Every Monday and Thursday night, a makeshift clinic tucked in the basement of a Minneapolis church welcomes people who have wide ranging health needs – from sore throats to tooth aches to blurry eyesight.
The Phillips Neighborhood Clinic opened in 2003 offering basic care to people without health insurance. University of Minnesota students in the schools of dentistry, healthcare administration, lab science, law, medicine, nursing, nutrition, pharmacy, physical therapy, public health and social work under the supervision of seasoned providers to diagnose and treat these patients.
“This is a totally free clinic for people who need care but aren’t able to pay for it, and we’re finding it’s more important now than ever,” said Brian Sick, MD, associate professor at the University of Minnesota Medical School and medical director of the clinic. “We’re changing with our patients and staying relevant in a quickly evolving healthcare system.”
Prior to the Affordable Care Act in 2010, the clinic typically served patients with acute conditions like injuries or bronchitis that required short-term treatment. This safety net clinic was a helpful tool in reducing expensive, unnecessary visits to nearby emergency departments.
Today, however, the patient population has changed.
With the passage of ACA, some of the patients now have health insurance and pursue treatment at traditional clinics.
But, other patients with chronic conditions arrived, looking for medications or services that are simply too expensive even for those who are fully insured.
The shifting patient population is prompting the Phillips Neighborhood Clinic to add new services, like nutrition and exercise classes and nurse educators to help patients managing chronic conditions. It has also started to staff ophthalmology experts one night per month, and the clinic recently held its first Women’s Health Night with a focus on preventative care.
Helping Patients Helps Students
The clinic, which is one of the largest free clinics in the nation, is not only filling a need in the healthcare system. It’s filling a need in the education system.
“It’s an ideal training ground for interprofessional experiences that help students prepare for a health environment oriented around collaborative teams,” Sick said. “This is a service for our community, but in helping patients, we’re helping students.”
It is managed by a board of 12 to 13 students representing each of the 11 professions who oversee nearly 400 other student volunteers. After being selected from a competitive application process, the students are then responsible for more than 1,000 patients each year.
Carly Dahl is a current medical school student who is pursuing a career in Obstetrics and Gynecology. She was one of the student leaders who helped organize the Women’s Health Night.
“The Women’s Health Night has given me the opportunity to work with my colleagues across many other health professions. Together, we identified a community need and created a service to target that need alongside community partners,” Dahl said. “This type of interprofessional collaboration for addressing gaps in healthcare is something I would absolutely not get anywhere else in my training.”
Nationwide, health science programs are incorporating free clinics into curriculum to bolster real-world learning experiences. Sick and colleagues at PNC found students who work in free clinics have better perceptions of underserved patients compared to students who lack the experience. This improved perception reduces implicit bias and helps build better relationships with patient, which translates to better care delivery.
To better serve the community, PNC is creating a needs assessment tool that will show what areas of the care are particularly lacking. The results will help guide the clinic in the future. Additionally the PNC has an active Community Advisory Board of community leaders, patients and past students, which helps the clinic stay in touch with the needs of the community.
“We passively watched as changes occurred. Our students then adapted to provide better care to those in need,” Sick said. “Now, we’re proactively assessing community needs to anticipate the changes. This is how the real world works and our students will be better off for it.”