Society of Student-Run Free Clinics Conference!

It’s not often that I get to write a blog post in the middle of a jungle with a waterfall 25 feet away. At least, that’s what it feels like sitting on the balcony of our hotel room, which overlooks an atrium full of tropical plants and flowing water. The Society of Student Run Free Clinics is having their annual conference at the Gaylord Opryland Resort and Convention Center, also known as the Grand Ole Opry. And grand it is – 9 acres of indoor gardens, shopping, entertainment, dining, and meeting space! It feels like an extravagant alternate reality. The Vegas of Nashville.

Light Show

Despite the numerous distractions, I spent the morning attending oral presentations and poster sessions, learning from fellow students and patients around the country. The breadth of student clinics was remarkable. Some served only the uninsured. Others, like ours at BIDMC, see patients referred by an affiliated hospital’s department of medicine or primary care center. Some have been in existence for more than half a decade, and others started just last year. But every person in attendance was excited about sharing new outcomes research, models of care, and initiatives for the future.

Oral Presentation

The first presentation I attended was a quality improvement assessment of an initiative to increase cancer-screening referrals at Albert Eisenstein Medical School’s community health outreach clinic. Their clinic serves as a gatekeeper role in seeing uninsured patients for two times (chronic patients get seen four times) before the patients are referred to a primary care physician. Many patients, if not all, have received minimal preventative care. Screening for cancer was therefore of paramount importance to the clinic, and this is achieved through a team of 1st year medical students who read patients charts and identify if age-related colonoscopies, pap smears, etc. have been performed. If not, the patient receives a referral for a free screening at a local clinic.

At BIDMC CCC, many of our patients already have primary care physicians who fulfill the role of the gatekeeper and preventative care manager. Perhaps one can argue that Eisenstein’s ventures have no place in our site.  But I think we have a unique focus in counseling patients about chronic diseases. Screening applies not only to cancer, but also to morbidities associated with chronic disease. We can help our patients navigate lifestyle changes, but we can also make a big difference by encouraging preventative care. Having concrete goals, such as taking steps to ensure every diabetic patient makes their yearly ophthalmology and podiatry appointments, could have a huge impact. If patients have heard the screening reminders from primary care physicians, we can be of a great help to be that follow-up voice and perhaps even use motivational interviewing to encourage actual follow-through.

On the topic of motivational interviewing, I also heard a great anecdote about George Washington University’s health coaching pilot program, which pairs up a patient and a 1st or 2nd year medical student in exploring health lifestyles. The pilot uses both group sessions and individual visits to help patients learn about nutrition and exercise. Some pretty innovative activities are used beyond simple discussions. For example, students take their patients grocery shopping to educate them about nutritional labels. Students also make home visits and walk around patients’ neighborhoods to identify spots ideal for exercising. 

Health coaching has been a theme in many of the posters during this conference as well. Many clinics have realized the value of personal attention for patients struggling to be motivated to lose weight or manage their hypertension. BIDMC CCC is looking forward to piloting our own health coaching program, so it was great to hear some of the challenges the group faced. Patient retention was a problem, with many patients feeling isolated during group sessions and others not being able to make group sessions due to transportation access. These patients were also not followed by a PCP, which made follow-up hard outside of the bimonthly student sessions.

The pilot leaders suggested targeting a community center to recruit patients at the start, such as a local church, where patients who are recruited would already know each other and be more motivated to complete the program together. It gave me the idea that students can perhaps set and complete personal goals of their own as a model for patients. If the patient decides to eat 4 servings of vegetables over a week, the student can make that goal too, showing the patient that he’s not alone in his journey.

I've been thoroughly enjoying my time at the conference, and look forward to an afternoon of even more learning, exploring, and presenting our research on didactics too! Can't wait for our next medical education committee meeting, where we can hopefully take a lot of these ideas and start talking about putting them into practice. 

Signing off with some more pictures of this beautiful place!

-Yun Xue MSII, Med Ed Committee