COLUMBIA — When David Atashroo and his fellow students at the MU School of Medicine set out to create a new health care option for the uninsured, they crossed state lines to the University of Kansas for their inspiration. But to find an increasing and urgent need for affordable health care, they didn’t have to look beyond their own community. In a conversation with friends at the University of Kansas in 2007, Atashroo learned that the KU medical school has a free community health clinic in the Kansas City area. The clinic is staffed by volunteers and has a mission to provide health care to the “medically underserved” while providing hands-on learning opportunities for medical students.
Noting that such a clinic did not exist in the Columbia area, Atashroo and several other medical students got together to talk about making it happen. It was then, Atashroo said, “I realized that this was a way, way bigger undertaking than anything I had done before.”
That undertaking is the future MedZou Clinic, slated to open in a downtown location in the fall of 2008. MU students and medical faculty volunteers plan to staff the free clinic and provide treatment for the uninsured and underinsured. The clinic will not replace any existing health care facilities, but will provide care for acute illnesses such as pneumonia or strep throat along with chronic conditions like hypertension or diabetes.
The beginnings of the MedZou Clinic were slow and marked with hard work and research.
“It took us a while to do it, because we wanted to do it the right way,” Atashroo said. “We really did a long time laying the groundwork.”
The groundwork included attending an educators conference, applying for grants and involving other classes of medical students in plans for the clinic. One of the students’ most important tasks, however, was proving to faculty in the School of Medicine that there was local need. So the students conducted a survey of more than 60 patients at the University Hospital Emergency Department. The results were eye-opening.
More than 50 percent of patients who responded indicated they had difficulties accessing health care in Columbia. Cost and unavailability of appointments were the two reasons cited most often. Twenty-one percent said they had no health insurance at all.
Using 2007 emergency room data, the students estimated that anywhere from 3,000 to 11,000 uninsured patients would pass through University Hospital this year.
“I think there are so many people in Columbia that are completely unaware that this problem exists,” medical student Dan Miller said. “Most have no idea that the problem is so large. There is health care disparity right here, and lots of it.”
Facilities already in place for the uninsured are also under strain. According to executive director Gloria Crull, the Columbia Family Health Center is taking new patients on a limited basis. New patients who are uninsured may have to wait up to eight months for care. Dr. Erik Lindbloom, an MU family medicine faculty member and a volunteer at the Family Health Center, said these problems are related to the Missouri Medicaid cuts of 2005.
“When Medicaid had all the dramatic cuts a few years ago, it greatly increased the number of patients who didn’t have coverage,” Lindbloom said. “All of a sudden a lot of our patients who previously had Medicaid didn’t have Medicaid. The MedZou Clinic is coming around at an ideal time.”
When the MedZou Clinic opens, its first priority will be to work to ease the burden on existing health care facilities.
“One thing that was very important to us, was to work collaboratively with the resources already in place,” medical student Kayla Schleicher said. “Part of our mission is to work closely with community organizations.”
In keeping with that mission, the clinic will initially work primarily with patients on the Family Health Center waiting list. In the future, students anticipate receiving referrals from community organizations such as Centro Latino, the Boone County Health Department and the Salvation Army. There are also plans to enlist the help of students and staff from the MU schools of social work, physical therapy and nursing and the master’s of public health program in providing care.
Much of the funding for the MedZou Clinic will come from a $30,000 grant from the American Association of Medical Colleges. This money will help the clinic meet location costs and purchase medical equipment and supplies on a yearly budget of less than $20,000.
The clinic is also accepting donations of money or medical equipment.
While the medical students said they had considered a nominal co-pay fee, plans at this time are for patient treatment and lab costs to be totally free.
Staff members at the MedZou Clinic will not be paid for their service. But the students hope to gain invaluable real-world experience by volunteering with patients in a community setting. Clinic work will eventually be offered as a medical school elective class.
“This clinic is a perfect opportunity to breed an environment of service and understanding of a different demographic,” Schleicher said. “It’s been invaluable for my education as a medical student and as a person.”
Starting in fall 2008, students at the MedZou Clinic hope to see 15 to 20 patients one day a week. The clinic’s hours may expand to as many nights a week as needed but medical student Dan Miller said in a perfect world, the clinic would not have to be open at all.
“All of us have this sort of intention that we’re not solving any problems,” Miller said. “We’re just doing like a little bit and with that little bit we’re slowly chipping away at something. We’ll do what’s needed.”