When medical school rotations and in-person clinical learning paused earlier this year, because of the coronavirus pandemic, it sidelined medical students when the medical community was being called to action. In response, students mobilized to do what they could to help. Nationally, medical student–led initiatives emerged to support those most vulnerable to the pandemic.
Results of one such initiative by Geisel School of Medicine students, described in “Lessons from a Free Clinic During Covid-19: Medical Students Serving Individuals Experiencing Homelessness Using Tele-Health,” has been published in the October issue of The Journal of Ambulatory Care Management.
Led by second-year Geisel students Katherine “Rin” Heflin ’23 and Leah Gillett ’23, the paper’s lead co-authors, and Abby Alexander Geisel ’20, the Homeless Healthcare Outreach Program is a collaboration between Geisel medical students, Upper Valley Haven, and Good Neighbor Health Clinic that supports those experiencing homelessness in a time of increased health and economic vulnerability. Under the supervision of clinic physicians and administrators—Drs. Peter Mason, Joseph O'Donnell, John Sanders, and John Wasson, along with medical assistant Caroline Watson and Haven staff Renee Weeks and Katie Edwards—the team of Geisel students have been providing regular telehealth check-ins to address the medical, social, and mental health concerns facing this patient population.
To date, 26 individuals are enrolled in the program and have been paired with 16 medical students.
“This project has been a powerful reminder of why I have chosen to add clinical care into my previous public health career: working alongside individual patients to solve tangible challenges together gives me energy as well as a type of hope that public policy work alone does not,” Heflin says. “Both holistic clinical care as well as public health payment and delivery system reforms are necessary to address complex health issues and improve health outcomes for our community's most disadvantaged members.
“When working with individuals struggling with homelessness, chronic health issues, poverty, stigma, or addiction, it's not just the achievements and positive moments that are powerful and personal—the constant setbacks and struggles are also vivid for me. I've found though that I'm developing tools that will help me as I continue this work in the decades ahead, such as unpacking my feelings with peers and mentors—especially the sting of disappointment and heartache when our efforts are not initially successful.
“In that vein,” she concludes, “it has been an absolute delight to work creatively on specific solutions to social and systemic barriers for patients as well as big-picture planning alongside dedicated Good Neighbor and Haven staff, classmates, and particularly physician mentors. Without their support and wisdom during this project, I would not feel as well-prepared to serve the complex and high-need populations I plan to center throughout my career.”
The Haven serves people struggling with poverty by providing a range of support, including food, shelter, education, and service coordination throughout the Upper Valley. For nearly 30 years, Good Neighbor Health Clinic has provided cost-free medical and dental care to uninsured and underinsured adults in the region. The two organizations have been vital to providing critical safety net services to vulnerable community members.
"Typical of their Geisel classmates, these students manifest a strong commitment to social justice and a drive to be of service to the marginalized and disadvantaged members of our society. It is particularly gratifying, from an educational standpoint, for me to see how they integrate their academic knowledge with an understanding of the social determinants of illness,” says Peter Mason, MD, an assistant professor of community and family medicine at Geisel. “They give me optimism, in these difficult times, about the future of medicine. They make me proud to be part of Geisel."
When the pandemic became a reality in the Upper Valley, discussions quickly pivoted to providing healthcare access and accurate information to at-risk people without the resources to shelter or quarantine in place. “Fortunately, a partnership developed with Haven and Good Neighbor staff, Geisel School of Medicine students, and Good Neighbor volunteer physicians,” says Dana Michalovic, executive director of the clinic. “Although the program was expected to be short-lived the need continues. Geisel students Leah Gillette and Rin Heflin, working with a group of Geisel volunteers and their mentors, have taken the lead by continuing to reach out to the most vulnerable of those among us. The Upper Valley community really owes these two student leaders a debt of gratitude for their work over the past seven months.”