Journal of Student-Run Clinics

Patient-Level Factors Associated with Antihypertensive Prescribing Patterns in a Free Clinic Setting

2025-03-19T02:23:08-05:00

Background: Hypertension is the world’s leading cause of cardiovascular disease and premature death. In the United States, non-White adults have higher rates of hypertension, yet lower rates of treatment. Furthermore, underinsured and uninsured populations experience unique barriers, receive fewer and lower quality healthcare services, and are the focus of less research; however, student-run free clinics (SRFCs) help address this gap and treat conditions like hypertension. This study assessed patient-level factors that may influence prescribing patterns for hypertension at SRFCs.

Methods: A chart review was conducted on patients diagnosed with hypertension (N=799) seen from January 2013-February 2020 inclusive at one SRFC network. The outcome variable was receipt of antihypertensive medication. A logistic regression analysis assessed the association between antihypertensive prescribing and patient-level variables (age, comorbidities, race, sex, education, language, housing, insurance status, transportation, employment status).

Results: After controlling for other factors, those with two or more comorbidities were more likely to be prescribed an antihypertensive than those with no comorbidities (odds ratio [OR] 1.31, 95% Confidence interval [CI] 1.04-1.65, p=0.021). When compared to non-Hispanic White patients, Hispanic patients were around 40% less likely to be prescribed an antihypertensive (OR 0.58, 95% CI 0.36-0.92, p=0.03). Insured patients were 60% less likely to be prescribed an antihypertensive than uninsured patients (OR 0.40, 95% CI 0.22-0.75, p=0.004).

Conclusions: This study found that, at an SRFC network, differences in antihypertensive prescribing exist by comorbidities, race, and insurance status, indicating patient-level hypertension treatment disparities in this population. This study suggests the need for research into how patient-level factors influence physicians’ treatment decisions and how educating SRFC patients about medication assistance programs can mitigate insurance-related disparities.

Characterization of Metabolic Illnesses and Metabolic Syndrome in an Underserved, Predominantly Hispanic/Latino Population at a Local Student Run Free Clinic

2025-04-09T18:01:20-05:00

Background: Lestonnac Clinics address a disparity in access to United States healthcare, providing free primary care to underserved populations. Student-run free clinics (SRFCs) consistently report high rates of metabolic illnesses, particularly within Latinx communities. However, research is limited on how these conditions co-occur within SRFC settings, leaving a gap in understanding their interplay and priority areas of care. This study aims to assess metabolic illness prevalence and comorbidity patterns in a SRFC with primarily Latinx patients.

Methods: This retrospective study analyzed data from uninsured patients (n=564) seen at a Lestonnac free clinic in Orange County, California, between 2019 and 2021. De-identified electronic health records were collected and included demographics, vitals, body mass index, and diagnoses of diabetes, fatty liver, hyperlipidemia, and hypertension. Statistical analysis using JMP were run including descriptive statistics, prevalence of metabolic illnesses and comorbidities, and Chi-square tests comparing condition proportions between two age groups, <50 years and ≥50 years (p<0.050).

Results: Findings revealed differences in diagnosis prevalence between age groups of 564 total patients, with those ages ≥50 showing the higher rates of hyperlipidemia, hypertension, and their co-occurrence, compared to those ages <50. Patients exhibited elevated rates of diabetes (28.7%), and hyperlipidemia (33.2%), surpassing national averages for Hispanic/Latino populations, 11.1% and 10.9%, respectively. However, our clinic demonstrated lower prevalence of fatty liver (15.3%), and hypertension (34.0%) compared to national data, 22.9% and 38.6%, respectively.

Conclusion: Our patients aged ≥50 had significantly higher rates of hyperlipidemia, hypertension, and their co-occurrence, while younger cohorts exhibited a high rate of hyperlipidemia. Diabetes and hyperlipidemia rates at our clinic exceeded national averages, underscoring the need for interventions targeting hyperlipidemia prevention in younger cohorts and hypertension, hyperlipidemia, and diabetes management in the aging population. Future research should aim to identify social determinants of health experienced by these patients to enhance prevention effectiveness.

Reaching the Homeless Patient Population: A Novel Student-Run Clinic Outreach Program

2025-03-31T17:51:49-05:00

Introduction: The Bishop Dudley Hospitality House (BDHH) is a non-profit organization founded in 2015 that provides support services, resources, and shelter to the poor and homeless community members of Sioux Falls, South Dakota. Recognizing that physical access to healthcare is a major barrier for many individuals that utilize the BDHH, University of South Dakota Sanford School of Medicine student leaders at the Coyote Clinic instituted a bimonthly satellite clinic in the on-site BDHH clinic room.

