Zweihander said:
Hey all,
I'm doing some research and I was wondering if anyone could give me info or links to info regarding student-run free clinics.
Which medical schools have them?
How do they work?
Where are they based?
What's the history of their establishment?
etc. etc.
As much info and detail as I can get a hold of. I certainly don't want anyone to do my research for me, but if y'all could point me to sources and websites that have this information (or even contact info for people that might) that would be ever-so-fantastic.
Thanks a bunch!
cheers
LSU Shreveport has one called the Comprhensive Care Clinic (CCC or "Comp Care") which is ostensibly "Student Run." It is run like a family practice clinic with regular patients who we follow during third and fourth year. While we have some autonomy, we have to "check out" with preceptors (faculty) who review our treatment plans and sometimes (but not often) see the patient with us to verify some physical finding.
During third and fourth year we have Comp Care once a week for four hours. The one immutable law at LSU Shreveport is that you wil not miss Comp Care. If you are scrubbed in on a long surgery when your time rolls around you have to politely scrub out. Comp Care patients are not scheduled during regular LSU vacation periods, holidays, or during your elective or away rotation blocks but other then that, with the exception of being allowed two excused absences you do it every week.
I alluded that Comp Care is run like a family practice clinic but "like" is the key word. Most of our patients are the proverbial train wrecks and have thick, Gutenberg Bible sized charts which say optimistically on the front, "One of three." The problem with Comp Care is that the patients have so many complaints that it is difficult for an inexperienced student doctor to sort them all out. If your preceptor pimps you about the patient's past medical history and for some reason you don't have a handle on it, if you say, "Patient is a 46-year-old black woman with a history of Hypertension, Coronary Artery Disease, Diabetes, Asthma, Obstuctive Sleep Apnea, obesity, and Gout you'll probably be essentially correct.
At a normal family practice clinic most of the patients come in with just one complaint which you deal with, being mindful of course, of the patients other medical problems. In Comp Care it's hard to know where to begin. Sometimes it helps to say, "OK, of all your problems, what is bothering you the most today," and go from there. having patients with many problems does give you pretty good training in creating problem lists and treatment plans, not to mention good experience in writing concise, goal-directed consults.
Another problem with Comp Care is that they kind of throw you in without any real training. On the second day of third year there I was with my white coat and Stethescope listening to somebody pour forth their medical history. I kind of felt like a fraud. I think it would be better to take all of the hours of comp care and use them for a family practice rotation where we could initially get a little more direct supervision from residents. I know we're supposed to be go-getters and self-directed learners but there are some things that are learned more efficiently if they are taught by an expert.
Now that I am almost done with third year (two more weeks!) I have gotten the hang of Comp Care and I am starting to actually make a difference with the patients. When you first start you are just a conduit for the recommendations of the preceptors who carefully spell everything out for you. Now I usually have a plan which I present and sometimes the preceptors accept my plan without comment. (You will rarely be praised in medical school but having a resident or attending sign off, without comment, on something you do is better then being complimented by all the silver-tounged flatterers in christendom.)
Another problem with Comp Care and how it differs from a real family practice clinic is that the patients are chronically late. Either that or they do not show up for their appointments without the courtesy of calling to cancel. It's true. We don't value anything if it's free. Consequently you can spend a good deal of time in Comp Care just sitting around. This is fine. I am a devout slacker when it is appropriate but this is not an efficient use of our time. Invariably, your 8:00AM and 8:45AM patients will walk in an two hours late and crowd all of your work from 10 to 12, 8 to 10 being spent twiddling the thumbs.
