Empowering Communities: The Role of Free Medical Clinics in the United States and the Contribution of Medical Students

 

Prathyusha Dasari
ACP Council of Student Members

— MEDICAL SCHOOL —
University of California
Riverside School of Medicine

— GRADUATING CLASS —
2024
 

Access to health care is a critical aspect of public well-being, yet a significant portion of the U.S. population faces barriers to obtaining medical services. The more than 1,400 free medical clinics and medical pharmacies play a vital role in addressing this issue by providing essential health care services to underserved communities (1). This article explores the landscape of free medical clinics in the United States and sheds light on the invaluable contribution of medical students in supporting these clinics.

Despite advances in medical care, a considerable number of Americans still lack access to affordable health care, with 26 million being uninsured and approximately 30 million living in "health care deserts" (2, 3). This is often due to financial constraints, lack of insurance, or geographical barriers (4-6). Free medical clinics emerge as a response to these challenges, acting as beacons of hope for individuals who might otherwise go without essential medical services (7).

Free medical clinics are nonprofit organizations that provide medical, dental, pharmaceutical, and—sometimes—mental health services to individuals without insurance or the means to afford health care. These clinics are often staffed by dedicated health care professionals who volunteer their time and expertise.

Here is a list of services offered by free medical clinics:

  • Primary Care: Free medical clinics serve as primary care providers for many individuals who lack regular access to health care.
  • Preventive Services: These clinics often focus on preventive care, promoting health and wellness within the communities they serve.
  • Chronic Disease Management: Managing chronic conditions is a crucial aspect of free medical clinic services, helping patients control diseases such as diabetes, hypertension, and asthma.
  • Dental Care: Some clinics extend their services to include dental care, addressing oral health needs in underserved populations.
  • Pharmaceutical Care: Charitable pharmacies exist sometimes in conjunction with free clinics so patients are able to fill their prescription and start their health care journey.

Medical students play a significant role in supporting the operations of free medical clinics. Their involvement goes beyond the scope of their educational curriculum and becomes a commitment to serving the community (8). Contributions of medical students include:

  • Direct Patient Care: Under the guidance of licensed health care professionals, medical students participate in providing direct patient care, honing their clinical skills while making a tangible impact.
  • Health Education Initiatives: Medical students often engage in community outreach programs, providing health education on topics such as nutrition, preventive care, and managing chronic conditions.
  • Administrative Support: From scheduling appointments to maintaining patient records, medical students contribute administratively to the efficient functioning of free medical clinics.

Benefits of medical student involvement:

  • Increased Capacity: Medical students contribute to the increased capacity of free clinics, allowing these organizations to serve a larger number of patients.
  • Early Diagnosis: Without free clinics, the uninsured population will not have the same access to high-quality care and will have diseases longer before they are diagnosed and receive treatment (9-11).
  • Decreased Demand on Emergency Departments: Without the option of free clinics, the uninsured population will either opt to not get medical care or use emergency departments (12, 13).
  • Community Engagement: Involvement in free medical clinics exposes medical students to diverse patient populations, fostering cultural competence and community engagement (14, 15).
  • Hands-On Learning: Students gain hands-on clinical experience, enhancing their medical education and preparing them for future patient care roles. This increases their motivation to work with the underserved population in the future and choose primary care specialties (16-18).
  • Advocacy and Awareness: Through their participation, medical students become advocates for health care accessibility, raising awareness about the importance of community clinics in addressing health disparities (15, 16, 19).

Free medical clinics serve as essential pillars in the quest for equitable health care. The collaboration between these clinics and medical students is a symbiotic relationship that benefits communities in need and enhances the education of future health care professionals. As we acknowledge the pivotal role of free medical clinics, we must also celebrate the dedication of medical students who contribute their time and skills to make a positive impact on the lives of those who need it most. In the multiple free clinics in the Inland Empire in California, such as Riverside Free Clinic, San Bernardino Free Clinic, Street Medicine Free Clinic, Pomona Free Clinic, and Coachella Valley Free Clinic, volunteer medical students, nursing students, and pharmacy students help patients in the Inland Empire who do not have the same access to care due to health care and socioeconomic disparities.

