UCSD Student Run Free Clinic Project

History

Students at the UCSD School of Medicine had wanted to start a free clinic for many years however, the models initially proposed did not gain the support of UCSD administration. One day, a UCSD pre-med student who had served at the Suitcase Clinic in Berkeley, California approached Dr. Ellen Beck, M.D, Clinical Professor in the Department of Family and Preventive Medicine at UCSD. Together, they called a meeting of interested students and formed a planning committee. The key learning for the team was that an exclusive building was not needed to house the clinic; the project needed an established community partner that could provide them with support and facilities.

The team identified a well established program already serving the homeless at the Pacific Beach United Methodist Church. Mary Mahy, a formerly homeless woman, had created the Harvest for the Hungry program and was receptive to the idea of a free medical clinic. With her support and assistance, the UCSD Student-Run Free Clinic Project gained access to several rooms in the church that they could use during the evenings. Thus, the first UCSD Student-Run Free Clinic site was opened at the Pacific Beach United Methodist Church on in January 1997. On that first night, 10 patients came seeking aid and over the next few months the clinic became very busy.

A minister from the First Lutheran Church in Downtown San Diego, who was passionate about social justice and serving the homeless, heard about the free clinic that had started in Pacific Beach. He approached Dr. Beck and asked if a second site could be started at his church. This coincided with rising student interest for the project and with a sufficient number of medical student volunteers, a second site was opened in October 1997.

The medical students then became interested in reaching out to underserved minority populations. Initially, Dr. Beck approached an inner city church. Though the congregation was primarily middle-class, the pastor of the church referred Dr. Beck to his wife, Dr. Louilyn Hargett, who was the leader at Baker Elementary School. Dr. Hargett along with the school's principal, Krisi Dean, welcomed the creation of a clinic and became partners with the UCSD Student-Run Free Clinic Project. During 1998, the San Diego Unified School District approved the request to use school buildings for a medical clinic. It was the school board's hope that the clinic would help to affirm the idea that school was at the center of the community. On October 13, 1998, the UCSD Student-Run Free Clinic Project's third site was opened at Baker Elementary.

Through the first 10 years of operations, the clinics provided no-cost healthcare to 7,500 people. At any given time, the clinics have approximately 2,500 active patients. The clinic funding comes from UCSD, grants, foundations, and donors.

Mission

Quoted from the UCSD Student-Run Free Clinic Project Project website:

"The UCSD Student-Run Free Clinic Project, in partnership with the community, provides accessible, quality health care for the underserved in respectful environments, in which students, health professionals, patients and community members learn from each other. We seek to sustain health through: free medical and preventive care, health education and access to social service."

Philosophy

The UCSD Student-Run Free Clinic Project's motto as quoted from the UCSD Student-Run Free Clinic Project Project website:

"Serving the Underserved."

The UCSD Student-Run Free Clinic Project strives to provide top-notch care to all of its patients and works towards fulfilling dimensions of unmet need. The clinic stresses safety and confidentiality and adheres to the Health Insurance Portability and Accountability Act (HIPAA). The UCSD Student-Run Free Clinic Project seeks to educate and empower its patients and encourages them to take control of their health; the clinic hopes that this grassroots effort will spread and make all San Diegans more conscious and proactive about their health. The UCSD Student-Run Free Clinic Project strives to act as a teacher not only to its patients, but also its students, doctors, and volunteers. The staff learn first hand from their patients about the health disparity affecting low-income people as well as the non medical needs of the underserved. The UCSD Student-Run Free Clinic Project works to create an environment where all who attend, feel energized, encouraged, supported, respected, trusted and open to one another, thus making the San Diego community a healthier place to live.

Services and Partners

The UCSD Student-Run Free Clinic Project offers many services in addition to basic medical care. These include care from specialized doctors, dentistry, acupuncture, a basic pharmacy, legal aid, and access to social workers.

Specialty Clinics

In efforts to provide comprehensive medical care, the UCSD Student-Run Free Clinic Project offers specialty clinics where active patients have the opportunity to receive care from a specialist. Specialty clinics are once-per-month occurrences that active patients must be referred to in advance of the scheduled specialty clinic date. Patients of the UCSD free clinics may be treated by a doctor representing: cardiology, dermatology, endocrinology, gastroenterology, gynecology, hematology/oncology, nephrology, neurology, ophthalmology, orthopedic surgery, podiatry, pulmonology, and rheumatology.

