FEATURE
ARE YOU A DOCTOR ?
Micah Kaiser , BS , & William J . Crump , MD
PROLOGUE
In my role as Associate Dean of the University of Louisville School of Medicine rural regional Trover Campus in Madisonville , Kentucky , I have watched our student-directed free clinic transform since we began in 2004 . This process accelerated when the COVID-19 epidemic forced us to transition to entirely telemedicine visits . Although communicating via phone with our uninsured , low-income patients was a challenge and some didn ’ t have video capability , our students got quite comfortable with these virtual visits , staffed by me .
We began cardiovascular screening at local food banks as our next step , and then most recently at the newly established Salvation Army homeless shelter . Until about a year ago , our town of 20,000 with a very sophisticated medical system lacked such a facility . The homeless in rural places are less concentrated so less visible , but we knew they were there .
The story recounted below shows our most recent phase of providing impromptu portable clinic sessions , staffed by me . Even though the patient discussed had insurance and some family support , just being in a shelter provided obstacles . That same day , we saw another patient with no family support and no phone , who had been off her blood pressure and diabetes medicines for almost a year . By working with our local health system to get labs done and choosing medications from the $ 4 list at a local pharmacy near a bus stop that accepts the shelter ’ s vouchers , she is now being treated appropriately . But what is most important is the sense of pride and ownership that my students feel providing this service . Community medicine concepts cannot be taught in a classroom , and the value of community engagement is learned best by personal experiences . I have watched this process develop in our students , and it provides meaning for all of us . - Bill Crump , MD
A PATIENT STORY
“ Are you a doctor ? I ’ ve been having this stabbing pain in my belly for the past week and I ’ ve had ulcers in the past .” This was how the patient greeted me as I entered the homeless shelter to do cardiovascular screenings . She had seen my scrubs but not yet my badge and assumed I was a physician . Little did she know how distant I felt from being a physician as a third-year medical student . I told her that I was not , but in my free-clinic role I could see her as a patient and maybe help . I made this bold statement
26 LOUISVILLE MEDICINE