Students establish free clinic

Wednesday, June 8, 2005 at 1:00am

For some Nashvillians who don't have health insurance and are facing the ever-increasing cost of health care, help may be on the way.

Two students at the Vanderbilt University School of Medicine (VUSM) have been working for more than a year - on top of their intense classroom studies - to found a free clinic for individuals who don't have the resources to pay for basic medical care.

Kristina Collins and Katie Cox, both in their second year of medical school at VUSM, became interested in helping partly because of the growing number of people who can no longer afford medical care and partly because of the restructuring of TennCare, which will likely leave significant numbers of Tennesseans without insurance.

"We could not do this without the support of Vanderbilt, the faculty and others," Collins said. "So many in the community have gotten behind the effort."

VUSM and 60 of its medial students, along with public and private organizations such as Skyline Medical Center, have not only shown interest but also become directly involved in establishing the clinic, which is slated to open this September.

"Helping the community is a key idea of what developing a clinic is about and part of the strategic plan of Vanderbilt," said Bonnie Miller, associate dean for undergraduate medical education at VUSM.

After reviewing demographics, the students made the decision to focus on North Nashville, around Dickerson Pike and near Skyline Medical Center.

One of the reasons was the high infant mortality rates, and particularly the premature infant mortality rate, which is 18 percent higher than any other district in Davidson County.

"We did a needs assessment for the area and performed in-depth interviews of people and their needs, like what access they had [to medical care]," Cox said.

In the survey, 35 percent of community respondents indicated they had no health insurance, 49 percent used the emergency room for primary care, and 14 percent chose not to seek treatment of any kind for a non-emergency health problem.

Most of the emergency room visits were made to Skyline. This results in more than 25,000 unnecessary ER visits per year at the HCA facility, according to the VUSM students.

"Of the 40,000 visits to the emergency department [each year], a large percentage of patients have primary care needs - earaches, sore throats and colds," said Robert Klein, chief executive of Skyline Medical Center. "Fifty to 55 percent of them are TennCare or uninsured."

Klein said what these students are doing is great and "we are going to support them as much as we can."

He added that Skyline has helped the clinic find a location for an office and intends to help with the payment of rent and medical supplies.

The Paul Newman Foundation recently made a sizable contribution, and a Vanderbilt alumnus has also made a donation, according to Cox. The clinic is looking for additional support.

According to VUSM, there are presently 50 student-run free clinics in the United States offering care to tens of thousands of patients per year.

Locally, the students project 2,000 walk-in patients during the first year.

Collins and Cox said the clinic will be open one day during the week and on Saturday afternoons. First- and second-year medical students will be paired with fourth-year students in order to obtain vital signs, histories and physicals. The fourth-year student will then present the patient to an attending physician.

Student volunteers will gain experience helping patients with health maintenance for chronic conditions, such as hypertension and diabetes, and serving as a primary contact for non-emergency medical illnesses. They also plan to provide health education and social services for patients with barriers to health care access.

"We really want to make a difference," Collins said.

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