How to help out ?

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Spectre of Ockham

Spectre of Ockham

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So I recently got a few quality tools for my personal bag :
pulsoximeter , contactless thermometer , a very good BP cuff and I plan on getting a mobile ECG , glucotest & more.

I already have a my ye old Littman and various stashed meds in moderate supply. I want to go out and help those in need with my tools.
I've been volunteering in a Level 1 Trauma center ER for three years now and I've been shadowing docs in internal med & general surgery (31 hour shift FTW) for another year so I got a good deal of experience.

Things is except going into rural backwater places and offering a simple screening there I don't have a lot of ideas . Should I ask local church leaders that might have some programs ?

Obviously I won't be practicing medicine or pretend to do that , a simple physical screening and some basic test is all I can do besides offering some over the counter pills , anything that is beyond my reach I'll recommend to a GP or ER , heck I'll recommend they see their family doctor anyway just to cover my ass. I thought about nursing homes and orphanages but those tend to have medical staff on hand already.

I'd love to hear your opinions and ideas on this matter.

EDIT : My area is not law suit friendly this stuff would be thrown out and the lawyer disbarred, also poor people that barely have money to eat don't sue.
 
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If you're in medical school, join AMA, AMSA, SNMA, etc... and have them set up weekly/bi-weekly health screening events. At any decent-sized school at least one of those clubs will be established enough to have a list of health fairs, churches, ethnic holidays that would love to have med students there doing health screenings.
 
SunsFun said:
If you're in medical school, join AMA, AMSA, SNMA, etc... and have them set up weekly/bi-weekly health screening events. At any decent-sized school at least one of those clubs will be established enough to have a list of health fairs, churches, ethnic holidays that would love to have med students there doing health screenings.
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Already doing that but it's more like once a year event and the clubs are more politics and petty squabbles over some 100$ grant than actual work but you actually give me an idea. I'm acquainted with the mayor and friends with some city councilors I could put together a few people and maybe get some approval from the local Red Cross . I already have a stack of accreditation from them so why not put them to use. This way I can maybe take 2-3 more students with me and have a small nimble team capable of opening bigger doors.

Thanks.

More ideas and opinions are always welcomed.
 
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Spectre of Ockham said:
Already doing that but it's more like once a year event and the clubs are more politics and petty squabbles over some 100$ grant than actual work but you actually give me an idea. I'm antiquated with the mayor and friends with some city councilors I could put together a few people and maybe get some approval from the local Red Cross . I already have a stack of accreditation from them so why not put them to use. This way I can maybe take 2-3 more students with me and have a small nimble team capable of opening bigger doors.

Thanks.

More ideas and opinions are always welcomed.
Click to expand...
I see. I think its a good idea to reach out to as many people as possible.

Also, talk to the interested classmates and see if you guys can start a local chapter of any of the numerous national med school organizations that doesn't yet have one at your school. You may need to be pretty assertive to get things moving, but if you're motivated enough - it can be done. Good luck!
 
Spectre of Ockham said:
So I recently got a few quality tools for my personal bag :
pulsoximeter , contactless thermometer , a very good BP cuff and I plan on getting a mobile ECG , glucotest & more.

I already have a my ye old Littman and various stashed meds in moderate supply. I want to go out and help those in need with my tools.
I've been volunteering in a Level 1 Trauma center ER for three years now and I've been shadowing docs in internal med & general surgery (31 hour shift FTW) for another year so I got a good deal of experience.

Things is except going into rural backwater places and offering a simple screening there I don't have a lot of ideas . Should I ask local church leaders that might have some programs ?

Obviously I won't be practicing medicine or pretend to do that , a simple physical screening and some basic test is all I can do besides offering some over the counter pills , anything that is beyond my reach I'll recommend to a GP or ER , heck I'll recommend they see their family doctor anyway just to cover my ass. I thought about nursing homes and orphanages but those tend to have medical staff on hand already.

I'd love to hear your opinions and ideas on this matter.

EDIT : My area is not law suit friendly this stuff would be thrown out and the lawyer disbarred, also poor people that barely have money to eat don't sue.
Click to expand...

lol you're crazy
 
Spectre of Ockham said:
So I recently got a few quality tools for my personal bag :
pulsoximeter , contactless thermometer , a very good BP cuff and I plan on getting a mobile ECG , glucotest & more.

I already have a my ye old Littman and various stashed meds in moderate supply. I want to go out and help those in need with my tools.
I've been volunteering in a Level 1 Trauma center ER for three years now and I've been shadowing docs in internal med & general surgery (31 hour shift FTW) for another year so I got a good deal of experience.

Things is except going into rural backwater places and offering a simple screening there I don't have a lot of ideas . Should I ask local church leaders that might have some programs ?

