David Strasorier has always questioned outdated models that create a disconnect between doctors and patients. An expert in public health and social work, he spearheaded the creation of the innovative Comprehensive Women's Counseling Units, linking academia, municipalities, and the community to provide solutions in the province of Córdoba, Argentina.
When David began his medical internship, he faced a harsh reality: everything he had learned over nearly five years in medical school did not correlate with what was happening in the hospital. The white coat he wore as a future doctor created an insurmountable distance from the patients.
"This is not my mission," he thought, prompting him to take a break and start studying for a degree in social work. With a master's degree in public health and a PhD in social psychology, his work has had a direct impact on thousands of people through his roles as a teacher, consultant on health programs, and the director of an innovative initiative that is improving healthcare access in Córdoba province, central Argentina.
The counselling unit is an active listening space where a decision can be built together between the woman and the professional on what is best for her health.
From his time in medical school, David questioned the old concept of health defined merely as the absence of disease. Aligning with the World Health Organisation's views, he understood health as a state of physical, mental, and social well-being.
At the National University of Córdoba (UNC), where he had been a student, they recognised his perspective and invited him to join as a lecturer. There, he began shaping a new way of thinking about medicine, emphasising the need to communicate with others in health. These "others" are not necessarily patients.
Professionals may misdiagnose or misunderstand patients when they do not view them holistically, assuming that "something must have happened" rather than recognising that they have a need for which they sought answers.
David has a habit: he goes to health centre waiting rooms, sits, and listens. He also approaches people and talks to them about why they are there, what they expect, and what solution they received. He was often exasperated hearing an administrative staff member’s negative response to a patient who had organised her family and travelled three hours to be seen, only to arrive too late to get a number for service.
"And she felt guilty for not arriving earlier," he notes. These hours of listening were the seed for the creation of the Comprehensive Women's Counseling Units, which were established in 2022 after signing a scientific and academic cooperation agreement between Roche and UNC. Fifteen municipalities and unions in the province are involved.
The traditional counselling model, where the counsellor tells the woman how long she should breastfeed and how often she should get a cervical screening, is also obsolete because it becomes prescriptive. David adopted a maternal breastfeeding program model from the Pan American Health Organisation based on non-traditional communication models and decided to expand it to women's overall health.
The partnership with the university provided the academic framework for counsellor training. The budget allocated by ordinance in each municipality ensures continuity beyond changes in local leadership.
The difference lies in the very definition of counselling: patients feel part of a space "where no one prescribes anything to them, but it is an active listening space where a decision can be built together between the patient and the professional on what is best for her health."
Through the program, actively promoted by Roche Argentina's Health Policies team, 14 counselling units had been created by the end of 2023. They certified 58 counsellors, and 7,170 women used the service, consulting on a wide variety of health and well-being issues. A practical guide for implementing counselling units was also developed.
"Access to information supports women. When they go into consultation with the professionals, they are equipped with knowledge," he emphasises.
David believes inspiration is never individual. The counselling unit coordinates with other agencies and organisations to meet various needs (e.g., employment or recreation). He highlights the value of the community: using local resources allows them to create their own counselling units and generate multiplier projects, like the network formed by a group of counsellors producing regional products in one locality.
Collaboration, exchange, and rethinking an idea together when it doesn't work as expected are, for David, the way to lead change. And, fundamentally, it is crucial to work on educating new generations. His greatest pride, he admits, is the inclusion of counselling as part of the curriculum in the Faculty of Medical Sciences at UNC.
"If we don't change the education system, we will never open up this new way of providing healthcare," he stresses. His students' feedback inspires him. As one final-year medical student said to him: "I finally feel like I'm studying what I came to study, which was healthcare." David’s decision when he was also finishing his degree, he confirmed, was the right one.
The counselling unit is an active listening space where a decision can be built together between the woman and the professional on what is best for her health.