Dental Care

Dental care is the greatest unmet health care need in the nation; 108 million people lack access to dental care. Patient restorative dental care, not solely emergency dental care, is made possible by the work of the UCSD Pre-Dental Society. UCSD students arrange for dentists to volunteer and treat patients on an appointment-only basis except at the Pacific Beach site. Approximately 5-10 patients are seen during each clinic session. Because of the limited resources and availability of volunteer professional dentists, potential dentistry patients are typically placed on a waiting list until there is room for them to receive full dental care except in the case of a dental emergency.

Acupuncture

Acupuncture is provided by the Pacific College of Oriental Medicine. Acupuncture trials are encouraged for pain and stress management as part of the integrative focus of the clinic.

Medication Dispensed

UCSD Skagg's School of Pharmacy students volunteer at the UCSD Student-Run Free Clinic Project under the supervision of a licensed pharmacist. The clinic's pharmacy dispenses many types of medication free of charge to patients. When a patient needs a drug that the pharmacy does not stock, the drug may be ordered though a pharmaceutical company drug donation program. The pharmacy works closely with volunteers who arrange to get medications through drug companies' patient assistance program. While this allows free clinics to obtain drugs for patients free of charge, there is an extensive amount of paperwork that must be completed for each patient enrolled in the program.

Legal Advice

California Western School of Law (Cal Western) organizes the Community Law Project at the Downtown clinic. The Community Law Project's mission is to offer pro bono legal advice, information and referral services to low income residents of the San Diego community. The law students from Cal Western work directly in a multidisciplinary context with the other clinics at the UCSD Student-Run Free Clinic Project to provide legal services to the client. The Community Law Project addresses all areas of law related to the indigent client, with more emphasis being in the areas of Family, Consumer, Administrative, and Immigration law. It does not provide legal representation.

Social Worker Consultations

Students from San Diego State University school of Social Work intern with the UCSD Student-Run Free Clinic Project Project under the guidance of a social worker. They provide patients with resources and information about public programs, housing, public services, and employment opportunities.

The Clinics

The Free Clinic Project aims to serve patients who are not eligible to receive health care through any other program.

New patient clinics are held Monday evening downtown and Wednesday evening in Pacific Beach. A medical student or a team of medical students conduct a comprehensive interview including information about the patient's present condition, history of the present illness, social and family history. A physical examination on the patient is also performed. The medical student(s) then presents the patient's case to an attending physician and together they talk with the patient. The attending, medical student and patient collaborate to determine the best course of action. If needed, medications are ordered from the pharmacy and are then dispensed to the patient.

Pacific Beach United Methodist Church (PB)

1561 Thomas Street
San Diego, CA 92109

First Lutheran Church (Downtown)

1420 Third Avenue
San Diego, CA 92101

Baker Elementary School (Baker)

4041 T Street
San Diego, CA 92113

Golden Avenue Elementary (Golden Avenue)

8025 Lincoln Street
Lemon Grove, CA 91945

Nationwide Impact

The UCSD Student-Run Free Clinic Project created a national faculty development program in 1999 called, "Addressing the Health Needs of the Underserved" with grant funding. Over 107 faculty from 30 states have visited UCSD for three week periods to learn the mechanics of creating similar student-run free clinic programs in their communities. The UCSD Student-Run Free Clinic Project now offers an Advanced Skills Program, in which previous participants return for a week and continue to learn from each other and their programs.

Through "Addressing the Health Needs of the Underserved," and individual consultations, the UCSD Student-Run Free Clinic Project Project has been emulated around the country in at least 7 new locations including Jackson, Mississippi; Lexington, Kentucky; Kansas City, Kansas; and Houston, Texas.

In addition, attendees have used information from the program to create 29 new resident curricula in community medicine, 18 new medical student curricula, successful grant proposals that address training in underserved communities, and new programs addressing the needs of migrant workers, street homeless, and other underserved groups.