Obviously I won't be practicing medicine or pretend to do that , a simple physical screening and some basic test is all I can do besides offering some over the counter pills , anything that is beyond my reach I'll recommend to a GP or ER , heck I'll recommend they see their family doctor anyway just to cover my ass. I thought about nursing homes and orphanages but those tend to have medical staff on hand already.

I'd love to hear your opinions and ideas on this matter.

EDIT : My area is not law suit friendly this stuff would be thrown out and the lawyer disbarred, also poor people that barely have money to eat don't sue.
Click to expand...

The fact that you think simply standing around in a "Level 1 Trauma center ER" and shadowing doctors gives you "a good deal of experience" shows how out of touch with reality you are.

Also, offering "screening" exams (during which I'm sure you're going to wear your little white coat) with an ECG, glucometer, etc sure seems like pretending to practice medicine to me. Even if no one brings a civil suit against you, acting in a way that would lead members of the lay public to think they were seeing a physician would certainly get the attention of the DA and local medical licensing board.

Chill out and try not to be such a weirdo.
 
Hmm something's not right. No US medical student in any part of the country would be this stupid.
 
For sure a pre-med. what medical student lists "shadowing" as something that allows them to see patients?
 
AnatomyGrey12 said:
For sure a pre-med. what medical student lists "shadowing" as something that allows them to see patients?
Click to expand...
To be fair, med students do shadow in preclinical years but usually in smaller/more competitive specialties. But I agree with the you that between the laundry list of shadowing and ED volunteering and the excitement about the new toys aka medical equipment (most of which will never be really used) OP does sound very much like a pre-med who got accepted to medical school this cycle and is itching to play doctor. Oh, and "a good deal of experience" my *ss.

OP, your stated desire to help the needy would be admirable if it didn't sound like your primary motivation is to play doctor. If you're really interested in helping people while in medical school, you'll find plenty of ways that don't necessitate carrying a stethoscope (by the way, do you even know how to use it?) - as was mentioned above, start by checking out organizations that already exist at your school and/or nationally. But please don't try to delineate boundaries of your ignorance at the expense of people in great need.

My school actually has a program where students do free hypertension, diabetes etc screenings in the community several times a year. An important part of the program is that at least one licensed physician is present at each screening to review abnormal results, answer questions, counsel patients.
As someone interested in psychiatry, I started thinking of adding a depression screening to the existing screening program for common chronic conditions. A depression screening, what could be easier? It's just SIGECAPS and no equipment is necessary whatsoever. However, issues arise when you think of people who screen positive for depression - what to do with them next? For people with frank suicidal ideation the answer is fairly simple - get them to an ED ASAP. However, what about the milder depression cases? The point of screening is early intervention, and is there really a point in screening if no intervention is available? (Eg. if it's hard or near impossible for people from lower SES to get reasonable mental health care - and obviously we won't be providing it as medical students.) So I pretty much abandoned the idea.
So even regardless all the other considerations, before embarking on a screening program think what you're going to do with people who screen positive. Is there anything you can offer to them?
 
Spectre of Ockham said:
Obviously I won't be practicing medicine or pretend to do that , a simple physical screening and some basic test is all I can do besides offering some over the counter pills , anything that is beyond my reach I'll recommend to a GP or ER , heck I'll recommend they see their family doctor anyway just to cover my ass. I thought about nursing homes and orphanages but those tend to have medical staff on hand already.
Click to expand...

If you want to do medical volunteering do it through an established charity or other organization. You don't have a medical license, there is no reason for you to be giving medical advice or screening with no supervision.


also poor people that barely have money to eat don't sue.
Click to expand...
lol
 
Amygdarya said:
To be fair, med students do shadow in preclinical years but usually in smaller/more competitive specialties.
Click to expand...

Oh definitely, just the way it was used as an example of "a good deal of experience" was something I've never seen a medical student do.

And OP, poor people most definitely sue.... all of the time actually.
 
Sounds hypo manic. I'm sure your novice skill at reading ekgs and trusty pulse ox will save a ton of lives out there. Thanks so much for the d*MN multivitamin.
 
Why don't you build a DIY portable x-ray machine too? You can go around doing full body scans for the needy.
 
A lot of medical schools have a student run free clinics that meet weekly or biweekly for those in need of non-emergent health care in the local area. Patients typically do not have insurance and hence why they come to us. But ALL patients are seen by an accredited physician.

My advice, if you are really passionate about helping out those in need, try talking to a few doctors in the area who are also passionate about this and attempt to start a free clinic. Or join and help in an existing clinic in the area. But for gods sake do not offer free screenings without any oversight.
 
