From the February 3, 2023 issue of the Transformational Times
The Value of Student-Run Free Clinics for Patients, Students, and the Community
By Rebecca Lundh, MD, SCU Medical Director
and Staci Young, PhD, SCU Research and Finance Director
Supporting tomorrow’s leaders in healthcare equity, these clinics offer patient-centered care and rewarding experiences for students...
Saturday Clinic for the Uninsured (SCU) is MCW’s student-run free clinic. Under faculty supervision, medical and pharmacy students are responsible for day-to-day operations and participate in providing patient care and education. Our motivation and inspiration for supporting and advising students at SCU stem from a commitment to health equity and social justice. We believe people have a right to quality healthcare, which means providing holistic and comprehensive care that addresses the diverse health needs and goals of each patient. Through the years, we strive to do this, together with thousands of medical and pharmacy students and hundreds of faculty members full of energy and passion.
Some History:
SCU began in 1991 as the Isaac Coggs Saturday Clinic for the Uninsured, housed in a federally qualified health center to meet primary healthcare needs of Milwaukee patients without access to healthcare because they lack insurance and financial resources. In 2001, SCU affiliated with community partner, Columbia-St. Mary’s, now Ascension Wisconsin, to continue this mission. Support and collaboration with health systems and other organizations is critical for free and charitable clinics to connect patients to clinical and community resources. SCU has been very fortunate to have these partnerships to provide care.
Over the past 30 years, the clinic has shifted from providing care on a first-come, first-served basis to patients who would spend hours waiting in lines outside the clinic before it opened, to care that is more patient-centered – meeting patients where they are and providing what they need for their health. Through student-led efforts, SCU has expanded its clinic services. It now provides telemedicine and many specialty services in-house, including pharmacy, ophthalmology, psychiatry, dermatology, neurology, and many others.
Student Experience:
MCW students have operated the clinic since the beginning, performing tasks from administration to direct patient care under the supervision of volunteer physicians, pharmacists, and faculty advisors. Even though they do not receive academic credit, hundreds of medical and pharmacy students still volunteer on a rotating basis each school year.
SCU holds incredible value as one of the first, and commonly the only, opportunity early medical students get to work one-on-one with patients. Students learn to apply their medical knowledge and skills in a supervised learning environment without the added pressure of educational or time restrictions in clerkships. Students also learn how to care for patients of different cultural, racial, or socioeconomic backgrounds. Many SCU patients have complex needs, and although addressing these can be challenging, it can be highly rewarding and useful for their training. For many students, the clinic provides their first experience addressing social determinants of health (SDOH) and is a tangible reminder of why they are working diligently on their education.
Student-led Research Efforts:
The research arm of SCU has grown and become stronger over the years. Student projects have demonstrated that health and wellness needs vary across patients and populations. Research findings add value and community benefit by providing evidence for tailoring resources and care toward the specific needs of patients.
For example, identifying and addressing SDOH are important aspects of healthcare and wellness. However, without appropriate screening we may not know the extent of patients’ needs, such as financial or food insecurity. Thus, we become focused on medical management of the condition rather than the root cause of the problem. Years ago, we supported a pathway project to address SDOH that has evolved into a robust program with trained volunteers to screen and assist patients in real time with SDOH using an organized resource bank. This program also includes patient follow-up to evaluate the utility of these resources and to make changes to the resource bank as needed.
Another student-led initiative is the newly formed Patient and Family Advisory Council (PFAC) that has been a growing source of feedback on current services we provide at the clinic and proposals for the future. The (PFAC) has helped provide ideas to improve patient understanding of SCU services and processes and input into student volunteer training. We will evaluate the experiences of individuals in the PFAC to inform future recruitment and meaningful participation.
We will continue to support research efforts and translate findings into innovative ways of delivering care to uninsured individuals to promote overall health and wellbeing. Through these projects (and others), we aim to be a holistic, community-engaged clinic that is welcoming and reliable for our patients. Our vision moving forward is to amplify our work that benefits both the community and MCW.
Envisioning the Future:
We consistently see that many of our students value delivering care for patients with a multitude of needs, and SCU provides this opportunity. We are grateful for the enthusiasm and dedication of these students and constantly inspired by their commitment and ideas. The articles shared in this issue showcase student leadership and reflections, and some of their initiatives.
As mentors in clinical care, research, and community engagement, our hope is that students remember their time at SCU and hold on to the values and lessons they learned as they continue in their training and future practices. In time, we are optimistic that we will see changes in the healthcare system that promote health equity and provide quality care for all individuals as we support tomorrow’s leaders in healthcare and medical education.
Rebecca Lundh, MD is an Assistant Professor of Family and Community Medicine and Medical Director for the Saturday Clinic for the Uninsured at MCW. She previously volunteered at SCU as a medical student and resident.
Staci A. Young, PhD is a Professor of Family and Community Medicine and Director of Research and Finance for the Saturday Clinic for the Uninsured. She is also the acting Senior Associate for Community Engagement at MCW.
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