the antidote to motive misattribution and key to finding lasting and heartfelt alternatives to politically-motivated self-aggrandizement. I hope to bring the same educational information, science-based medical services, political willpower and financial resources to West Virginia as I wish to do for northeast and southeast Washington D.C.