SouthernSurgeon said:
2. Any health screening event needs to have the resources in place to act upon abnormal findings. Like you just randomly found that someone has a fib with your ECG, or diabetes with your glucometer...but now they have no access to care or no insurance? All you've done now is put them into a state of distress about their newly diagnosed medical condition but nothing to do to actually help them.
Click to expand...
And you've given them a pre-existing condition. This won't affect their insurability today, but it may significantly negatively affect their ability to get medical insurance starting tomorrow.
 
giphy.gif
 
OK let's get a few things in order :

#1 I'm not in the US but in the EU , different laws , everyone has insurance.

#2 By shadowing I mean actually doing the physical in the ER ,then the attending that has 8 cases per hour thrown at him comes for a minute I present him the case , he charts and gives out the prescription or admits the patient. Again different laws and let's be honest you don't need to be fellow do diagnose the 100th bronchitis or UTI that you've seen that month.

#3 I and a few fellow students already organized screening events at rural churches. The only papers we had were our certifications from the Red Cross that we knew BLS , ALS , APSS & such. Not all people have the knowledge or the tools to check themselves regularly , chronic patients included.

#4 I've been a volunteer paramedic for 1 year, then I moved on to the critical case sector at the ER of a Level 1 Trauma Center as working on the ambulance was too easy case wise. Now I don't know how your ER is structured but this particular room of the ER is reserved for things like polytraumatized patients , strokes , myocardial infarctions , pulmonary embolisms , suicide attempts overdoses and so on. The work I've been doing there was basically one of an RN taking vitals , placing lines , administering treatment , placing Foleys and so on. Short of intubating a patient and administering thrombolytic therapy I've done all that could be done. If I wanted to "play doctor" I could just show up at the beginning of the shift and go for it - we've been chronically understaffed for years.

#5 By stashed meds I mean a large amount of over the counter various medication and a few boxes of broad-spectrums.

So getting back to this the kind of people I have in mind are the poorest of the poor. Not exactly homeless but we're talking about the type of people that can barely afford the bus ticket and who can almost never afford to purchase their prescription. It's cold outside and cases of long neglected patients show up in droves at the ER with conditions that could have been easily prevented or managed. A fair amount of chronic patients also neglect their conditions until they are two steps from the grave . Guess who needs a 10 day hospital stay then ? BTW this group of population is also very poorly educated or afflicted by mental issues - you can't really do a lot for them beyond a history , a physicals , some free vitamins / NSAIDS / broad-spectrums and recommending that they go to a GP or ER but IMHO it's better then letting them wait until the ambulance brigs them in shock with a GSC of 5 and sats in the 80s.

A free clinic would be a good idea but I don't have the budget for it nor the time to commit . The only things I have is my equipment and I can also muster a few colleagues that have similar experience and maybe some resources.
 
Amygdarya said:
As someone interested in psychiatry, I started thinking of adding a depression screening to the existing screening program for common chronic conditions. A depression screening, what could be easier?
Click to expand...

Ignoring some of the nastier parts of the post you do have a very good idea. I'm not qualified to do mental screening since psychiatry is last year in our curriculum but I will try to bring along someone that does have the necessary skills and by that I mean either a RN that works in a psychiatric hospital or maybe just maybe a resident. 1st year residents over here only work limited shifts so I might manage to convince someone. If a test is positive we can refer them to a the local mental health clinic - assuming they will actually go.
 
Spectre of Ockham said:
Ignoring some of the nastier parts of the post you do have a very good idea. I'm not qualified to do mental screening since psychiatry is last year in our curriculum but I will try to bring along someone that does have the necessary skills and by that I mean either a RN that works in a psychiatric hospital or maybe just maybe a resident. 1st year residents over here only work limited shifts so I might manage to convince someone. If a test is positive we can refer them to a the local mental health clinic - assuming they will actually go.
Click to expand...
My apologies for the nastiness of my previous post. I'm just sick and tired of people wanting to play doctor for all the wrong reasons. Now that you explained your background and current situation, your original question makes more sense.

As stated above, my main concern with screening programs is the follow up of positive findings. In other words, assuming your findings are correct*, what do you have to offer to people with newly found condition? If you can refer people to readily available local resources, great. I would even try contacting those organizations to see if they'd be interested in participating/contributing to your screening program - unless other screening programs are already available in the area.

* - you should have a clinician - ideally a physician - at all of the screenings to make sure correct techniques are used, to review results and to counsel patients as necessary.
 
#4 I've been a volunteer paramedic for 1 year, then I moved on to the critical case sector at the ER of a Level 1 Trauma Center as working on the ambulance was too easy case wise. Now I don't know how your ER is structured but this particular room of the ER is reserved for things like polytraumatized patients , strokes , myocardial infarctions , pulmonary embolisms , suicide attempts overdoses and so on. The work I've been doing there was basically one of an RN taking vitals , placing lines , administering treatment , placing Foleys and so on. Short of intubating a patient and administering thrombolytic therapy I've done all that could be done. If I wanted to "play doctor" I could just show up at the beginning of the shift and go for it - we've been chronically understaffed for years.

