Addressing Healthcare Barriers and Informing Opioid Treatment at Morse Clinic of Durham – with Nihith Ravikanti

Hi! My name is Nihith Ravikanti, and I am a junior honors student from Kansas City, Kansas, double majoring in Neuroscience and Nutrition and minoring in Data Science. After graduating, I plan to attend medical school where I hope to apply my experiences at UNC and ultimately become a compassionate physician. Alongside the Gil Internship, this semester I have been working as an inpatient phlebotomist at UNC Rex Hospital and a medical assistant at Family Dermatology. I am also a clinical research assistant in Dr. Mauck’s lab in the Department of Anesthesiology at the UNC School of Medicine, where I mainly study nutritional interventions for treating chronic pain. Despite having a diverse range of clinical experiences, my Gil Internship at Morse Clinic of Durham has been truly eye-opening.

When I was exploring potential worksites, I knew that I wanted one in the field of Psychiatry. Medicine is where my passion and future career lies, and Psychiatry is a specialty that overlaps closely with my majors and interests. I was also hoping to work directly with underserved patients. I am happy to say that I found a perfect fit in Morse Clinic of Durham, an opioid treatment clinic that offers Medication Assisted Treatment. There are currently nine Morse Clinics, and my worksite serves patients in Durham County.

Coming into the internship, I was a little worried. Addiction and substance use was a topic that were only covered briefly in my introductory neuroscience and public health courses. So, at the start of my internship I took the time to shadow all the different parts of the clinic, review the current literature, and ask as many questions as I could. This prep work paid off, because it helped me build a foundation that would guide the rest of my internship. It also helped me appreciate the interdisciplinary nature of opioid treatment. I saw firsthand how effective the combination of medication and counseling was on patients.

My day-to-day activities included assisting medical providers with responsibilities such as scribing and bringing patients back from the lobby. This helped increase the efficiency of medical visits and gave me insight into what a future career in Psychiatry could look like. I also worked on several long-term projects during my time at Morse Clinic of Durham.

My main project involved designing, conducting, and analyzing a survey assessing patients’ access to and barriers to primary care and mental health services. Survey and question design was challenging, and it was something I had almost no previous background on. However, with the help of the Odum Institute at UNC- Chapel Hill, I was able to create a survey that was both concise and useful. I administered the survey on a tablet in the lobby of the clinic over four days. I was able to gather 53 responses, which was about 30% of the clinic’s patients. Through this experience, I realized the importance of building trust and rapport with patients, because those who had seen and talked to me previously while I was with the provider were more likely to complete the survey. Results of the survey were informative. For both primary care services and mental health services, we learned metrics like how long it has been since patients have last seen a provider, barriers impacting them from seeing a provider, and interest in being connected to a provider. We found that transportation was the biggest barrier for both primary care and mental health access. This will help the clinic focus on improving support and education on transportation resources. Furthermore, clinic staff can follow up individually with patients who expressed interest in being connected to a provider.

The next project I worked on was a report evaluating how quickly patents who tested positive for fentanyl were being see by a medical provider. Timely follow-up is important to ensure patients are on the right dose for them and making progress. I analyzed data from the EHR system Methasoft to help the clinic determine if their follow-up time needed improvement.

My final deliverable was designing brochures for two new Morse Clinics opening soon, one in Chapel Hill, and the other in Roxboro. These new clinics aim to help address regional gaps in availability for opioid treatment in North Carolina. I made these brochures by modifying and improving the designs created by a previous Gil Intern at Morse Clinic of Durham. It was exciting to build on the foundation of a previous intern like me and also contribute to the expansion of Morse Clinics.

My time at Morse Clinic of Durham has been incredible, and has further solidified my decision to pursue a career in medicine. I am so grateful to Dr. Steven Buzinski, Emily Dolegowski, and the rest of the Gil Internship Program for making this opportunity possible. I would also like to thank Dr. Eric Morse and Arthur Payne for their mentorship, and the rest of the clinic staff for making this experience so meaningful.