Student-run clinic offers care to kids in need

By Diane Carman

Years ago when Teresa Long was a resident at Warren Village, she tentatively signed up for an appointment for well-child care at something called the Healthy Beginnings clinic, just to see what it was like.

One of her children had a seizure disorder and all of them needed routine immunizations, treatment for the occasional cold or flu virus, check-ups and care for the bumps and bruises that come with normal childhood. The clinic was held nearly every Wednesday evening at Warren Village. It was free and residents could access it right where they lived.

It was fabulous, she said. The interns and the doctors were always very kind and very thorough. It was never a rush-rush kind of situation. If you needed to talk, they were there to listen.

Sixteen years later, she still comes back to the clinic now and then, driving to Denver from her home in Aurora. I just like it, she said.

A Peds Club project

The idea for Healthy Beginnings came from students who were members of a pediatrics club at the University of Colorado School of Medicine in the 1990s.

We wanted to start a clinic, said Dr. Stephanie Stevens, then a medical student and now a practicing pediatrician as well as course director and faculty advisor for Healthy Beginnings, but it was an uphill battle to get Warren Village to want us there. Ultimately they said, Sure, try it. But they didnt expect us to succeed.

Warren Village is a transformational housing program for homeless single parents working to get off public assistance.

The Healthy Beginnings program was roughly modeled after the Stout Street Clinic,which provides health care to the homeless in Denver and gives medical students opportunities for supervised patient contact. The students operate the clinics, setting up individual examining rooms in the large meeting space at Warren Village, scheduling patients and functioning like a typical pediatrics office.

They provide well-child examinations, immunizations, diagnosis and treatment of routine conditions, such as urinary tract infections or bronchiolitis, and referrals to hospitals or specialists for more complicated conditions. A licensed physician supervises the clinics and often conducts instructional discussions after clinic hours. Participating students receive elective credits for the program and the children receive the services for free.

Lab work is done through Denver Health Medical Center or Childrens Hospital, and costs are covered by insurance plans, public health programs such as CHP+ and foundations that have supported Healthy Beginnings since it was launched in 1998.

Convenience a big plus

The residents love having the clinics here, said Elyse Montgomery, director of family services for Warren Village. All residents are

required to work or attend school, so making time for regular doctor appointments is a challenge. The fact that it is so accessible is really helpful, Montgomery said.

Long agreed, noting that when single parents are working to establish themselves in new jobs, it often can be very difficult to get time off to take children to doctors during the work day.

The clinics are good for the med students as well.

A steering committee of students runs the clinics, from fund-raising and scheduling physician advisors to recruiting student participants and managing supplies.

Its very much a student-run project, said Stevens, who has served in every capacity from student and attending physician to course director. For most students its their first opportunity to be a doctor.

Sarah Rosquist, fourth-year med student and co-chair of the Health Beginnings steering committee, said that seeing patients at the clinic stands out as one of the highlights of her experience in medical school. I left every clinic night reinvigorated about medical school.

Throughout medical school, students spend one day a week working alongside licensed physicians, or preceptors. At the clinic, they take the lead, examining the patients, counseling the parents and diagnosing conditions.

Big impact on childrens health

Dr. Stephen Berman, professor of pediatrics at the School of Medicine and the original faculty advisor for Healthy Beginnings, said the students may not have had any made-for-TV moments of diagnosing cancer and dramatically saving a life in the 13 years since the program began, but they have had an enormous impact on the Warren Village families in the innumerable small ways that only good pediatricians can.

They have identified children who needed developmental evaluations and such things as speech therapy and physical therapy, he said.

Most of the children arrive behind in their immunizations and within two years nearly all are up to date. Parents receive counseling on good nutrition, asthma care, safety, developing good sleep habits and how to discipline. And immigrant families learn how to access health care in this country and how to communicate with a doctor.

The attending physicians at the clinics are volunteers from the community. Berman said the original group was comprised of recently retired pediatricians who sought a way to volunteer their services. In more recent years, the retirees have been joined by a wide range of local physicians who agree to attend the clinics anywhere from two nights a year to 20 or more. School of Medicine Dean Richard Krugman has been a frequent volunteer, according to Susan H. France, former executive director of Warren Village.

One of the tasks of the steering committee is to recruit, schedule and manage the attending physicians who volunteer to support the clinic. They maintain a list of back-up volunteers, including some who feel such allegiance to the project they will come at a moments notice to keep it going.

One physician would do it every day, said fourth-year student and committee member Kira Bersanti. She loves it.

Students overcome nerves

Teresa Long said she sometimes sensed nervousness on the part of the students examining her children. After all, most of them were younger than she was.

Are you kidding? said Matt McCullough, fourth-year med student and co-chair of the steering committee. I was terrified.

There are so many things you dont know how to do, said Rosquist. I was so nervous.

But working with the attending physicians gave the students both skills and confidence. Healthy Beginnings has become an essential part of the students development into physicians as well as a vitally important program for the Warren Village families working their way out of poverty.

The program has had really amazing staying power, Berman said. Its been passed down from one generation of medical students to the next.