Student run clinics

Discussion in 'Medical Students - MD' started by Dark Sandbars, May 19, 2002.

  1. Dark Sandbars

    Dark Sandbars Member

    Joined:
    Dec 27, 2001
    Messages:
    47
    Likes Received:
    0
    I'm hoping some people on this forum can address some of the challenges and pitfalls of starting up a student run clinic.

    1) Just what exactly should the clinic do? Provide basic walk-in services? Is there a template that shows exactly what services should be rendered?
    2) What exactly would the students do? How many physicians would need to be recruited for the project? What staffing levels do we need? (Students? Physicians?)
    3) Is liability insurance a major issue?
     
  2. Thread continues after this sponsor message. SDN Members do not see this ad.

  3. conrad

    conrad Member

    Joined:
    Nov 22, 2001
    Messages:
    34
    Likes Received:
    0
    I spent a lot of time last year working with joint group of faculty and students from both University of Maryland and Johns Hopkins in Baltimore trying to set up a student-run clinic, and eventually we settled for a smaller-scale health education program that reached out to the potential patients.

    First of all, setting up a student-run clinic is hard, particularly so if there is no gung-ho faculty member willing to help significantly. In our case, we had tacit acceptance by both schools of medicine in Baltimore but there was no central physician figure who could pull enough strings to get equipment and space donated, because no one had the time (or the inclination) to sponsor such a project. And on further research of the available clinics and services in the city, we realized that the main bottleneck was not so much a lack of availability of free or sliding-scale clinics, but a lack of understanding of HOW to get the benefits (eg., Medicare/Medicaid/CHIP assistance) and actually getting out to the doctor. Additionally we had some trouble scheduling around the varying schedules of students from both schools, and had difficulty finding enough people willing to make a significant commitment to make it work.

    On the other hand, other schools HAVE set up student-run clinics with some success, and some have their information available online, like the Philly clinic at Jefferson, at Wash. U., and some of the UC schools, to name a few. So it's not impossible, but we just ran into some roadblocks and found in our research that health education was more necessary (though less glamorous) than free clinical care.

    To address some of your specific questions:

    1. What the clinic should do depends on what things you can get donated, and whether you'll be able to find physician supervision to do so. It is generally considered unethical to screen patients for things like hypertension or diabetes without having a place to refer them to for long-term care, so if you are going to do screening, you should be prepared to send them to a real clinic, or do the long-term care in-house. If you are doing the latter, there are a lot of issues to consider, like finding a place, getting the equipment, finding proper supervision from physicians, organizing the paperwork, getting meds, etc. The list goes on and on. :) But all of these things can be made a lot easier if you have a strong supporting faculty willing to sacrifice time and money to help set it up. So the services that you can offer really depend mostly on how much 'stuff' you can get, and how many doctors you can find to actually 'do' the care (because as students we of course cannot take full responsibility for the care of a patient).

    2. What would the students do? Students would probably have to do lots of the paperwork, the legwork in getting the 'stuff', and continue to do this the entire time the clinic is open. If you can imagine the various aspects of a medical practice, you start to realize the scope of what a full-scale clinic will involve, because running the clinic will take a large, coordinated, and dedicated group of student volunteers (who, by the way, are ALSO med students...). So I'd say probably 60-80% of the work would be non-clinical -- administrative, lobbying, etc. Then a few people might be able to see patients clinically (who would then be seen by the physician on duty) and learn some medicine too. But you have to also remember that too many medical students seeing patients gets unwieldy, and some attendings may only want to take a few students at a time. I've been working at a community clinic run by one of the Baltimore hospital systems (so not student-run), and there, the student clinic is open on Saturdays; the patients are from the clinic's established patient base, and the support staff of one nurse assistant/secretary is supplied by the clinic. One doctor usually works with two or three medical students to see patients, and we get through a max of about 20 people per Saturday (clinic open 9am-12pm). So the care comes slower to the patients but we do learn clinical stuff, but all the equipment and staff comes from what already is provided by the hospital system. Based on those numbers, then, if a student-run clinic were open once a week, having eight attendings volunteering once every other month would allow 2-3 students to see about 20 patients each Saturday.

    3. Liability is potentially a huge issue, especially for first and second year students who have very little or no liability insurance. This was something we never ended up figuring out (and didn't need to since we went the health education route).

    So those are the basics, and there are more nuances that are important, like developing a relationship with a community, ensuring the quality of care for the patients, and finding medical students willing to give up some precious studying time to devote to this project, all of which affect the eventual success and longevity of the clinic...
     
  4. nmehta

    nmehta Senior Member

    Joined:
    Mar 14, 2000
    Messages:
    151
    Likes Received:
    0
    I attend Tufts medical school and we have a fully student run clinic known as Sharewood. I currently serve on the executive board. Rather than my typing responses to all your questions, i think you would benefit from the information on our website.

    <a href="http://www.tufts.edu/med/stu-org/Sharewood/" target="_blank">http://www.tufts.edu/med/stu-org/Sharewood/</a>

    Let me know if you have any questions. We just celebrated five successful years! Drop me an email at [email protected]

    Neel
    TUSM M'05
     
  5. Cdc28p

    Cdc28p Senior Member

    Joined:
    Mar 13, 2002
    Messages:
    325
    Likes Received:
    0
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by nmehta:
    <strong>I attend Tufts medical school and we have a fully student run clinic known as Sharewood. I currently serve on the executive board. Rather than my typing responses to all your questions, i think you would benefit from the information on our website.

    <a href="http://www.tufts.edu/med/stu-org/Sharewood/" target="_blank">http://www.tufts.edu/med/stu-org/Sharewood/</a>

    Let me know if you have any questions. We just celebrated five successful years! Drop me an email at [email protected]

    Neel
    TUSM M'05</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Sharewood is an awesome clinic! Check it out!
     
  6. rajneel1

    rajneel1 Senior Member

    Joined:
    Oct 29, 2001
    Messages:
    376
    Likes Received:
    1
    stanford has arbor clinic and UCD has a bunch: imani, paul hom, tepati, and another new clinics.
     

Share This Page