References

  1. The National Association of Free & Charitable Clinics (NAFC). Home page. Accessed at https://nafcclinics.org on 13 January 2024.
  2. Peter G. Peterson Foundation. The Share of Americans without Health Insurance in 2022 Matched a Record Low. 9 November 2023. Accessed at www.pgpf.org/blog/2023/11/the-share-of-americans-without-health-insurance-in-2022-matched-a-record-low on 13 January 2024.
  3. Webb J. Contributed Content: Left Stranded: Millions in Healthcare Deserts Battle for Access to Life-Saving Services. HealthLeaders; 5 September 2023. Accessed at www.healthleadersmedia.com/innovation/contributed-content-left-stranded-millions-healthcare-deserts-battle-access-life-saving on 13 January 2024.
  4. Call KT, McAlpine DD, Garcia CM, et al. Barriers to care in an ethnically diverse publicly insured population: is health care reform enough? Med Care. 2014;52:720-727. [PMID: 25023917] doi:10.1097/MLR.0000000000000172
  5. Douthit N, Kiv S, Dwolatzky T, et al. Exposing some important barriers to health care access in the rural USA. Public Health. 2015;129:611-620. [PMID: 26025176] doi:10.1016/j.puhe.2015.04.001
  6. Wolters Kluwer. Five Key Barriers to Healthcare Access in the United States. Accessed at www.wolterskluwer.com/en/expert-insights/five-key-barriers-to-healthcare-access-in-the-united-states on 13 January 2024.
  7. Birs A, Liu X, Nash B, et al. Medical care in a free clinic: a comprehensive evaluation of patient experience, incentives, and barriers to optimal medical care with consideration of a facility fee. Cureus. 2016;8:e500. [PMID: 27014534] doi:10.7759/cureus.500
  8. Smith SD, Yoon R, Johnson ML, et al. The effect of involvement in a student-run free clinic project on attitudes toward the underserved and interest in primary care. J Health Care Poor Underserved. 2014;25:877-889. [PMID: 24858891] doi:10.1353/hpu.2014.0083
  9. Ayanian JZ, Weissman JS, Schneider EC, et al. Unmet health needs of uninsured adults in the United States. JAMA. 2000;284:2061-2069. [PMID: 11042754] doi:10.1001/jama.284.16.2061
  10. Baicker K, Taubman SL, Allen HL, et al; Oregon Health Study Group. The Oregon experiment---effects of Medicaid on clinical outcomes. N Engl J Med. 2013;368:1713-1722. [PMID: 23635051] doi:10.1056/NEJMsa1212321
  11. Garfield R, Licata R, Young K. The Uninsured at the Starting Line: Findings from the 2013 Kaiser Survey of Low-Income Americans and the ACA. KFF; 6 February 2014. Accessed at www.kff.org/uninsured/report/the-uninsured-at-the-starting-line-findings-from-the-2013-kaiser-survey-of-low-income-americans-and-the-aca on 13 January 2024.
  12. Gertz AM, Frank S, Blixen CE. A survey of patients and providers at free clinics across the United States. J Community Health. 2011;36:83-93. [PMID: 20532596] doi:10.1007/s10900-010-9286-x
  13. Butala NM, Murk W, Horwitz LI, et al. What is the quality of preventive care provided in a student-run free clinic? J Health Care Poor Underserved. 2012;23:414-424. [PMID: 22643487] doi:10.1353/hpu.2012.0034
  14. Haq CL, Cleeland L, Gjerde CL, et al. Student and faculty collaboration in a clinic for the medically underserved. Fam Med. 1996;28:570-574. [PMID: 8884254]
  15. Eckenfels EJ. Contemporary medical students' quest for self-fulfillment through community service. Acad Med. 1997;72:1043-1050. [PMID: 9435709] doi:10.1097/00001888-199712000-00013
  16. Ko M, Edelstein RA, Heslin KC, et al. Impact of the University of California, Los Angeles/Charles R. Drew University Medical Education Program on medical students' intentions to practice in underserved areas. Acad Med. 2005;80:803-808. [PMID: 16123457] doi:10.1097/00001888-200509000-00004
  17. Tippets E, Westpheling K. The Health Promotion-Disease Prevention Project: effect on medical students' attitudes toward practice in medically underserved areas. Fam Med. 1996;28:467-471. [PMID: 8818615]
  18. O'toole TP, Hanusa BH, Gibbon JL, et al. Experiences and attitudes of residents and students influence voluntary service with homeless populations. J Gen Intern Med. 1999;14:211-216. [PMID: 10203632] doi:10.1046/j.1525-1497.1999.00319.x
  19. Coulehan J, Williams PC. Vanquishing virtue: the impact of medical education. Acad Med. 2001;76:598-605. [PMID: 11401802] doi:10.1097/00001888-200106000-00008

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