Episode #479 Care After Dark, With Jeff Hom, MD
On This Episode Of The Public Health Epidemiology Conversations (PHEC) Podcast
An internal medicine physician on rethinking access to addiction care
What happens when someone finally decides they're ready to ask for help, but it's 10 p.m. and the clinic closed hours ago? That question sits at the center of this conversation with Dr. Jeffrey Hom, an internal medicine physician and Medical Officer for Science and Policy in the Substance Use Services Section of the San Francisco Department of Public Health.
Dr. Hom's path into public health started at a soup kitchen, not a classroom. Years of volunteering at one of San Francisco's busiest soup kitchens before medical school showed him how closely health is tied to housing, food, and access. That experience shaped a career now focused on the overdose crisis, a topic he calls urgent, personal, and deeply preventable.
Building care around real barriers, not convenient hours
Dr. Hom walks Dr. Huntley through the low barrier buprenorphine treatment program his department launched, a telehealth line that connects people experiencing homelessness with a clinician between 8 p.m. and midnight. What started as a response to community feedback has grown into a brick and mortar drop-in clinic that has now supported more than 10,000 clinical encounters.
Fighting stigma with stories, not statistics
The conversation also digs into Living Proof, a media campaign featuring San Francisco residents in recovery who share their stories in their own words, several of whom became co-authors on the campaign's published evaluation. Dr. Hom and Dr. Huntley talk candidly about stigma, coalition building in a politically challenging moment, and why the smallest policy changes, the ones made inside a single clinic or department, often create the most immediate impact.
If you've ever wondered how policy actually gets made or unmade, and what it takes to keep showing up for communities when the political climate feels uncertain, this episode offers both honest reflection and real hope.
About Our Guest
Jeffrey Hom, MD
Dr. Jeffrey Hom is an internal medicine physician who currently serves as the Medical Officer for Science and Policy in the Substance Use Services Section of the San Francisco Department of Public Health. In this role, Dr. Hom focuses on the policy and evidence side of substance use work, including helping develop local legislation and informing how California regulates access to medications like methadone and buprenorphine used to treat opioid use disorder.
Dr. Hom's interest in public health developed through years of volunteering at the St. Anthony Foundation, one of San Francisco's busiest soup kitchens, before he attended medical school. That experience, combined with witnessing firsthand how social circumstances shape health outcomes, drew him toward public health alongside clinical practice. His grandmother's work at the UC Berkeley School of Public Health also gave him early exposure to the field. Earlier in his career, Dr. Hom worked in Philadelphia, where he helped advance policy efforts around pharmaceutical industry practices and access to care. Much of his career since has centered on the overdose crisis, work he describes as sitting at the intersection of medicine, public health, economics, law, media, and policy.
Listen To This Episode Of The Public Health Epidemiology Conversations (PHEC) Podcast
Conversation Highlights
Meet people where they are, and when they're ready.
Dr. Hom's low barrier buprenorphine program began after hearing directly from people experiencing homelessness that nighttime access to treatment was missing. Building care around that specific, real barrier turned into a program with more than 10,000 clinical encounters in its first two years.
A few nighttime hours can close a major gap in care.
The department's telehealth line, staffed between 8 p.m. and midnight, gives people a way to connect with a clinician and potentially start medication in the moment, rather than waiting until morning when the urgency or willingness may have passed.
Personal storytelling can shift public stigma.
The Living Proof media campaign features San Francisco residents in recovery sharing first-person testimonials. The campaign's evaluation data suggests it is genuinely changing minds and reducing social stigma around substance use.
Lived experience deserves more than a seat at the table, it deserves authorship.
Several Living Proof participants became co-authors on the campaign's published evaluation, giving people with lived experience a formal, ongoing way to hold the health department accountable and shape future programming.
Good evidence alone doesn't guarantee good policy.
Reflecting on past efforts that didn't succeed, including a failed policy in Philadelphia and unsuccessful attempts to open overdose prevention sites, Dr. Hom points out that policy change also requires the right coalition, the right timing, and real political will.
Coalitions can outlast the crisis that created them.
Dr. Hom sees a spillover effect where relationships built during one public health emergency, like COVID-19, continue to pay off when applied to entirely different challenges down the road.
You don't need a title to make policy change.
Dr. Hom distinguishes between "big P" policy, the legislation that makes headlines, and "little P" policy, the everyday rules set by a clinic, school, or company. He encourages listeners to look for the little P policy opportunities already within their reach.
"I think some of the most consequential work starts that way. You know, it's a small internal change that then grows." - Dr. Jeffrey Hom
Join The PHEC Podcast Community
The conversation doesn't have to end when the episode does.
If you're looking to connect with other public health professionals, epidemiologists, and change-makers who are passionate about improving health outcomes, we invite you to join our growing community.
Join the community today and continue the conversation with public health professionals who understand your work and share your commitment to making a difference.
Connect With Our Guest:
Resources Mentioned In This Episode:
Public Health Consulting
DrCHHuntley LLC is a public health consulting firm that specializes in epidemiology consulting, supporting large nonprofit organizations in South Carolina, North Carolina, Georgia, Mississippi, and Florida that serve Black, Indigenous, and People of Color (BIPOC). We also provide nationwide public health consulting and epidemiology consulting support to BIPOC organizations across the United States.
Comments