A free clinic would be a good idea but I don't have the budget for it nor the time to commit . The only things I have is my equipment and I can also muster a few colleagues that have similar experience and maybe some resources.[/QUOTE]


Troll level 7/10...

Ff you were a "volunteer paramedic" you would be intubating patients. If you were good at your job, you would be getting paid-being a paramedic requires an extensive amount of initial and continual training. The only thing I can identify as being a paramedic is your level of arrogance that you can "play doctor"... For the sake of the community you "serve" I hope this is a troll.
 
wxman393 said:
I'm still confused about the "broad spectrum" comment. OP, are you just randomly handing out meds without an Rx? Maybe things are different in the EU


Sent from my iPhone using SDN mobile
Click to expand...
I don't know which country OP comes from but you can get many meds including all kinds of antibiotics without prescription in many countries outside of the US.
 
medic0114 said:
Ff you were a "volunteer paramedic" you would be intubating patients.
Click to expand...

First of all just because you can doesn't mean you will. Intubating over here is done only by ER doctors , some ambulances have doctors and only those rigs get sent to cases that might require intubation , the rest of the rigs don't even have a kit. Also in the ER when intubation is required it's done in seconds by the medic that's closest to the laryngoscope , no one sits around and waits for you to run to the kit and intubate , I'm a student no matter the training if other doctors are available I won't be allowed to intubate simply due to the fact that I might screw it up and waste precious seconds , heck somethings attending shove residents aside if they judge the case too difficult to handle. The only way I'd be intubating would be during a mass casualty event.

wxman393 said:
Have you thought of volunteering for a medical mission trip?
Click to expand...

Volunteering no , but I'll now think about that , plenty of torn up areas in need of help. In fact if I can get some extra cash I might be able to organize one to back water villages.

wxman393 said:
I'm still confused about the "broad spectrum" comment. OP, are you just randomly handing out meds without an Rx? Maybe things are different in the EU
Click to expand...
The rule is you need a script to buy or sell but there is no law against giving to others , just to be clear I'm talking about macrolids and amoxiciline+clavulanic acid nothing fancy like vanco + various over the counter meds & multi-vitamins . What I can give would be basically a few water drops to fire , my hope is that it would buy these folks time to go to a GP and not end up in the ER. I'd obviously supervise the first dose and hang around to make sure they don't develop a severe reaction.
 
Spectre of Ockham said:
OK let's get a few things in order :

#1 I'm not in the US but in the EU , different laws , everyone has insurance.

#2 By shadowing I mean actually doing the physical in the ER ,then the attending that has 8 cases per hour thrown at him comes for a minute I present him the case , he charts and gives out the prescription or admits the patient. Again different laws and let's be honest you don't need to be fellow do diagnose the 100th bronchitis or UTI that you've seen that month.

#3 I and a few fellow students already organized screening events at rural churches. The only papers we had were our certifications from the Red Cross that we knew BLS , ALS , APSS & such. Not all people have the knowledge or the tools to check themselves regularly , chronic patients included.

#4 I've been a volunteer paramedic for 1 year, then I moved on to the critical case sector at the ER of a Level 1 Trauma Center as working on the ambulance was too easy case wise. Now I don't know how your ER is structured but this particular room of the ER is reserved for things like polytraumatized patients , strokes , myocardial infarctions , pulmonary embolisms , suicide attempts overdoses and so on. The work I've been doing there was basically one of an RN taking vitals , placing lines , administering treatment , placing Foleys and so on. Short of intubating a patient and administering thrombolytic therapy I've done all that could be done. If I wanted to "play doctor" I could just show up at the beginning of the shift and go for it - we've been chronically understaffed for years.

#5 By stashed meds I mean a large amount of over the counter various medication and a few boxes of broad-spectrums.

So getting back to this the kind of people I have in mind are the poorest of the poor. Not exactly homeless but we're talking about the type of people that can barely afford the bus ticket and who can almost never afford to purchase their prescription. It's cold outside and cases of long neglected patients show up in droves at the ER with conditions that could have been easily prevented or managed. A fair amount of chronic patients also neglect their conditions until they are two steps from the grave . Guess who needs a 10 day hospital stay then ? BTW this group of population is also very poorly educated or afflicted by mental issues - you can't really do a lot for them beyond a history , a physicals , some free vitamins / NSAIDS / broad-spectrums and recommending that they go to a GP or ER but IMHO it's better then letting them wait until the ambulance brigs them in shock with a GSC of 5 and sats in the 80s.

A free clinic would be a good idea but I don't have the budget for it nor the time to commit . The only things I have is my equipment and I can also muster a few colleagues that have similar experience and maybe some resources.
Click to expand...

dude you've probably killed so many people by now.
 
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