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Learning to Practice Population Health
RFU's pro bono Interprofessional Community Clinic (ICC) is an incubator for students who are interested in developing new and better processes of care in the service of vulnerable populations.
Initiated in 2013 by three Chicago Medical School students in response to a significant uninsured and underinsured local population, the ICC in 2018 served 136 patients, 64 percent of them Spanish speakers, across 549 clinical encounters that took place one night each week in the Rosalind Franklin University Health Clinics.
Interprofessional teams of student clinicians and supervising faculty give a level of attention to patients unseen in other student-driven health clinics. They work to understand their patient populations, the conditions in which they live, work and raise their families. They work to build rapport and trust. Writing a prescription or recommending a treatment option is only the beginning of care. Students learn how to discuss the reality behind the visit: Can patients pay for their medication? Do they have transportation to pick it up? Are they convinced of the need for it? Is there a plan for follow-up in case of issues?
Student clinicians continue to apply the knowledge they learned from local community health workers (CHWs) through the RFU-sponsored series of workshops and presentations, "Connecting our Comunidades: Latino Health and Culture." Topics included barriers to care, delivering care in a culturally specific and sensitive manner, and how immigration policies affect health and health care.
ICC patients are often in what CHWs call "survival mode." Many work two or three jobs, often part-time and seasonal, and live in households that fall below the poverty line. Health is not prioritized until problems become severe. It's not uncommon to see men and women with untreated diabetes and its calling card: neuropathy and a foot ulcer. Patients who live in the shadows are suddenly front and center at the ICC during visits that average two hours and offer four co-located services — medicine, podiatric medicine, physical therapy and behavioral health — with additional consults available from pharmacy and nursing.
"As a group, all our knowledge is gathered together and we can act as one provider," said Nicole Delino, SCPM '22, president of the Interprofessional Clinic Initiative, the student organization that operates the ICC. "We really see how together we are so much stronger."
Other ICC population health interventions include education in support of patient self-management and the cultivation of community and clinical partnerships to help meet patient needs for housing, food, legal assistance and more complex medical care.