A Wheeling Street Doctor Takes L.A.

Photo courtesy of Dr. William Mercer

In late March, Dr. William Mercer planned on visiting L.A. for a long term care symposium held by a society he has been involved with for the last thirty years. 

He decided to take full advantage of the trip and use it as an opportunity to connect with Brett Feldman, a fellow street doctor based in California. Feldman founded USC’s street medicine program, a counterpart to Wheeling’s Project HOPE, the mobile healthcare clinic and team of doctors who treat Wheeling’s unhoused population. 

So Mercer joined Feldman’s street team as they made rounds on the streets of L.A. 

The team first showed Mercer their pharmacy, much of which is funded by Los Angeles County, and some by the University of Southern California. 

The L.A. team doesn’t have one large mobile clinic vehicle like Project HOPE has in Wheeling; they use several trucks. Teams of four to five doctors set out every day, each with a specific focus. Mercer was assigned to the addiction team. 

They began to drive around the streets of L.A. looking for people in active addiction in need of care. 

Mercer learned that many of the team's patients are immigrants without documentation, which poses a unique set of challenges. The first patient they came across was a 65-year-old woman addicted to fentanyl, an immigrant from Ireland. The team informed Mercer that if found by Immigration Enforcement officers, she would be deported right away. 

A new program allows the L.A. doctors to give patients a once-monthly suboxone injection that Mercer describes as a “game-changer.” Suboxone is a prescription opioid used to treat addiction withdrawal symptoms. 

“The people I saw really like this approach because sometimes with suboxone that comes in a film they can sell it, they can lose it so this once a month shot is very convenient and lets them try to get better control of their addiction,” Mercer said. “At this stage they’re not trying to get high, they're just trying to prevent side effects from withdrawal.”

The team drove the streets under the Hollywood Sign – the areas surrounding the iconic landmark are a common place for unhoused Angelinos to stay, Mercer said. 

Mercer learned that another location frequented by unhoused communities, MacArthur Park, had recently been swept by the city. Many people’s belongings and tents were quickly removed and disposed of, similar to the camp clearing this past December in Wheeling.

The addiction team then traveled to Skid Row, a well-known fifty-some block radius in downtown L.A. home to thousands of unhoused people, many living in tents and other makeshift homes.

“I mean everybody’s heard about skid row but actually it didn’t look much different when we had people on the streets in Wheeling with their tents and belongings, the volume [in L.A.] is just much more,” Mercer said.

In Los Angeles, there are approximately around 70,000 unhoused people, while Wheeling has several hundred. Despite the vast difference in population size, Mercer said he feels Wheeling’s street medicine program rivals that of larger cities. 

“I’m proud to report that I think our Project HOPE here in Wheeling holds its own to any of these street medicine groups,” Mercer said.

In the past, Project HOPE representatives attended an international street medicine symposium in Rotterdam, Netherlands.

“We were asked because of what we have achieved in a small community,” Mercer said.

Mercer noted this work is all in thanks to Jim Withers, a Pittsburgh doctor who headed some of the first street medicine efforts in the 1990s. Withers went on to found the Street Medicine Institute. 

Now, Mercer estimates that around 140 U.S. cities have active street medicine programs.