Domestic Violence Prevention is Key Goal in Illinois Family Clinic

Darrell Ballinger, M.D., keeps a sharp eye out for signs of domestic violence affecting his female patients at Southern Illinois Healthcare Foundation (SIHF), a community health center located amid the oftentimes mean streets of East St. Louis. The OB/GYN was taken aback when one woman reported that she had told her church pastor about being beaten by her husband and his response was, “You’re a married woman and you should follow the husband’s rule.”

That motivated Ballinger, a former NHSC Scholar, to give a talk to a group of local clergy persons that generated an interesting discussion. “They had no clue on how to handle this social issue,” he found, “and a lot of them were afraid to bring it up,” for fear of offending some of their parishioners.

Ballinger is not at all squeamish about tackling a literal life and death issue for some of the patients he serves. “We ask our patients about these things and, if necessary, we refer them to the domestic violence counselor here,” he explains. Ballinger believes these efforts have helped many women avoid serious injuries and even death as a result of their domestic relationships.

“I talk a lot about non-medical things with my patients because these things are very important in terms of their overall health,” he adds.

Ballinger is also no stranger to urban realities. He was born and reared in New York City’s Bronx borough. His interest in medicine was spurred by a brother’s illness and by Ballinger’s own strong commitment to physical fitness training. While in high school he participated in the Marine Corps Physical Fitness program for students. Ballinger was captain of his school’s fitness team that went on to win the Marines’ national championship in 1973. To help compete, he studied the physiology of muscles, heart and lungs so intensively he concluded that, “Heck, I might as well become a doctor!”

Ballinger majored in biochemistry at Lehman College in the Bronx, and then started medical school at Boston University, under a 4-year NHSC Scholarship.

“I’ve always had the dream of working in an underserved area,” he recalls. “The part of the Bronx I grew up in wasn’t one of the wealthiest areas, so working in communities that are not wealthy was acceptable to me. I figured the best way to give health care is to employ people. That was my dream in college—to increase the employment rate and, therefore, increase health care access. Once people get employment, they are able to pay for the health care.”

After completing his residency at Harlem Hospital in 1986, Ballinger joined SIHF to serve his NHSC commitment. In relocating from the Big Apple, it helped that SIHF is situated near Alton, Illinois, home to many current and past generations of his family. “We had a family reunion in Alton when I was about 10 years old,” he notes. “It was nice coming back to work here.”

Like many new clinicians, Ballinger found entering the community health setting a real challenge. He says that many first-time practitioners struggle with translating their medical knowledge, gained in school and residency programs, into practical patient communication skills. “Almost your entire medical education is based in a hospital setting,” he says. “You spend a few hours a week in a clinic setting which is the exact opposite of the real world of practice.” It takes time and experience to learn how to talk and relate to patients in the office, he explains.

Ballinger left SIHF in 1990 to pursue a health care career in other settings. He worked for a time at an HMO and then a county health department in St. Louis. Eventually, Ballinger moved to Atlanta, Georgia, to work for a large hospital-based community health center. He even tried private practice for a while. All along, he became increasingly disillusioned with what he saw as the assembly-line medicine practiced at those facilities. He was also saddened to discover that “my dream—about working in poor areas and helping people—had ended.”

Rather than let it die, Ballinger came back to SIHF in 1994, after discussions with Medical Director Theodore Ross, M.D. Ballinger is now OB/GYN director at the center.

He sees women of all ages and medical conditions at SIHF’s four main clinics. “I try to give good health care but I also try to give good advice,” Ballinger says. Over time, he’s come to see the needs of his patients as being similar within various age ranges, such as between 14-21, and 22-30. “Each age range has a particular set of problems,” he says. For Ballinger’s younger patients, concerns generally stem from social and sexual maturation issues.

A skilled clinician, Ballinger believes, is keenly attuned to how each patient is reacting to him or her, personally, and to whatever messages are being conveyed. “You may remind them of their father or say the same thing their mother told them that really made them angry. You have to pick up on the fact that, for some reason, you’ve made this patient mad, and then know how to defuse the situation.”

Ballinger is especially gratified by one sign of success. Many of his patients end up working at SIHF clinics as technicians and in other capacities, in keeping with his youthful dream of providing employment opportunities, along with health care, to the neediest people in society. “Over 20 percent of our employees are former patients,” he reports. “That means they listened to me. They finished their high school education, got some additional training, and they liked what they heard at SIHF so much they’ve come back to work here.”

Ballinger enjoys the close collaborative spirit at SIHF. “We always sit down and discuss a patient’s situation, particularly those with multiple problems. They may have a gynecological problem and an internal medicine problem. Pediatricians are also consulted in connection with impending deliveries. SIHF professional staff meet quarterly for intensive review of certain cases, but Ballinger finds that the “most important conversations are the impromptu, one-on-one discussions over what to do about a particular patient. That’s when it really counts.”

Ballinger completed courses on health care administration in his capacity as SIHF’s director of OB/GYN. He believes more clinicians—and health professions schools that train them—need to broaden their educational experience to encompass non-medical areas, such as administration. “We need more training in administration—how to deal with nurses and patients, so we create good policies and procedures that won’t get you into hot water down the road.”