A student-run health-care clinic, self-examined

Twenty-two medical students currently earn credit by volunteering at the clinic.
Twenty-two medical students currently earn credit by volunteering at the clinic. Photo by Florence Dethy.

Audrey Provenzano MED ’10 started working at HAVEN — an entirely student-run free health-care clinic in Fair Haven, Conn. — four years ago as a first-year medical school student. Now one of the clinic’s associate directors, Provenzano recalled how, in her first year, she dispensed free prescriptions to underserved individuals. That was four years ago — before the recession, when the clinic was still in its infancy. Staff reporter Florence Dethy investigates.

Back then, Provenzano said, the clinic was seeing between four and five patients per hour each Saturday it was open. Now, that number has swelled to more than eight clinical patients per hour — a rise she attributed to the community’s increased need for health care as unemployment has continued to climb since last spring.

The clinic offers services to uninsured Fair Haven residents, age 18 and older.
The clinic offers services to uninsured Fair Haven residents, age 18 and older.

“There’s a lot of people that maybe didn’t used to qualify [for HAVEN’s services] but lost their insurance and now do qualify,” Provenzano said. “It’s really sad — people have no access to health care.”

Founded in 2004, HAVEN provides free health care to uninsured individuals in Fair Haven who qualify and is run predominantly by students from Yale’s health professional schools, though a large number of undergraduate volunteers who serve as interpreters also volunteer at the clinic. Approximately 80 percent of the clinic’s patients are Spanish-speaking, said Co-Director of Social Services Michelle Conroy ’10.

Mary Christine Sullivan, one of HAVEN’s directors of patient services, said the clinic has been overbooked practically every weekend since the spring and that if the volume does not taper off by mid-fall, the clinic’s board will have to address the issue.

“At this point, new patients have about a month to two-month wait for an appointment,” Conroy said, adding that she has seen an uptick in the amount of anxiety, stress and signs of domestic violence that patients bring with them to the clinic — an uptick that has occurred in tandem with the increase in the community’s unemployment rate.

Anchored around the goals of increased access to health care and the real-world application of their medical studies, the enterprise was opened when a group of medical school students recognized a need in the community: New Haven lacked a stationary free health-care clinic, and certain populations were increasingly lacking access to health care.

“The idea of HAVEN was for medical students to develop a no-questions-asked environment where they could see patients,” said Yale School of Medicine Professor David Laffell ’77, who is also the chief executive officer of the Yale Medical Group.

And while there is no question that the clinic has been a valuable addition to the community, the clinic’s volunteers are just beginning to quantify the degree to which it has been able to effect positive medical outcomes.

Currently, William Murk YSPH ’10, HAVEN’s research chair, is investigating the clinic’s impact on the Fair Haven community. More specifically, he is examining whether its preventative screening programs are having an effect, he said.

“We’re going to be looking at hospital records to see if the rates of patients [going into the facility] with these conditions [such as hypertension] from this community are changing,” he explained of his study, which is still in its formative stages.

Since most individuals utilizing HAVEN’s services are undocumented, he added that he would be examining whether HAVEN reduced the burden on local emergency rooms in the study as well.

As the clinic’s number of clients has grown over the past few years, so too has its volunteer base. And two years ago, Yale School of Medicine students’ clinic hours began to count toward one of their graduation requirements.

This year, 22 medical students volunteer at the clinic each week for 12 weeks and earn medical school credit for their labor, Provenzano said. It is the second year the clinic hours-for-credit program has been in place.

“I feel very fortunate to go in week after week and be part of something that is truly providing a resource to the people of that community based entirely upon volunteer support,” said Jennifer Yuhas MED ’12, the clinic’s director of patient services.

The clinic serves individuals at least 18 years of age who do not have health insurance, who live in Fair Haven — zip code 06513 — and who are not already patients at the community health center. They are individuals “that otherwise would be afraid to get into the system,” as Laffell put it.

“Behind the scenes, [the medical school is] very helpful,” Laffell said. “What we have done is we’ve arranged to prepare free specialty care to their patients that require it.”

To date, the clinic has had about 2,100 clinic visits distributed over 150 clinic sessions, according to Murk’s records.

Comments

  • FQHC

    And what happened to the philosphy of the funded by grants, state $$$, federal $$$, private $$$ and 330 granted Federally Qualified Health Centers providing “free” care: oh yeah, they are in competition with the private sector providers yet are receiving a $125.oo/per office visit “donation” whereas the private sector provider receives significantly less!
    KUDOS to the medical students and FAIR HAVEN COMMUNITY HEALTH CENTER, Katrina’s heart and mind has always been on service and community

  • Bohdan A. Oryshkevich, MD, MPH

    I am not certain that student run clinics are a replacement for primary care provided through normal funding. This is purely a stopgap measure in a health care system riddled with inadequacies. That is why we need reform.

    The sad reality is that few Yale pre-meds are going to go into primary care. Without primary there is not going to be any sustainable health care reform.

    This is in a university with a great medical school. Where is the leadership in the medical school for health care reform so that everyone in this country can get health care organized by genuine professionals.

    Bohdan A. Oryshkevich, MD, MPH