Penn Medicine Urology residents Christopher Herrera, MD, MSHP, left, and Esther Nivasch Turner, MD
In partnership with Puentes de Salud, a Philadelphia nonprofit health center that primarily cares for low-income Spanish-speaking patients, two Penn Medicine Urology residents are leading an effort to provide free vasectomies at PPMC’s outpatient urology clinic to patients without access to insurance that would cover the procedure.
It’s about more than offering free vasectomies to an underserved population: Chief Urology resident Esther Nivasch Turner, MD, and first-year Urology resident Christopher Herrera, MD, MSHP, want to make sure that the men have the same patient-care experience as anyone else coming to Penn Medicine, regardless of whether they are documented, have insurance, or speak English.
“We’re making sure that these patients get the experience that any patient in our clinics would get – that they get literally the same discharge instructions, the same pre-op instructions ... the same experience, other than the fact that they might be a Spanish speaker,” Herrera said.
Working under Puneet Masson, MD, Penn’s director of Male Reproductive Medicine and Surgery, Nivasch Turner and Herrera received a grant from the Bach Fund, which supports PPMC projects, to cover 20 vasectomies for Puentes patients. The first two surgeries were performed in late February and March.
A vasectomy is a minor surgical procedure, typically done in a urologist’s office under local anesthesia, that provides a permanent, highly effective form of birth control for men and families. But vasectomies are typically not covered by Emergency Medicaid, the program that provides medical coverage to individuals who do not qualify for other insurance due to citizenship or immigration status.
When explaining the vasectomy procedure to patients, Puentes providers start by asking patients if they already have children and if they want to have additional children.
The residents developed a Spanish script for Puentes providers to explain the vasectomy procedure to patients – which mirrors the information Penn patients get – as well as Spanish-language versions of the preparation and home-care instructions and other educational materials given to all Penn vasectomy patients. The pre- and post-operative evaluations happen at Puentes, with the actual procedure taking place at the Penn Urology clinic at 3737 Market Street. Patients can have a liaison from Puentes with them during the procedure and a video or phone Spanish-speaking interpreter if needed.
In the future, the physicians hope to expand the initiative to more patients as well as learn more about cultural attitudes toward male contraception, existing safe contraceptive procedures, and unmet needs in this patient population.
“There are a lot of thoughts about what it means to be a man, what it means to be a woman, and where your virility fits into that,” Nivasch Turner said. “We’re hoping to eventually start collecting information from patients about what they see as the benefits of the procedure, and what was most helpful in making this feel like an accessible procedure that would not deprive them of something that they think of as a primary part of their manhood.”