Highs & Lows of Free Clinic Volunteering

November 19, 2015

A heartrending sense of limits and financial hardships is tempered by the crackling energy of the volunteers and celebrations of patient successes.

“Where else would the underserved go if we weren’t there?”

Sunny Smith, MD, Co-Director, UCSD Student-Run Free Clinic

I’ve just wrapped up a long Monday in clinic, usually one of the busiest days of the week. I will have exhorted patients whose diabetes is not yet at goal to select one change they’d like to focus on implementing, or if they already have made a change, to check in on their progress. Or at times – and I love these moments – I’ll have congratulated those who have either reached or sustained optimal control. These visits are interspersed with tending to the seemingly endless paperwork and messages. But I’m not done yet. I’m heading south on the highway to the downtown location of the University of California, San Diego Student-Run Free Clinic.

I see stark contrasts. On the one hand, there’s a heartrending sense of limits, such as having only metformin, glipizide, or Lantus to prescribe. I hear about the crushing financial pressures the patients face every day. On the other, there’s an uplifting feeling. The clinic is crackling with energy, from the spark that accompanies learning and teaching, and the enthusiasm of the students as well as of the attendings from the University and the San Diego community who volunteer.

Many of the patients we see have diabetes, and we celebrate the successes – a 56-year-old gentleman whose A1c decreased markedly after he made significant lifestyle changes. He proudly noted cutting his consumption of tortillas. We discuss a patient who has chronic abdominal pain, only to ultimately be diagnosed with primary hyperparathyroidism.

Founded in 1997 by Ellen Beck, MD, the UCSD Student-Run Free Clinic had modest beginnings. The first night, the team saw 10 patients in a church space. The clinic now offers primary care and specialty clinics, among others, endocrinology, cardiology, nephrology, pulmonary, neurology, and podiatry. Other services include acupuncture, a dental clinic, and legal advice. Medical, pharmacy, social work, public health, and other pre-health profession students from UCSD come together to both learn and teach.

This clinic is one of approximately 24 student-run clinics in the United States. The clinics currently serve 2,500 patients and have helped more than 75,000 people in this country.

Michelle Johnson, MD, Co-Director of the UCSD Free Clinic, noted that glucose test strips alone cost an astounding $25,000 per year. The larger problems of the health care system seem magnified here, as many patients fall into the working-poor category – those who earn too much to qualify for assistance but too little to pay for insurance out-of-pocket.

I urge each of you to consider volunteering your time at your local free clinic. The physicians of tomorrow are ready to absorb your clinical acumen and your wisdom.

For me, Mary Richards-Moya, MD, a UCSD School of Medicine alumna, best captured what we feel. “The free clinic has been the most special part of medical school for me – it’s the part, when I think about medical school 20 years from now, that I’ll always remember.”

For more information on the UCSD Free Clinic, please contact: Anne Crane, at acrane@ucsd.edu or visit http://meded.ucsd.edu/freeclinic.

For more information on Project Access, visit http://sdcmsf.org/programs/project-access-san-diego/.

The National Association of Free and Charitable Clinics: http://www.nafcclinics.org