Student-run clinic is a HAVEN for uninsured

When it comes to health care, New HAVEN’s Fair HAVEN neighborhood has more than its share of the underserved and uninsured. Thanks to a new free medical clinic launched by students from the School of Medicine, the School of Nursing, Epidemiology and Public Health and the Physician Associate Program, many residents of Fair HAVEN, including some who have never been to a doctor for chronic, life-threatening illnesses, are getting treatment as well as education to ward off future health problems.

The clinic, known as HAVEN (an acronym for Health Care, Advocacy, Volunteerism, Education and Neighborhood), was the brainchild of Karen Archabald and other students from the medical school’s Class of 2007 and Ryan Hebert of the Class of 2008. HAVEN provides an array of medical services to uninsured patients free of charge every Saturday morning, says Mallika Mendu, who is co-director of the clinic with fellow member of the Class of 2008 Margaret Samuels-Kalow.

Each patient at HAVEN is seen by a team of students and an attending clinician who may be a physician or nurse practitioner from the Fair HAVEN Community Health Center (FHCHC), which houses HAVEN, or a faculty member from the School of Medicine, the School of Nursing or the Physician Associate program.

Getting adequate and healthful nutrition is a major issue for the clinic’s patients, and most come in with multiple unmanaged chronic diseases, such as diabetes and hypertension, says education coordinator Corinna Levine, a second-year medical student. The students run an educational program to provide general information about diseases and their management that supplements the instructions patients receive from the attending physician. The clinic’s personnel offer one-on-one education on these issues during patient visits, and group classes at HAVEN are in the planning stages, Levine says.

Patients also receive a social work consultation from students that informs them about agencies that provide assistance with non-medical issues, such as housing. Cynthia Correll, the clinic’s social work coordinator and a second-year medical student, says that most patients are unaware that they may be eligible for public health insurance programs. The applications for such programs are complicated, she says, and they are often not available in Spanish, the language spoken by most of the clinic’s patients. Interpreters on the clinic’s staff help to overcome the language barrier.

The clinic receives funding from all the Yale health profession programs and is seeking grants from community sources. HAVEN works from a list of generic drugs, but patients still find it difficult to afford prescriptions, and the clinic organizers have built up a stock of commonly prescribed medicines to give to patients at low cost.

Yale-New HAVEN Hospital is donating laboratory services to HAVEN, and the students who run the clinic have recruited specialists who have agreed to see patients who are referred to them on a pro bono basis. Almost 200 students are involved in the free clinic, about 30 of whom see patients at HAVEN on any given Saturday.

Working around the constraints facing low-income patients is a skill that can only be learned in practice, according to Mary Bartlett, M.S.N., A.P.R.N., a nurse practitioner and 2000 graduate of the School of Nursing who acts as HAVEN’s medical director along with Laurie Bridger, M.D., assistant clinical professor of medicine and a medical director of the FHCHC.

Bartlett says she is impressed that the students who work in the clinic have opted to gain this experience early in their careers and that they are learning to work in interdisciplinary teams. Bartlett was eager to join the project because of the well-researched business plan the students presented and because of their commitment to the clinic, which she says she finds “revitalizing.”

For the students, the clinic is a way to make a difference the day they arrive in New HAVEN. Rachel Solomon, the clinic’s phlebotomist and a member of the School of Medicine’s Class of 2009, says that although many medical students talk about traveling abroad to do humanitarian work, “there’s a real need in our own community.”