Skip to main content

Engagement: Profile of Rebecca Bixby

Rebecca Bixby CRNP
I like the word ‘engagement,’ instead of ‘access.' A disengaged community is one that regards the health center as ‘just’ a place for a doctor’s visit.
Engagement: Profile of Rebecca Bixby

As an outreach worker fresh out of college and newly arrived in New Jersey, Rebecca Bixby, CRNP, visited migrant camps, took blood pressures, did glucose screenings, and did a lot of interpretation -- she had studied Spanish as a minor in college, and was happy to translate. But when she accompanied Spanish speaking patients to appointments at clinics or a hospital, “I noticed… that there were no bilingual providers. I didn’t meet any while I was in that position.” The lack of direct communication hindered care, she believes. “It was extremely difficult [for patients] to communicate their chief complaints, [or] their feelings about what was going on… There was a complete disconnect,” Bixby said. In response, Bixby decided to return to school to get her advanced nursing degree.

ORGANIZING WHILE STUDYING

While studying at the University of Pennsylvania School of Nursing, she became involved with Juntos, a Latino immigrant advocacy organization. Again, in working with the community at Juntos, she noticed a strong disconnect between health services and the Latino community. “The language access wasn’t there, and, culturally, there were no health care settings serving this growing immigrant community,” Bixby said. In 2007, and in response to the lack of health connections, Bixby co-founded a health clinic called Puentes de Salud (Bridges to Health).  
The free clinic provided health care for immigrants in Philadelphia, many of whom had roots in the Mexican state of Puebla -- earning the town the new nickname, “Puebladelphia.”  Deforestation and movement from the countryside to the bigger cities in Mexico had led to a “collapsing enterprise system in the towns” of the region, Bixby said.  The influx of workers settled into a booming restaurant industry in Philadelphia, among other industries. 
But the community needed more, Bixby soon realized. Soon after starting Puentes, and while still attending school, she launched a program for women called Latina Community Health Services, which she calls a “spinoff from Puentes,” in which women could receive prenatal care in a “bilingual, bicultural environment,” she said. 
Both programs picked up quickly, she says, because they were initiated by community input. “Townhall-style” meetings at the local Catholic church provided an important level of communication with the community that helped shape the programs and gave the participants a feeling of connection to the programs once they launched, she says. 

While studying at the University of Pennsylvania School of Nursing, she became involved with Juntos, a Latino immigrant advocacy organization. Again, in working with the community at Juntos, she noticed a strong disconnect between health services and the Latino community. “The language access wasn’t there, and, culturally, there were no health care settings serving this growing immigrant community,” Bixby said. In 2007, and in response to the lack of health connections, Bixby co-founded a health clinic called Puentes de Salud (Bridges to Health).  

MCN Bixby

The free clinic provided health care for immigrants in Philadelphia, many of whom had roots in the Mexican state of Puebla -- earning the town the new nickname, “Puebladelphia.”  Deforestation and movement from the countryside to the bigger cities in Mexico had led to a “collapsing enterprise system in the towns” of the region, Bixby said.  The influx of workers settled into a booming restaurant industry in Philadelphia, among other industries. 

But the community needed more, Bixby soon realized. Soon after starting Puentes, and while still attending school, she launched a program for women called Latina Community Health Services, which she calls a “spinoff from Puentes,” in which women could receive prenatal care in a “bilingual, bicultural environment,” she said. 

Both programs picked up quickly, she says, because they were initiated by community input. “Townhall-style” meetings at the local Catholic church provided an important level of communication with the community that helped shape the programs and gave the participants a feeling of connection to the programs once they launched, she says. 

CONTINUING TO CONNECT

After graduating, Bixby “took a hiatus” for two years to Monterrey, Mexico, to work for a program that trained Mexican nurses for employment along the US-Mexico border. The goal was to place them in hospitals in border towns like McAllen, Texas, where bilingual nurses are in high demand, she said.  The idea of clinician exchanges, and stronger clinician cross-border collaboration, still thrills Bixby, who continues to see troubling divide between the patient population and health providers across the US. She sees greater cross-border collaboration, including nursing programs like the one with which she was involved, as one way to “bridge this gap that keeps coming up -- the biculturalism, the bilingualism being an issue in health care delivery,” she said.

NEXT STEP

In 2013, while still in Mexico, Bixby was contacted by Peggy Harris, NP, the clinical director of La Comunidad Hispana. Soon after, Bixby was back in Pennsylvania to take over Harris’s position as clinical director when she retired. The Federally Qualified Health Center is located in Kennett Square, known as the “Mushroom Capital of the World.” 

“It’s not a seasonal industry,” Bixby specified, but “the population is similar to other migrant populations in that there is turnover, people do move around and do go back and forth from their home communities in Mexico to here.”  She estimates that roughly 90 percent of the clinic’s patients are uninsured. “We’ve tried to make a dent” in the percentage as a certified enrollment site and with a strong outreach program, which brought the percentage down to 80. During the last enrollment period, the clinic contacted 5000 people. “Of those, very few were eligible,” Bixby noted. 

Bixby continues to believe that a successful health center is one that is fully integrated into the community, with high community engagement. “I like the word ‘engagement,’ instead of ‘access,’” she noted, when speaking of La Comunidad Hispana’s work with the community. “A disengaged community is one that regards the health center as ‘just’ a place for a doctor’s visit,” she said. 

Conversation with the community is the key to a successful migrant health program. “I’ve been a part of a lot of successful models – and they’re all different. It’s so much about the immediate community that you’re engaging with,” she noted. “We can create access, but if people aren’t engaged in your process, then why would they come?” 

“If there’s something that is scalable, it is making sure that you’re not just providing medical care, but also addressing social determinants in an engaged way in the community,” she continued. “There’s got to be a baseline connection to make your medical services more effective, and… [to] be what the community really needs.”

DRIVE THE AGENDA

As clinical director, Bixby’s focus has adjusted to the national conversation on health care. Health centers, she says, “are positioned to set the agenda for migrant health, because we know our patient population.” With good data sets and excellent outcomes, Bixby believes health centers can and should drive policy and national and regional conversations around patient engagement. Once a health center has that level of connection to be successful within the community, then it has a responsibility to represent that population on a larger level. As clinical director, “that’s what gets me up in the morning,” she said.

Photos by Carol Moore Photography, 2015

30 CLINICIANS MAKING A DIFFERENCE is a project celebrating Migrant Clinicians Network's 30th anniversary through the life stories of 30 clinicians making a difference in migrant health. Learn more about Migrant Clinicians Network.

DONATE

to help support the work of migrant clinicians

SIGN UP

for our eNewsletter

CONNECT

with MCN on our blog

More Clinicians

Contact Us