Dr. Lewko talks about his experience treating chronic disease in Ukraine and his impression of the UCU Medical Clinic.
Dr. Michael Lewko is a rheumatologist and traveling consultant, a locum tenens physician. In the three years since he retired from private practice, he has traveled throughout the U.S. to wherever there is a need, treating patients with musculoskeletal disorders, arthritis, systemic inflammatory and autoimmune diseases. He also brought this consultative model for chronic disease to Ukraine, in his capacity as a board-certified rheumatologist and geriatrician. “I have a focus on chronic diseases, and, [as rheumatologists], we hope to make chronic diseases quite treatable and reversible,” explains Dr. Lewko. “At least to get the patients to low disease activity and possible remission. That all entails quite a bit of medical assessment, treatment and target goals. I wanted to bring that type of expertise to Ukraine.”
Dr. Lewko has been involved with UCU for many years. His association began when he started researching his roots in Ukraine and encouraging others with a Ukrainian background to do the same. Through these activities, he met Father Bohdan Prach, former Rector of UCU, who became a good friend. Dr. Lewko is also a long-time member of the Ukrainian Medical Association of North America (UMANA), New York Metro branch.
Inspired by the UCU Medical Clinic
Dr. Lewko first saw the Medical Clinic when it opened last spring and it inspired him to think big. He wondered how to get physicians from abroad to be a part of it. “Surgeons can come in and do a great job, help the patients, and then are able to return to their countries,” he said. “But from a chronic disease perspective, it’s much more challenging. How do we bring specialists in and help out in many ways?”
Addressing the larger healthcare issues in Ukraine is a piece of that puzzle. “We need to try to change the approach to healthcare, leftover from the Soviet mentality, to make it more patient-centered, more wellness and preventive focused. We want to provide the type of ongoing care where the patient is empowered with education and many supportive resources.”
Dr. Lewko returned to the clinic the following fall and spent two weeks providing consultative services for patients with rheumatology issues – treating musculoskeletal disorders, arthritis, systemic inflammatory and autoimmune diseases. “There were over 20 patients that came in. I partnered with a Ukrainian internal medicine doctor who could assist me with the language and translation to write full electronic medical records and go over a lengthy assessment and patient history. With the help of this excellent physician, I was able to discern the situation, conduct a physical exam and put together a plan based on what I thought was the issue.”
He quickly realized how much there is to learn about the health system in Ukraine. “I am used to so many resources; my practice was an integrated rheumatology practice with many other services, including a dedicated center that provided infusions and diagnostics, and in Ukraine, it is more challenging to put together a solid rheumatological consultation.” One of the biggest differences was the access to prescription medications. Biologic drugs can be very, very expensive; in fact, rheumatology is the second most expensive specialty after oncology. “In the U.S. the patient can get those medications by way of a specialty care pharmacy. In Ukraine, there is nothing like that,” Dr. Lewko noted. “It’s in the hands of the patient to try to figure out where and how they will get it!”
Dr. Lewko hopes to return to the clinic and has suggested using telehealth to follow up with his Ukrainian patients. That could yield ongoing feedback on the diagnostics and the treatment protocol that he started so he could track their continuing symptoms and care.
UCU Medical Clinic Leading Change in Healthcare
At a team building session as part of the clinic’s six-month anniversary, Dr. Lewko met the medical clinic’s staff as well as the many providers that rotate through the clinic: the young doctors and the specialists in various fields like rehabilitation, gynecology, pediatrics and psychiatry. It’s an interdisciplinary approach that makes the facility much more than a clinic.
“I feel it’s a beacon,” Dr. Lewko enthuses. “It is really a place where a chronic care model can evolve: where you can provide a proactive, patient-centered, multi-focused, center of excellent care. It can be a place that empowers the patient through education and access to prevention and wellness programs so that the patient can be their own care provider. They will know how to monitor their diet, physical activity, lifestyle changes, medication intake and self-management. They will have a system in place that maintains their health. That is the way to a healthy nation.”
“Ukraine has so many challenges right now and will have for decades to come. There is going to be a need for someone to lead. This clinic of UCU is much more than a clinic. It is a new model of chronic care – conventional medicine with coordinating wellness and prevention measures – that represents the future of the best healthcare in Ukraine.”
