Students gain skills & understanding while serving uninsured patients under supervision of faculty doctors

Newswise — ANN ARBOR, Mich. — Uninsured residents of rural Livingston County, Mich. and surrounding areas who need health care have a new option to turn to every Saturday afternoon: a free medical clinic run entirely by University of Michigan Medical School students.

The students, and U-M faculty physicians, volunteer their time to provide free primary care each week at a storefront clinic in Pinckney.

The U-M Student Run Free Clinic, as it is called, uses the same location as the Faith Medical Clinic, a free-care site for patients without insurance that offers appointments on Thursday evenings and Saturday mornings. On the afternoon of Oct. 6, the team will hold an Open House to welcome the community.

For the U-M students, the free clinic is not just a chance to give back to the community – it’s also a chance to get to learn more about opportunities to care for the uninsured and to know the administrative and business side of medicine.

Students plan for and handle all the details and challenges of running the clinic, and deal with everything from appointment scheduling and interviewing new arrivals, to entering information into a computerized medical record system. The U-M Medical School Dean’s office is providing funding, as is Michigan Central Student Government.

Already in the clinic’s pilot period, the students and their faculty supervisors have seen patients with everything from simple ailments to chronic conditions such as hypertension, diabetes and shoulder joint issues.

The students handle all aspects of the visit except for those that require a licensed physician -- a role filled by a faculty physician from the Medical School. Patients who need more advanced care receive a referral and help in finding low-cost or free options, including through the U-M Health System’s own charity care program.

“The U-M Student Run Free Clinic gives our students a real sense of all the moving parts that must be aligned to create a well-run clinic, the issues facing the uninsured and the importance of ‘caring’ for all in our communities,” says Hari Conjeevaram, M.D., M.Sc., an associate professor of internal medicine who is the lead faculty advisor to the clinic team and medical director of the clinic. “Although health care reform should give more uninsured Americans access to care over the next few years, services like the Faith Clinic and our student-run clinic provide a vital safety net for non-emergency and preventive care.”

The experience of running the clinic and taking patients’ vital signs and medical histories is especially important for the first- and second-year medical students, whose classroom studies don’t yet bring them into contact with patients.

The U-M SRFC is also unique in the country in that third- and fourth-year medical students participate in seeing and examining patients, help review and make recommendations on patient care under the supervision of the faculty physician, and mentor the first- and second-year students.

The idea to start a SRFC was first brought to the attention of Medical School leaders by five founding student directors now in their third year of medical school: Alexander Andrews, Karen Chow, Lauren Dennisuk, Michael Gao, and Alexandra Pulst-Korenberg. Mohamad Issa, a second-year medical student who is one of the current student directors, says the lessons in business and clinic management, professional relationships and optimizing the patient experience have all been valuable. He notes that students from all four classes have all been eager to volunteer.

“The demand is there from the students and the need is there from the patients,” he said. “And we know the more practice we get before our third year of medical school, the more opportunities we’ll have to improve our bedside manner.”

He notes that the willingness of faculty members to volunteer time to supervise the clinic and lead the patient appointments has been inspiring. Among those volunteering has been Kevin Flaherty, M.D., FCCP, who has been involved in the Faith Medical Clinic for several years. Brent Williams, M.D., M.P.H., director of the Medical School’s Global Health and Disparities Path of Excellence, who has worked on many services for the uninsured, is also part of the faculty team advising the students. Both Flaherty and Williams are associate professors of internal medicine.

An advisory committee, medical director and several student directors and coordinators will continue to work together to ensure the clinic’s smooth and efficient operations, and sustainability. Current members of the SRFC advisory committee include Joe Kolars, M.D., senior associate dean for education & global initiatives; Williams; Flaherty; Conjeevaram; Jim Bell, the Medical School’s chief administrative officer; Carolyn Cole-Brown, the chief department administrator for the Department of Orthopedic Surgery; Candia Laughlin, MS, RN, director of nursing & patient care services in U-M Ambulatory Care Nursing; and the student directors Natalie Hoffmann, Sarah Williams, Andrew Gardner and Issa.

The new clinic is not the only place where U-M medical students and doctors can volunteer; the school’s faculty, staff and trainees also serve patients at several sites in Washtenaw County and travel around the world to provide care in other countries. But this is the only one where the clinic’s operations are entirely run by students.

The Faith Medical Clinic’s leaders, nurse practitioner Laura Goldman, APRN, BC, and her husband Mitchell Goldman, M.D., FACEP, welcome the U-M medical students and faculty as new partners in the effort to serve the uninsured residents of Livingston County who have few other places to turn. The additional Saturday hours have helped eliminate a waiting list for care, and Laura Goldman hopes that the collaboration can grow and involve more services and types of health professionals.

The Faith Clinic has other partners, including volunteer physicians and health professionals from the area, the government of Putnam Township where Pinckney is located, the Livingston County Health Department, St. Joseph Mercy Livingston Hospital, Blue Cross Blue Shield of Michigan, and local businesses and volunteers who give money, time or goods and services.

The student-run clinic runs from 1:30 to 5 p.m. each Saturday, just after the Faith Clinic’s regular Saturday hours. The clinic is located at 133 S. Howell Street in Pinckney, MI. To schedule an appointment or for more details about the U-M SRFC, call (734) 680-0804.# # #

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