At the start of this year, Chief Medical Officer Dr. Adrienne Trustman let staff know that she would be stepping down from her position, but not leaving Health Care for the Homeless. Below, Adrienne reflects on her upcoming transition back to being a full-time doctor.

What has your time at Health Care for the Homeless looked like to date?

I started at the agency in June 2015 as a medical provider, then I moved into the Vice President of Medicine role for three years. I was promoted to the Chief Medical Officer in February 2020. That makes me the “COVID CMO!” And we’ve done a lot together since then:

• We were the first in Baltimore to test an entire shelter for COVID and proved to the City that it's vital to support shelters during a pandemic.
• We are the first and only Federally Qualified Health Center in Maryland to provide syringe services.
• We've vaccinated clients (and staff) every day for the past year.
• We've stayed present and cared for clients, and each other, through one of the most challenging times in our lives.

What draws you so strongly back to the clinic?

I really miss being a full-time doctor. It’s something I’ve always wanted to be since I was really little. As CMO, I spend two half-days a week with clients. I love the relationships I have and want to expand on that. I love seeing people get better when they take steps toward recovery. My new role as Lead MAT provider will involve a lot more work with the Medication-Assisted Treatment (MAT) team and Syringe Service Program (SSP). When I did MAT group during my first three years here, we didn’t offer flu shots, colon cancer screenings and other basic primary care in conjunction with opioid use disorder medication like Suboxone. I would love to figure out how to integrate more of those services. And I’m ready to give my first syringe kit out!

Why are harm reduction services important?

Harm reduction is a huge part of chronic disease management and preventive health care. People have busy lives and competing priorities, and it’s our job as health care providers to help them figure out how to prioritize their health care in the greater context of their lives. That may be taking one blood pressure medication instead of the recommended three— because that’s better than no blood pressure medications. Or it may be taking oral diabetic treatments because of concerns about insulin.

To me, syringe services fits this model nicely. A person who is not ready to stop using drugs but is well aware of the risks of HIV/HCV may be very motivated to use clean needles. Then it’s up to us as health care providers to work toward being a trusted source of health information so that we can discuss the risk/benefits of treatment with a medicine like Suboxone. We’re seeing that play out already in the MAT program. Folks come for syringes then open up to engaging in further treatment.

You and the other members of our leadership team have had ongoing trainings on racial equity and inclusion over the last year. How does an REI lens inform your work as a doctor?

In primary care, racial equity comes up all day, every day. I’m working with people who have been harmed and unfairly judged by the health care system in the past but also on an ongoing basis. If we look at the Big Picture, we need to examine the fact that people across different identities aren’t getting the care they need and deserve. There is a lot of trust to build or rebuild.

It’s common for clients to tell me that they've never had a medical provider believe that the symptoms they describe are real and valid. With that in mind, I try to bring a bit of skepticism to care that clients might have received already. That often means offering a treatment or test that wasn’t offered in the past based on race or income or housing status. I tend to dig into my empathy by thinking about what I would do if this was being experienced by my family member or myself—might I behave in a similar way? Often the answer is yes.

Why stay at Health Care for the Homeless in particular?

Our mission and the way we live it out is unique in Baltimore. I like that we see people and don’t charge. I like that we provide medications for people when they can’t afford them. I would be frustrated going to a place that excluded people based on ability to pay.

We see people who haven’t had the opportunity to have stability in their lives. I like being a stable part of people’s lives—and I’ve gotten attached to a couple hundred people! I wouldn’t want to start that over in another place. Plus, I think our medical leadership team is excellent. Sr. Medical Director Laura Garcia is a great boss!

When do you transition to your new position?

While I'm eager to get back to seeing clients more often, I am committed to supporting the agency as we look for our next CMO, and I plan to continue as CMO until that time. If you know someone who would be great for the job—encourage them to apply!

View the job listing for Chief Medical Officer