Peer schools remedy health needs differently



During their four years in New Haven, Yale undergraduates not only grapple with daunting academics and social situations, but also must learn to take responsibility for their own physical well-being. When illness strikes, Yale University Health Services often plays a large role in students’ recovery.

Providing quality care for the entire Yale community is no easy task. UHS must offer the full spectrum of health care services, including insurance, a wide variety of specialty medical departments, urgent care and a pharmacy. Every week, Student Medicine at UHS — just one of many departments — handles 430 undergraduates.

“I think it’s always a challenge to get the balance right,” Nancy Creel, associate director of administrative services at UHS, said. “You want to make sure you offer a wide range of services.”

But Yale’s health system is just one way of organizing the complex network of medical care and services that a large and diverse university community requires. While most other universities have similar health care structures, there are some marked differences between programs.



Picking providers

At the University of Massachusetts at Amherst, where the undergraduate population is three times the size of Yale’s, health officials have begun encouraging students to select a primary care provider — a doctor, nurse practitioner or physician assistant that handles the majority of a student’s health needs. The primary care provider becomes familiar with the student’s health history and is able to coordinate with other physicians.

“If you have a primary care provider that gets used to you, you have greater access to care,” University of Massachusetts Health Services Director Bernette Melby said. “It allows for some of those routine conversations that come up, so those things that do come up aren’t overlooked in episodic care.”

In particular, Melby said, having a primary care provider will allow students to more easily figure out the services and procedures available to them. The system is new, Melby said, and is therefore not extremely popular among students. But she said she believes the program will ultimately improve the care provided to students. Appointments will be more simple to make, and clinicians are organized into teams, should a student’s provider be unavailable.

Yale also encourages undergraduates to select a “primary care clinician” and requires that graduate and professional students be assigned a clinician.

Creel said selecting a primary care clinician is elective for undergraduates because UHS does not want students to be discouraged from coming to the clinic if their primary clinicians are unavailable.

“We want you to come and see someone when you need to be seen,” Creel said. “Because Yale College students are a very healthy bunch, they don’t come in that often. You’re not as much of a challenge as an older student.”



Assigning care

Although Yale does not require undergraduates to select a primary care clinician, Harvard assigns each student a physician as a way to coordinate the health service, Deputy director of Harvard’s University Health Services Jack Kasten said.

Yalun Tu, a Harvard sophomore, said he appreciates the system of assigning doctors.

“We’re big fans of having the specific doctors because they can know your history,” Tu said. “Myself, I have a great doctor, he’s really good.”

Tu also said he thinks students regard the health services well, though he said students sometimes think the doctors “don’t care very much.”

Kasten said the center has recently worked to improve its services by adding extra resources to the mental health department and increasing outreach work.

“We’re getting a lot more favorable reviews recently than we have in the past,” Kasten said. “Students make their impressions known and we try to accommodate them.”



Small packages

A smaller operation than Yale’s, Princeton’s health system is more limited than Yale’s but “very well received,” Director and Chief Medical Officer at Princeton Daniel Silverman said.

Silverman said the main difference between Yale’s and Princeton’s health services is that while Yale provides primary care for all faculty and staff as well as students, Princeton provides primary care for students only. Princeton University Health Services sees faculty and staff for work-related injuries, but the university provides insurance for them to see primary care givers outside the university, Silverman said.

While Princeton’s UHS offers all basic health needs as well as gynecology and mental health, Silverman said it does not provide the same breadth of specialties as Yale, lacking, for example, dermatology.

In the course of one year, Princeton’s UHS will see 80 percent of any class of students at least once, Silverman said. In a recent survey, 97 percent of students said they were “satisfied” or “very satisfied” with the healthcare they receive, Silverman said.

Anna Lineback, a Princeton sophomore, said students sometimes mock the health services but appreciate the effort UHS puts into soliciting student opinions.

“It’s nice to know that they want our feedback,” Lineback said. “It makes me feel good about the place.”

At Yale, where students can provide feedback to Member Services or individual departments at UHS, Creel said UHS’ program is organized to serve a diverse, but well-defined patient group.

“If you know who you patient population is, you can design your services to better suit them,” she said.

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