Methods: In this study, we first describe the establishment of the collaboration between a student-run free clinic and a community homeless shelter. Additionally, to demonstrate the impact of such an outreach and subsequent referral program, we have collected and analyzed data regarding the demographics, insurance status, and access to a primary care provider of the patients, their chief complaints, acuity level, referrals, and whether they attended their follow-up appointment.

Results: Over the course of February 1, 2022 through June 30, 2023, a total of 80 clinical encounters and 57 patients were seen at the Coyote Clinic BDHH Satellite Clinic. A total of 29 referrals to the main Coyote Clinic downtown were made and one patient was sent to the Emergency Department directly from BDHH.

Conclusions: The BDHH satellite clinic has created an additional entry point for healthcare to a high-risk population. Our hope is this model can be adopted by other student-run free clinics seeking to serve similar patient populations.

Chicago’s South Side Free Clinic: A Medical Student-led Initiative and Community-Focused Effort to Re-engage Residents with Healthcare

2025-05-22T03:35:11-05:00

Student-run free clinics (SRFCs) can provide primary care options for historically underserved communities. Chicago’s South Side is a predominantly African American community with poor access to medical care. Previously, SRFCs did not service this patient population. The South Side Free Clinic (SSFC) is a SRFC founded to establish sustainable health services directed by community organizations and stakeholders. University of Chicago Pritzker School of Medicine student leaders conducted a clinical needs assessment (CNA) identifying healthcare barriers. Through this com-munity-focused approach and an interdisciplinary partnership, the SSFC aimed to rebuild medical trust, to increase healthcare access, and to address health disparities. Between April-August 2022, 115 CNA responses were collected (South Side residents: 61% (70/115) versus non-South Side residents: 39% (45/115). Sixty-four percent (45/70) of South Side respondents stated they could afford their health insurance, however 72% (34/45) of respondents living outside of the South Side could not. The majority, 67% (77/115) of participants, reported that they would attend a SRFC. Since opening, the clinic has provided general medical check-ups, over-the-counter medications, point-of-care testing, routine access to primary care physicians, and preventive health services. Patient feedback, long-term surveillance, workflow efficacy tracking, and quality improvement metrics will help assess the South Side’s healthcare needs and identify future clinic service requirements. Ultimately, the SSFC will highlight and address the health care disparities impacting disadvantaged communities in Chicago’s South Side.

CommunityCare Free Medical Clinic: A Model of an Entirely Student-Driven Free Clinic in Your Backyard

2025-05-29T03:40:35-05:00

Student-run free clinics improve health care access for underinsured patients in the United States. This descriptive report delves into our unique, entirely student-led model aimed at deliver-Ing healthcare services to underserved communities and how our model combines many services offered at other student-run free clinics. According to the 2022-2023 Lucas County Community Health Assessment, 6% of Lucas County, Ohio, adults were uninsured, with 12% of Black adults being uninsured. Targeting this historically underserved demographic informed the location of some of our clinic sites. To ensure that our student-led initiative maintains the same quality as a federally-funded clinic, we prioritize working in interprofessional teams of students and providers. To reduce the burden of transportation, we also seek to provide as many on-site ancillary ser-vices as possible, such as vision screening and point-of- care lab testing. Additionally, we provide extensive medical trainee education focused on integrating inclusivity, cultural sensitivity, and patient advocacy. We seek to provide a cost-effective, replicable clinic model and empower the next generation of medical trainees to advocate for underserved communities across the United States.

Model for Providing Wrap-Around Care for Patients with Substance Use Disorders at a Single-Site, Urban Student-Run Free Clinic

2025-06-03T03:45:53-05:00

Patients with substance use disorders (SUDs) have low levels of care access and utilization, driven by factors such as medical provider stigma, disinterest and inadequate education. Student-run free-clinics (SRFCs) are uniquely positioned to begin addressing these interlocking problems, with impact possible both in the near and long-term - for example, the potential to increase access to care for patients with SUDs now while also preparing medical students to enter the workforce as physicians equipped to provide this population with stigma-free, evidence-based care in the future. However, few SRFC-based interventions aimed at caring for this patient population have been implemented or published in the literature. The authors aim to fill this gap by describing a pilot intervention that aspires to provide wrap-around services to patients with SUDs at the East Harlem Health Outreach Partnership (EHHOP), a single-site, urban SRFC. Prior to this intervention, EHHOP already had a strong groundwork in place to care for patients with SUDs, consisting of primary care integrated with opt-in mental health care, capable of providing both pharmacotherapy and psychotherapy. The pilot intervention described here aims to fill gaps in this groundwork, specifically (1) improved patient identification through universal patient screening and connection to immediate care through creation of a consult/liaison service, (2) increased student-provider education to address variable levels of prior experience, and (3) strengthened harm reduction infrastructure to offer both on-site education and resources, with seamless referrals to community organizations for services physically unavailable in the clinic. In describing this process of addressing gaps in effort to provide wrap-around services for EHHOP patients with SUDs, the authors aim to provide a scalable model for peer SRFCs to adapt to better their care for this patient population.

