The PACE approach has allowed Rachel Broudy to reconcile her activist history and her work as a physician.
When my partner, Alex, was diagnosed with dementia in the summer of 2019, an Amherst friend gave me a simple piece of advice: “Call Rachel.” Although we’d known each other casually at Amherst, we hadn’t spoken in years. Still, I called Rachel. And for the next two and a half years, Rachel Broudy ’90, M.D., offered kindness, compassion and perspective, giving me both concrete advice (“Call this geriatrician!”) and insight into the system in which I was floundering. In Alex’s final months, she helped me focus on what mattered most.
At Amherst, Broudy was a women’s and gender studies (WAGS) major and an activist. Her path to medicine was not straightforward. She spent her 20s exploring—activism, nonprofit work, graduate school—trying to figure out how to “change the world,” she says. The realization that her strength lay in caretaking led her, at age 30, to medical school at Case Western Reserve University in Cleveland, which welcomes nontraditional students. While she still wasn’t sure she’d made the right decision, “the thought of not knowing what I was going to do with my life was worse than being in medical school,” she says now.
When she returned to Boston to do her internship at Brigham and Women’s Hospital, something unexpected happened. Through a chance offer of some part-time hours at the Cambridge Health Alliance (CHA), she was introduced to the PACE model of health care. PACE stands for “Program of All-Inclusive Care for the Elderly,” in which teams of medical professionals, social workers and aides join together to provide services for elders with complex medical needs, with the aim of keeping them at home as long as possible.
Broudy remembers walking into the day center and seeing a room full of people—Haitian, Irish, Latina—“sitting at these tables, talking, playing games, loud, totally raucous.” Within a week, despite the elevator only working half the time, she felt like she was home. As she describes it, “there was an entire team around the table. The social worker was there. The aides were there. When I sat down with families, it wasn’t like I only had 15 minutes. It felt like it was on a human scale. It felt like I wasn’t doing it alone.”
Broudy with a fellow staffer at Pioneer Valley Hospice & Palliative Care.
PACE allowed Broudy to reconcile her activist history and her work as a physician—to treat people in the way that she felt would help them the most, even if it wasn’t what she’d learned in medical school textbooks. In fact, she had long believed “that medicine has a pomposity about itself, or an arrogance about what truth is. And from the get-go, I knew that wasn’t true. That’s what we learned in WAGS, right? Question the patriarchy!” PACE enabled her “to integrate people’s lives with medical care in a way that made sense—not what the guidelines said was the best care, but what worked best for people.”
Broudy eventually became medical director of the CHA PACE program. She left when her daughter Pia was born in 2010, and then, a few years later, itching to return to the Valley, she became the founding medical director of Mercy LIFE, the first PACE program in Western Massachusetts. She held that role until 2018, when several mergers left Mercy LIFE owned by a Michigan-based health care company.
She now balances two positions, as medical director of Pioneer Valley Hospice & Palliative Care in Greenfield, Mass., and as a lead faculty member in the elder care program at Ariadne Labs, a joint center for health systems innovation in Boston. She is also on the board of LifePath, an elder services agency in Greenfield, which recently opened a new community engagement center. Funded by a grant from the state, the center provides training, support and respite for caregivers, along with a day program for the elderly and people with disabilities.
Broudy hopes it will serve as a new model of care for both clients and caregivers—one with belonging and inclusion at the heart of it. When people walk in, she hopes they feel like she did when she first discovered PACE: that this is a place that can help them on a human scale, and that they are not alone.
Photographs by Jessica Scranton