Ou Medicine

Bridges to Access

By April Wilkerson
Writer, OU College of Medicine,

When OU medical student Amber Liles treats a patient whose diabetes and hypertension remain stubbornly out of control, she’s not only considering her next clinical approach.

Brandon Geister, left, receives the R. Murali Krishna Award from Dr. Krishna, founder of the Health Alliance for the Uninsured. Geister has spent many hours volunteering at King’s Klinic.

She’s also looking beyond the medical to the social obstacles that keep her patient from being healthy: the lack of full-time employment and health insurance; the car that won’t run more than a week without breaking down; the near-empty wallet that leads to cheap food instead of nutritious food.

In that dual vision, Liles sees an uphill battle, but she also sees hope.

For decades, medical education was steeped solely in science; future physicians were taught to remain somewhat aloof when it came to patients’ personal struggles. But increasingly, medical students are shown that a patient’s hurdles bear much consideration because even the best medication may not be able to overcome a life where the disparities are simply stacked too high.

Liles, Class of 2014, was the chair of the 2012 Bridges to Access Conference, an annual event that aims to inform health professions students about the city and state where they’re doing their training. The somber part of organizing the conference was realizing the lengthy list of social factors affecting health – conference topics ranged from a “conversation with the uninsured” to domestic violence and its effect on health, to health obstacles in the geriatric community. The encouraging part is that medical students of today (and physicians of the future) are much better equipped to make a difference when they understand the issues.

“Students grow up in our own little worlds, go to college in our own little worlds and stay involved only in the few things that surround us on a daily basis,” Liles said. “But sometimes all we need is a little push to become aware of what surrounds us and how we can make a difference in our community. I know that my experiences have made me more empathetic and understanding of the circumstances people are in.”

The Bridges to Access Conference – this year was the fifth annual -- is but one part of the OU Community Health Alliance. The student-initiated, student-run organization began in the 2007-08 academic year with a proposal to the College of Medicine to formalize the work students were already doing in Oklahoma City’s free clinics. Subsequently, the students were able to earn credit in two Community Health elective courses.

Rhonda Sparks, M.D., faculty advisor for the OUCHA, said cultivating community involvement is important for tomorrow’s physicians. But the College of Medicine hasn’t had to push students to get involved, she said. They’re eager to be a part of the group.

“We are looking at a study now to determine if students who were involved in OUCHA are more likely to volunteer their time during residency and beyond,” Sparks said. “I have no doubt that’s going to be the case. These students have set the bar high for themselves.”

That’s not insignificant, given the rigors of medical education. But from her time spent with students at the clinics, Sparks knows their intersection with patients’ lives is making an impression.

“We’re in a little bit of a bubble on campus,” Sparks said. “We definitely have patients with all sorts of social stressors, but they come to our complex, we treat them, then they leave our complex. At community clinics, it seems like you’re seeing patients more in their environments. You get to see those patients in the full light of what their lives are like.”

The OUCHA has three main areas: health education, community clinics and community involvement. Katie Shoush, Class of 2013 and incoming OUCHA president, said first- and second-year students focus more on community activities, such as Tar Wars, which educates elementary students on the dangers of smoking. By their third year, medical students are equipped to make a difference on a medical level. That’s also the year when many students are working in the hospital, where they see results of health problems they first encountered in the clinics.

“In the hospital, when you see someone there for a diabetic foot amputation, you realize you’re seeing the outcome of poor health and a lack of resources,” Shoush said. “But I think if you’re not aware of those problems, you can’t change them. So I think that when we see the problems, we can address them and start to make changes.”

OUCHA students volunteer at 12 free clinics in Oklahoma County. The Health Alliance for the Uninsured, an Oklahoma City-based organization that works with free clinics to improve access to care for the medically underserved, provides a seat on its board to an OUCHA member. Pam Cross, executive director for Health Alliance for the Uninsured, said the students are eager to connect with patients and seek ways to help them.

“One of the best benefits we have noticed is the individual attention students show to patients,” Cross said. “Some patients have limited health literacy, and students in several of the clinics have done an outstanding job of educating patients and ensuring they better understand how to take their medication, eat better, and even communicate better with their health care provider.”

OUCHA students also learn about and connect clinic patients to community resources, an experience that may be just as vital as the medical treatment. Cross said the students have shown a tremendous willingness to share information that can help patients overcome the barriers they face.

“I think what students often learn in the charitable clinic setting is a comprehensive approach to patient care,” Cross said. “The Health Alliance for the Uninsured believes that better prepares health professionals to maintain awareness and compassion as they begin their careers.”

The Health Alliance for the Uninsured also honors an OUHSC student each year with the R. Murali Krishna Award, named for the founder of the HAU. This year’s winner was College of Medicine student Brandon Geister, who focused his efforts on King’s Klinic. He began volunteering there shortly after he started medical school, and soon he was getting others involved. Now, 10 to 15 medical students volunteer their time and skill at King’s Clinic. He also found a successor for himself as he graduates this spring and heads to his residency.

King’s Klinic received another boost this year from the Health Dash, an OUCHA fundraising race/walk through the OUHSC campus. Class of 2014 student Ronni Farris, who organized the event, said 320 people entered, resulting in $13,000 the OHCHA can donate to the clinic.

Farris also heads the education arm of OUCHA, organizing students for Tar Wars and a diabetes education clinic, activities that put medical students in the position of promoting healthy behaviors before problems arise.

“As we become more aware of the problems facing society today, we learn how important it is to find ways to keep people out of the hospital,” Farris said.