Team-Based Care

The increasing complexity of medical care demands the team approach practiced at the Interprofessional Community Clinic, where students are learning to carry the torch of interprofessionalism for a new generation of patients and practitioners. 

The new patient, a single mom who spends more than 60 hours a week standing at her job at a grocery store, hobbled into the Interprofessional Community Clinic (ICC). Previously diagnosed with a callus, she was now surrounded by a small team of students, both podiatric and medical, who conducted a thorough health history and detailed physical exam. They asked lots of questions, and listened. 

“We discovered that a ligament that helps support bones at the ball of the foot had ruptured, causing the instability of the joint and resulting in increased pressure and pain,” said Ashka Trivedi, DPM ’11, ICC podiatry attending. “The callus that had developed was due to a structural injury.”

Our students are gaining early clinical exposure and access to a greatly underserved community of patients who struggle with chronic diseases and disease management.” -Martin Yorath, DPM ’94

The patient left the clinic with a new diagnosis — plantar plate injury — and a conservative option for treatment — orthotic modifications and padding. She also had hope of a referral for the surgery that would not only bring her relief from pain, but take into consideration her finances and family obligations.

Podiatry specialty clinic students and providers, collaborating with other ICC disciplines — nursing, psychology, medicine, pharmacy and physical therapy — offer both patient-centered care and student-centered learning. A small group of interprofessional students sees every patient then presents to a team of faculty attendings, like rounds at a hospital, then all work together to create a treatment plan.

“Our students are gaining early clinical exposure and access to a greatly underserved community of patients who struggle with chronic diseases and disease management,” said Martin Yorath, DPM ’94, associate professor and medical director of the Rosalind Franklin University Health Clinics, which houses the ICC. 

Shruti Dosi, a second-year student at Dr. William M. Scholl College of Podiatric Medicine and past student podiatry leader of the ICC, said demand is great for physicians who understand the diabetic foot and value a team approach to care.

“RFU’s mission is interprofessionalism and that’s exactly what the clinic is doing,” Shruti said. “As a podiatry student in the clinic, you also see the patient as a whole. You’re reminded that the feet are not a separate entity.”

“Health care has become so complicated one person can’t do it all,” said Nancy L. Parsley, DPM ’93, MHPE, Scholl College dean and RFU associate provost of interprofessional strategy. “Podiatric medicine lends itself well to functioning in an interprofessional environment. You can’t treat patients with complex diseases like diabetes in isolation. It’s the feet, the eyes, the kidneys, the management of blood sugar, the potential complications of a hospitalization and more.”

Justin Krautbauer, CMS ’19, president of the initiative that runs the ICC, notes the reciprocal benefit of the podiatry specialty clinic. Scholl College students gain interprofessional experience with medical patients, while students from other disciplines gain exposure to podiatric services.

The interprofessional teams — nursing, pharmacy, physical therapy, medical, psychology and podiatric students — are critical. They are the core of the clinic.” -Melissa Chen, MD

“The interprofessional teams — nursing, pharmacy, physical therapy, medical, psychology and podiatric students — are critical. They are the core of the clinic,” said Melissa Chen, MD, assistant clinical professor and ICC internist. “It’s really impressive and wonderful to see interprofessionalism in process, to see it come alive and to see students internalize how to work with each other.

“My pharmacy colleague knows drug interactions; my nursing colleagues know so much more about educating patients than I do; my PT colleagues know how to evaluate this musculoskeletal complaint; my psychology colleagues can help with counseling and motivational interviewing. And because so many problems manifest in the lower extremity, I need the knowledge of the podiatrist.”

This story first appeared in the Spring 2016 issue of Helix.