Every Tuesday and Thursday at 6 p.m., men climb the stairs to the second story of the Allentown Rescue Mission in Pennsylvania to two modest rooms that have been remodeled into a free health clinic. PA students from nearby DeSales University are already there, ready to receive their patients.
The students treat the men — who are homeless or in need — for many common health issues, including diabetes, hypertension, upper respiratory infections, and allergies. More complex cases are referred out. The three first-year students and two second-year students on duty work as a team, while their preceptors — volunteer PAs or MDs — provide support.
“The didactic students can practice palpating an abdomen or listening to a heart as they learn those skills in H&P. The clinical students can cement the clinical skills that they are learning on rotation,” said Wayne Stuart, MD, DeSales’ program director and the clinic’s medical director. “There is something special about the patients ‘belonging’ to the students, which the students take very seriously.”
The clinic began in 2006, when DeSales PA student Brett Feldman wanted to volunteer at a free clinic as he’d previously done while living near Chicago. Finding none, he decided to start his own. When he asked the PA faculty for support, they agreed. The rescue mission donated space, and the university approved the enterprise. Originally offered one evening a week, demand quickly exceeded supply, and clinic hours expanded to a second night. There are now some 50 local PAs and MDs who volunteer alongside the DeSales students. In 2014, the clinic saw 228 new patients and 607 follow-up visits.
For second-year student Ryland Copeland, the free clinic was a major draw when choosing a PA school. “The clinic is pretty much the main reason why I wanted to come to DeSales,” she said. “Working in underserved areas in an urban area is where I see myself.”
She noted that many students are passionate about their work at the rescue mission. “When we’re on vacation, we don’t have to serve in the clinic, but it’s usually a fight to see who can sign up.”
First-year student Lauren Rice volunteers on the clinic’s advisory board alongside Copeland, but she hadn’t been particularly interested in the clinic when she applied to DeSales as an undergraduate. She said her experience as an intern last summer for a community health department, along with her work at the Allentown mission, has influenced her career plans. “I have deemed [working in community health] a necessary part of my future, and I feel a level of responsibility to do so,” she said.
Running the clinic isn’t without its challenges. Though the space is provided, funds are needed for medications (some, but not all are donated) and the occasional blood test or x-ray. The clinic is supported through donations and student fundraisers, including clothing drives and an annual 5K run. Stuart said, initially, it was difficult to convince the university to allow the PA program to open the clinic. “We are not hired principally to be clinicians but rather as academics,” he said. “However, they have come around.” The university is now very supportive, having established an endowment to provide continued financial support for the clinic.
Through an application process, Corinne Feldman, MMS, PA-C, the clinic’s executive director (and Brett Feldman’s wife), had the rescue mission recognized as a free clinic under the Health Resources and Services Administration’s Free Clinics Federal Tort Claims Act program. This designation provides the clinic with free malpractice insurance.
Beyond the hands-on practice the students experience, there are added benefits. They learn about cost-effective medicine, and second-year students mentor their first-year peers. All of DeSales’ PA program faculty take shifts at the clinic where they are able to model good clinical behavior to their students. “It really informs their attitudes about us as teachers and gives us more credibility in the classroom,” Stuart said.
Copeland recalls one particularly memorable patient who visited the clinic regularly for basic health maintenance. She watched as he let his guard down with Corinne who, in turn, went above and beyond her responsibilities as a health care provider. “It was really great to see that trusting relationship build,” Copeland said. “She spent hours helping him with tasks like filling out complicated paperwork for Medicaid benefits.” The PA student class rallied to collect various items the man needed to get back on his feet.
DeSales is in the process of surveying graduates to determine how many are working in underserved populations. “I think that a free clinic like ours does influence our students,” he said. “They see that service to vulnerable populations is possible and rewarding.”