Community clinic celebrates first
year of service to underserved
by
Heather WoolwinePublic Relations
In August the CARES (Community Aid, Relief, Education and Support) Clinic celebrated its first anniversary and a full year of service to underserved and disadvantaged patients who need primary health care.
The student-run free clinic, initiated by first- and second-year MUSC medical students, and Wanda Gonsalves, M.D., Family Medicine, provides preventive and episodic primary care to uninsured patients regardless of race, ethnicity, religion, immigration or socioeconomic status. Students are responsible for the overall management of the clinic and daily operations, and it is funded primarily by a $10,000 donation from the Medical Society of South Carolina. This donation helps with monthly costs associated with the lab, pharmacy and supplies. Others also have stepped forward to help with product and service donations, including the Christ Our King Catholic Church, the MUSC YES Campaign, the MUSC Charity Ball, MUSC Family Medicine, and small donations from community members.
The CARES Clinic sees patients 6:30-9 p.m., Tuesdays and Thursdays. The program always is looking for more student and physician volunteers. The patient appointment hotline is 876-7097 and additional information can be found at http://www.thecaresclinic.org.
Dr. Brian Davis,
internal medicine resident, and a medical student, examine a patient's
eyes for signs of infection.Not only have numerous patients received health care services that they may not have received otherwise, but the opportunity for students to interact with patients and each other early in their education has proven priceless.
“Medical school is often so busy and stressful that we sometimes lose sight of why we came here,” said Amanda Jackson, medical student and a CARES Clinic founder. “The CARES Clinic helps to bring the picture back into focus. It’s an opportunity to directly help those in need and for us to share the valuable skills we are learning.
“Every time I go out to the CARES Clinic, I am just amazed that in one spot you can have access to so much: evaluation by a physician; lab services; prescription medications; physical therapy; psychiatry services; and mammograms. With the CARES Clinic being at ECCO (East Cooper Community Outreach), we can offer even more,” Jackson said. “We can refer patients to the free dental clinic, to the eye clinic, to MediAssist for help with prescription medications and enrollment in Medicaid and Disability, to the food bank, to the clothing bank, and to free diabetes classes. It’s really convenient for those in need.”
Physical therapy
students Robin Ferguson, Jim Butcher and Kristin Timm tape a patient's
shoulder to relieve pressure and ready him for therapy. The CARES Clinic operates within the East Cooper University Family Medicine space at ECCO when that office closes for the day. This gives students an opportunity to see patients, who cannot afford health insurance, in a real setting that mimics what they will see in private practice.
Most of the student volunteers learn of the clinic via a family medicine service-learning elective called “Caring for the Community” that asks them to volunteer in the clinic five nights a semester, with three clinical evenings and two administrative evenings. In the classroom, students discuss the vast array of health care needs for a diverse population of people with few resources, often evoking creative and critical thinking skills beneficial to budding health care professionals.
And it’s not just future physicians learning at the clinic. Physical therapy students, physician assistant students, and soon students from the College of Nursing will become involved with caring for this particular patient population. In addition, psychiatry residents offer help for patients with mental health issues, and pharmacy students recently began attending the clinic. The Alliance for Hispanic Health will offer interpreter services in the near future for Spanish-speaking patients.
“We’d really like to see more pharmacy students and faculty involved in the clinic. ... I believe students could learn a lot from their presence. Nursing students will hopefully play a role in the clinic by providing patient education. We’ve mostly focused on providing patient care, but next we’d like to determine what other needs the patients have that we might fulfill. We need to start to focus on those needs, and work as a team of health care providers in meeting those needs,” Gonsalves said.
For physical therapy students in particular, helping with the clinic offers a chance to practice clinical reasoning skills and to refine examination and treatment abilities. For most physical therapy students, there is no substitute for placing a healing hand on a real patient to fine tune their methods. “One of the great things about it is that we are fitting our knowledge and skills into a treatment plan that is adapted specifically for each patient, treating the patient as a whole and not only their main complaint, as well as teaching them about prevention,” said Ben Thomas, physical therapy student. “We commend and thank all who gave this past year, both those who fund the clinic and those who serve there, and we encourage you to keep this gift of experience and service to further the community.”
Physical therapy student Robin Ferguson agreed, “It is a wonderful opportunity to serve. It is a wonderful opportunity to learn. There are few chances in our educational career to do both at the same time,” she said.
Bill Hueston, M.D., Family Medicine chairman, said the clinic is valuable to students because it illuminates all those things about patient practice that they stay up late to read in textbooks. A big promoter of community outreach at all educational and professional levels, Hueston said the feedback he received in the last year was positive. “Several students have told me that they have learned as much or more at the CARES Clinic than in their formal courses at MUSC,” he said. “Not only do they learn about the nuts and bolts of medicine, but they also learn about people and some of the struggles that the less fortunate face. This will make them more compassionate and understanding physicians in the future.”
Indeed, with the cost of health care soaring and the number of uninsured patients rising, tomorrow’s clinicians and health care professionals must have a wide understanding of what their patients are up against in terms of access to quality health care. Not to mention the need to understand how to successfully break down barriers to provide care to those who need it most and who are least likely to get it.
“There are 45 million Americans without insurance, so places like our free clinic offer just a little help. So first and foremost, I believe we are helping the community,” Gonsalves said. “As faculty, we are called upon to be role models for our students. We’re showing the importance of giving back to the community. The clinic also develops skills our learners need in the early preclinical years. And, we are introducing them to working in multidisciplinary team models, which we will all be doing more of in the future. Lastly, learning how a clinic/physician practice works early on is invaluable, since this is something that students don’t get until in residency or out in practice.”
Hueston further explained the service to the community that the student-run clinic provides each week. “Without this clinic, many of these individuals would not receive any care for problems like diabetes or hypertension. ... They most likely would end up in hospital emergency rooms after a stroke, heart attack, or other devastating complication of their chronic illness. So not only is the CARES Clinic effective at helping these people with their current medical problems, but I see it as an investment in the future health and well-being of the people it serves.”
To continue providing for the future of under-served populations, the student and faculty volunteers who organize the clinic understand that more volunteers must be recruited and donations must continue, in addition to the funding provided by the Medical Society. Students collectively expressed their desire to hold the clinic more evenings during the week, to offer an interpreter service, and to offer more treatments and services currently not on the list. Students want physicians, physical therapists and other clinicians throughout the Lowcountry to volunteer services, and see the clinic as an opportunity for anyone with the medical know-how to support the mission of MUSC students to care for the disadvantaged. Without much-needed volunteers and donations, the clinic can not function.
“We need dedicated students who continue to be passionate about what they’re doing. We need organizations and personal donors of their time and money to help us achieve our goal of providing care to the uninsured in the area, and we need faculty who will continue to donate their time to make this successful,” Gonsalves said. “Getting other primary care faculty such as Internal Medicine and Med-Peds, as well as folks in the community, would help.”
Friday, Oct. 20, 2006
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