This is the latest in a series of profiles of health care professionals who have benefited from the Massachusetts Loan Repayment Program (MLRP). The MLRP works to increase access to comprehensive primary care in underserved areas, by providing up to $50,000 towards outstanding educational loans for health professionals who commit to work at an eligible health care organization for two full-time years.
Interested in science from a young age, Dr. Marshall Fleurant grew up thinking that one day he’d be a scientist. But after working in a laboratory – an environment he found a bit isolating – he decided to take his passion for science to the more personal setting of clinical medicine. “I have always been good with people,” Dr. Fleurant says, “and I thought being a doctor would be the perfect combination of people and science.”
Dr. Fleurant enrolled in the Albert Einstein College of Medicine, located in the Bronx in New York. During his time there he had the opportunity to provide clinical services to underserved populations – an experience that fostered his interest in the social determinants of health. Further pursuing this interest in social determinants and population health, he received his Master of Public Health (MPH) at the Harvard School of Public Health (HSPH).
Dr. Fleurant now works at Boston Medical Center (BMC) where he is a primary care physician and an assistant professor of medicine. In his role as a physician providing direct care, Dr. Fleurant works in the department of general medicine where he sees adult patients five days a week on an outpatient basis. “I enjoy seeing patients on an outpatient basis,” he says, “where communication is fostered and I can get to know the patients on a personal level.”
Dr. Fleurant also provides follow-up care to immigrants at BMC, where his ability to speak fluently in Haitian-Creole provides a distinct advantage in treating many of his patients. In not requiring an interpreter, Dr. Fleurant finds that his Haitian-Creole speaking patients are much more comfortable and reveal more information than they might otherwise – allowing Dr. Fleurant to get more detailed patient histories and a richer and more complete understanding of their medical conditions. Dr. Fleurant describes the experience as “a homecoming, a re-familiarization of the culture.”
There are challenges to working with underserved populations. “Some of these patients have significant social and behavioral issues and social needs that affect health,” he says, “and it can be very hard to disentangle the two.” He believes that in order to be effective, population health requires a multi-pronged approach which addresses these issues – an approach which BMC supports, Dr. Fleurant tells us.
Dr. Fleurant heard about the Massachusetts Loan Repayment Program (MLRP) during his time at HSPH. As he began considering various employment opportunities, he actively considered whether hospitals and health centers qualified for loan repayment programs. Dr. Fleurant knew that he wanted to provide care for underserved populations, but he could not ignore his mounting student loans. Boston Medical Center qualifies for MLRP – a factor which definitely influenced his decision to accept BMC’s offer of employment.
Dr. Fleurant supports the MLRP because it acknowledges those that want to provide care for underserved populations, and makes that work possible. “Providing care to the underserved is not always easy work,” Dr. Fleurant says, “but the MLRP makes me feel like I have made the right decision; to me it’s another sign that I am in the right place.”