Free Clinic Research Collective

Letter From the Editor

Abigail Lewis, Lauren Rahman, Whitney Stuard Sambhariya, MD PhD — Sat, 01 Jul 2023 09:48:30 -0700

Assessing Access to Advanced Dermatologic Healthcare for Underinsured Free Clinic Patients

Sat, 01 Jul 2023 09:18:02 -0700

Background: Agape Dermatology Student Run Free Clinic serves the dermatologic needs of underinsured patients in the Dallas-Ft. Worth community. Patients with complex or recalcitrant diseases can be referred to Parkland County Hospital system through Parkland Financial Aid (PFA) program, which provides financial assistance for medical services. The purpose of this study was to characterize the demographics and outcomes of patients referred from Agape Dermatology Free Clinic to Parkland PFA.

Methods: Data from Agape's electronic health record (AthenaOne) and Parkland's electronic health record (Epic) was collected from 2018 to 2022. Retrospective chart review was performed to obtain the following primary outcomes: patient demographics, reason for referral, status of referral, approval rates, and reason for denial for the PFA program.

Results: Sixty-eight patients were referred from Agape Dermatology to Parkland PFA. The most common diagnoses for referral were: psoriasis (22.1%), vitiligo (10.3%) and lipoma (7.35%). The majority of patients reported Spanish as their primary language. Twenty-one patients were approved for PFA. The primary reason that patients did not receive PFA was failing to start their application. Barriers that may have prevented initiation of a PFA application include miscommunication, lack of expectations about the time and steps required to apply, language barriers, lack of printer resources, and inability to obtain documentation (e.g. employer letters or utility bills).

Conclusions: Our analysis has identified a substantial need for improving the referral process from a dermatology free clinic to more advanced healthcare. Future work includes conducting patient interviews and surveys to define individual challenges and implementing targeted interventions to optimize the PFA integration process.

A Manager’s Perspective: Implementation and Evolution of a Novel Telehealth Protocol in a SRFC

Sat, 01 Jul 2023 09:22:30 -0700

The student-run component of the Agape Clinic restarted virtually during the COVID-19 pandemic. Utilizing the pre-existing telehealth protocol to abide by strict safety restrictions, Agape was the only active student-run free clinic (SRFC) on campus. Initially, the virtual protocol combined Doximity Dialer and Microsoft Teams; however, limitations of this protocol hindered patient care. As the need to continue virtual clinic operations became apparent, the Agape clinic managers implemented a new virtual workflow using Zoom. After over a year of virtual operations, a successful telehealth protocol was developed – one that can be an asset to SRFCs beyond COVID-19.

UT Southwestern Student-Run Free Clinic: Reducing Patient Wait Time

Meghana Gogineni, Milan Ho, Nora Gimpel, MD — Sat, 01 Jul 2023 09:36:38 -0700

Agape Multidisciplinary (Agape MD) is a student-run free clinic partnership between UT Southwestern and the Agape Clinic serving patients in Dallas, Texas. As medical student clinic managers, we noticed lengthy wait times for patients. After tracking wait time over 6 months, we report patient wait times for each component of the visit and used root cause analysis to identify strategies for and obstacles to reducing wait time. Based on this analysis, we plan to stagger appointment times, streamline intake and check-out times, and recruit more faculty members to support our patient volume.

A Shot of Hope

Brandon William Moritz — Sat, 01 Jul 2023 09:42:14 -0700

A third year medical student shares a reflection from the COVID-19 pandemic and from his first time administering a COVID-19 vaccine to a patient at The University of Oklahoma College of Medicine's student-run free clinic, Unity Clinic.

Clinic and COVID

Lindsey Taylor Webb — Sat, 01 Jul 2023 09:44:49 -0700

This is a reflection of a second-year medical student's clinical experience with the unexpected effects of COVID. It takes you from the emotions of the first face-to-face clinical experience through the separation thrust upon all to the revelation of a new way to practice medicine. The reflection reminds the reader that the reason medical students work so vehemently is to make a difference in the lives of others.