NHCW Health Care Hero: Dr. Richard Gil

Tuesday, August 14, 2018

Dr. Richard Gil, a primary care physician at Old Town Clinic (OTC), understands that change in the community health setting usually doesn’t come in one fell swoop. It usually doesn’t come in several medium-sized swoops either. He’s happy to see his patients make changes that they’re willing and able to make, small as they may be.

“A lot of our patients are so high risk that when we can avert a crisis, it feels like a victory,” he says.

Richard knows high risk. After all, part of his week is dedicated to being one of the providers on Central City Concern’s (CCC) Summit Team, which works with our most medically fragile patients with the most complex needs. The rest of his week is spent working with one of OTC’s four care teams, which also serves Portland’s homeless and otherwise vulnerable population. Before working in Portland, he trained for his residency in the South Bronx, the poorest congressional district in the country.

“I want to work with folks who nobody else wants to work with and give them good, quality care—care they absolutely deserve.”

Regardless of the team he finds himself working with on any given day, Richard is intent on giving each patient the time and attention he believes they deserve. Often that means letting an appointment run over time so that his patient is able to express all their concerns and anxieties. At other times, it means writing a letter to a specialist to give them helpful background information about a referred patient. It could also mean doing stretches or breathing exercises to ensure that he’s in the right mindset to be the doctor he wants to be for his patients. Richard’s mindfulness doesn’t go unnoticed.

In addition to addressing his patients’ health issues, “he truly listens to [his patients’] stories and tries to understand them as human beings,” a colleague of his says.

Both of Richard’s parents were social workers, each working with a different underserved, overlooked population. He heard often about their work: their frustrations with the system, the dignity of their clients, the little victories that made their work worth it. The passion for helping the people OTC serves—those who have by and large been marginalized and mistreated by the mainstream medical system—is, he says, “sort of baked into me.”

“I want to work with folks who nobody else wants to work with and give them good, quality care—care they absolutely deserve.”

Richard also treats many patients referred to OTC by Puentes, CCC’s culturally responsive substance use disorder and mental health treatment program for Portland’s Spanish-speaking population. Richard’s mother is Puerto Rican, his father Cuban. As a Latino, Spanish-speaking provider, Richard is thrilled to integrate such a direct, personal connection into his practice, especially knowing about the hardships—exposure to violence and racism—his mother endured.

“I love seeing my Spanish-speaking patients, especially those I don’t see often. They know I’m bicultural and bilingual. Knowing that they trust me to listen to them and meet their health needs… that feels awesome.”

As a Latino, Spanish-speaking provider, Richard is thrilled to integrate such a direct, personal connection into his practice, especially knowing about the hardships—exposure to violence and racism—his mother endured.

Despite the relationships he’s made and the progress he’s seen with his patients, Richard admits that his work as a provider isn’t without adversity. “I still have a hard time putting it into words, but I know that the secondary trauma we all feel working here affects me,” he says. “A couple tough interactions with patients or just seeing the tremendous suffering they may go through: that can be really hard.”

He knows how difficult this work can be without support, having had experience being “a lone island providing care.” So he leans on his care team colleagues. “I couldn’t be sustained without everyone else. It’s clearly a team game here and I can’t ask for a better place to work or better people to work with.”

With the support of his teams, Richard thrives in helping his patients move toward their health goals in the face of the trauma and competing priorities that come part and parcel with living outside.

“I love it when I can have a conversation and incorporate a lot of ‘change talk’ to get patients to move from Point A to Point B. That might not amount to really big change right now, but over time, I see it inch them forward,” Richard says with a smile. “I love that part of care.”