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This study examines patient care in the SHOW free clinic in Phoenix, Arizona, which serves adults experiencing homelessness. This study asks two questions: First, do clinicians in Phoenix’s SHOW free clinic discuss with patients how to pay for and where to access follow-up services and medications? Second, how do the backgrounds of patients, measured by scales based on the Gelberg-Anderson behavioral model for vulnerable populations, correlate with patient outcomes, including number of unmet needs in clinic, patient satisfaction with care, and patient perceived health status? To answer these questions, structured surveys were administered to SHOW clinic patients at the end of their visits. Results were analyzed using Pearson’s correlations and odds ratios. 21 patients completed the survey over four weeks in February-March 2017. We did not identify any statistically significant correlations between predisposing factors such as severity/duration of homelessness, mental health history, ethnicity, or LGBTQ status and quality of care outcomes. Twenty nine percent of surveyed patients reported having one or more unmet needs following their SHOW clinic visit suggesting an important area for future research. The results from this study indicate that measuring unmet needs is a feasible alternative to patient satisfaction surveys for assessing quality of care in student-run free clinics for homeless populations.
Due to the COVID-19 pandemic, pre-health individuals around the world encountered a range of challenges. Research and internship opportunities were cancelled, clinical experience was unreachable, and prerequisites became more demanding in a remote setting. I myself was working in a research lab in Switzerland when the pandemic was declared, resulting in my career-altering internship to be cut short six months. My life-long friend, Alejandra, had the same experience and reached out to me with an extraordinary idea to unite and empower pre-health individuals on a national level. With my skills in event planning combined with her vision, we built the National Pre-Health Conference (NPHC): a 3-day virtual event for pre-health individuals to explore medical careers and learn how to pursue their professional goals, particularly during these uncertain times. We held our inaugural conference with the theme A Future in Medicine in 2020 with over 1000 attendees from around the country. In 2021, we held our second-annual conference with the theme Unity in Healthcare with over 1000 attendees as well. In addition to planning the second-annual NPHC, I employed pre-event and post-event surveys to assess the confidence level of attendees before and after the conference in healthcare experience, research experience, standardized testing, community service, academics, essay writing, and completing graduate/professionals school applications. We found that NPHC improved the confidence level of attendees in all categories. Overall, understanding how NPHC benefits pre-health students will help our team improve for future conferences.
Despite differences in schooling and clinical experience prior to practice, advanced practice providers often have similar scopes of practice, which raises concerns about the quality of care being provided. In this paper, we explore if prescribing patterns are comparable between provider types by comparing differences in time spent on pharmacological interventions utilizing a simulated healthcare environment. Physicians (MDs and DOs), Nurse Practitioners (NPs), and Physician Assistants (PAs) actively practicing in Family Practice/Medicine or Internal Medicine in the U.S. state license/recognition were recruited at healthcare conferences and simulation centers. Participants were provided 20 minutes to complete the patient consultation on a Standardized Patient (SP) presenting with a chief complaint of a post-hospitalization follow-up for heart failure, fatigue, and some edema. All encounters were recorded and uploaded to be reviewed by undergraduate evaluators, who were responsible for quantifying the amount of time the participants spent on each of the task categories, including pharmacologic interventions. With a total of 46 participants in this study, the average amount of time spent discussing this activity per visit across each provider type was 14.8 seconds for MDs/DOs, 29.2 seconds for NPs, and 38.8 seconds for PAs. The results of this study suggest that PAs (p= 0.0028) spent significantly more time discussing pharmacological interventions and were significantly more likely to discuss pharmacological interventions (p=0.0243) when compared with physicians (MD/DOs). It is important to note that the sample size of PAs was very small (N=9), which could potentially skew the results and not be representative of the population. With limited literature that examines whether time spent discussing pharmacological interventions is comparable across provider types, it is important for more simulated healthcare research to be conducted on this topic.
