Students serve uninsured, hone skills at JayDoc Clinic

February 17, 2014

By Joe Stumpe

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The JayDoc Community Clinic was started for people just like Michelle Whitley.

Whitley, a 45-year-old Wichitan, suffers from lupus, an autoimmune disease that requires regular monitoring of her medication and condition. She has a part-time job in a warehouse, but no health insurance. On a recent Saturday at the clinic, she was able to have her lupus checked and also get a flu shot, all for a $5 donation and without having to miss so much as an hour from work.

"I loved it. They were very friendly," Whitley said of clinic personnel.

The clinic is staffed by students from the University of Kansas School of Medicine–Wichita, whose predecessors started the clinic in 2005. Supervised by physician volunteers from the community, the students see several hundred low-income, uninsured patients each year.

The goal is simple, said Daniel DeJong, a fourth-year medical student who is the clinic's senior executive director. "We want to provide the best medical care we can. Patients who have never had insurance or have lost it, we provide them an option to maintain access to health care through those unfortunate times."

The clinic, located in the Guadalupe Clinic building at 940 S. St. Francis, is open from 9 a.m. to 1 p.m. Saturdays. It offers acute care for illnesses and injuries, assistance with medicine and medical equipment, chronic disease management, diagnostic tests, diabetes care, women's health (excluding prenatal care), patient education, and referrals to specialists.

The clinic was the brainchild of former KU students Jennifer Koontz and Robin Linscheid. Koontz and Linscheid started their medical studies at KU's Kansas City campus and were active in organizing the first JayDoc clinic there, before finishing their degrees in Wichita.

"I was excited for their interest in doing this," said Dr. Scott Moser, of the Wichita campus' department of Family and Community Medicine. Moser has been the clinic's faculty advisor since its inception.

Koontz, who now practices at Pinnacle Sports Medicine in Newton, still volunteers at the clinic, while Linscheid, after volunteering at hospitals in Paraguay for a year, returned to her native Fresno, Calif., to practice.

Moser said the pair researched the needs of the community and realized that, while there were several "safety net" clinics, none were open on the weekend. "One of the challenges for the working poor is they can't leave work to go see the doctor," Moser said.

Students assigned to the family medicine rotation are required to help out at the clinic, but many other students also volunteer. In 2013, 86 students spent at least one Saturday there, along with 30 attending physicians. They saw a total of 379 patients, up from 284 the year before.

Students get more out of the experience than just the good feeling that comes with helping people. They get an opportunity to see patients, make diagnoses, and develop plans of action -- albeit under the watchful eyes of the attending physicians.

"It's helpful for us because the doctors are pretty lenient with letting us be the doctors," said Caitlin Chiles, a third-year student from Wichita who is the junior executive director, and who will succeed DeJong next year. "We have a lot more autonomy than we do in any other setting."

Moser agrees. "They are supervised, but they are the main ones the patients see when they come in," he said. "They also get to see more serious disease, and patients who are in worse shape, because they haven't been able to get access to preventive care and management throughout their lives. These people tend to be sicker than patients they see otherwise."

The students work in teams, pairing less-experienced first-year and second-year students with more seasoned third-year and fourth-year students. During a typical patient visit, a first-year student was taking vital signs and basic history; a second-year student completed the examination. Third-year students might oversee the whole encounter and recommend treatment, while a fourth-year student would manage several encounters at once.

All patients are also seen by attending physicians, who confer with the students regarding treatment plans.

DeJong's most memorable experiences at the clinic have been when a patient's situation was serious enough that he or she needed to be transported to a hospital emergency room. "There might have been patients who wouldn't have made it without (visiting the clinic)," he said.

Responding to other needs in the community, the JayDoc Clinic also recently started opening on two Wednesday nights a month. One is devoted to providing comprehensive care for patients with diabetes. The other offers Pap smears and colposcopy exams.

DeJong has never seen a clinic patient express surprise or concern at being cared for by a student. "I think it's well accepted," he says.

Whitley, the lupus patient, agreed after making her first visit to the clinic. While she noticed that her caregivers "were pretty young," she also calls them "very thorough."

And a couple weeks later, the advice that she get a flu shot seemed to be paying off.

"I haven't caught anything yet," she said.

KU School of Medicine–Wichita
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