Student-Run Clinic Mental Health Services

2025-06-05T03:46:37-05:00

Introduction: Student-run clinics (SRCs) are a critical healthcare resource in Sacramento for people experiencing homelessness, people who inject drugs (PWID), and uninsured people. University of California, Davis (UC Davis) School of Medicine-affiliated SRCs are staffed by volunteer students and physicians to serve the Sacramento community at no cost to the patient. Two of these clinics, Willow Clinic and Joan Viteri Memorial Clinic (JVMC), host a free, joint mental health care clinic to support the psychiatric needs of their overlapping patient populations. This descriptive report details the Willow Clinic and JVMC mental health clinic model, reflecting on the three years of operation to provide critical operational insights to other medical schools operating similar clinics in their communities.

Methods: At Willow Clinic and JVMC, patients presenting for care at the general medical clinic were offered standardized mental health screening utilizing a Patient Health Questionnaire-9 survey and a Generalized Anxiety Disorder-7 survey. Those who screened positive in either tool were offered to be scheduled for a Mental Health Clinic (MHC) appointment. Patient feedback and MHC attendance trends were utilized to revise the clinic workflow iteratively.

Results: In the SRCs, over 90% of patients are screened, but only 8.3% of patients screening positive attend MHC appointments. Though there are strengths in this approach relating to screening, the weaknesses relating to patient retention are iteratively being addressed to improve utilization.

Conclusion: People experiencing homelessness, people who use injection drugs, and uninsured patients face a disproportionate burden of barriers to mental health care. The MHC, through two partner SRCs at UC Davis, provides an opportunity to reduce some of these barriers to mental healthcare. This innovative model has promoted health equity in the Sacramento community and is a possible model for other similar SRCs to better serve their communities.

Dermatology Centered Student Run Free Clinics: A Community Necessity

2025-04-02T02:47:35-05:00

Background: Student-run free clinics (SRFCs) play a crucial role in providing preventive healthcare and addressing disparities, especially in underserved communities. However, dermatologic care remains largely unavailable in SRFCs. This review examines the need for dermatology-centered SRFCs, evaluates current literature, and suggests ways to enhance dermatologic access for underserved populations, focusing on Camden County, New Jersey.

Methods: A comprehensive literature review was conducted using PubMed, Embase, Cochrane, and Google Scholar databases to identify studies on dermatologic services in SRFCs and barriers to care, particularly for minority and uninsured populations.

Results: The review identified limited availability of dermatologic services in SRFCs, with only a few successfully integrating dermatology clinics. Partnerships between SRFCs and dermatology departments have shown positive outcomes, such as reduced wait times, improved access to care for conditions like acne and skin cancers, and better early disease detection. Challenges include logistical barriers, financial limitations, and limited provider availability, with minority and uninsured patients most affected.

Conclusion: The findings highlight an unmet need for dermatologic care within SRFCs. Collaborations between SRFCs and dermatology departments offer promise in improving care access and outcomes, enhancing medical education, and fostering community engagement. Establishing dermatology-focused SRFCs could address healthcare disparities and boost dermatologic health literacy in underserved communities. Further research is needed to assess the long-term impact of these initiatives on health outcomes.

Plastic Surgery at a Student-Run Free Clinic: A Review of the Literature and a Call for Access

2025-04-15T03:04:02-05:00

Background: Across the nation, academic medical centers and associated professional schools have established student-run free clinics (SRFCs) aimed at delivering healthcare to underserved populations. Many of these clinics have expanded their services beyond primary care by offering specialty clinics. However, there is limited information available regarding plastic and reconstructive surgery (PRS) related services within SRFCs. The aim of this study is to identify the presence of PRS services in current SRFCs and highlight barriers and opportunities for plastic surgeons to be involved within SRFCs.

Methods: Aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature review was conducted via PubMed, Embase, and Web of Science from January 2000 to April 2024. Search terms focused on clinical services that are within the scope of practice of a plastic surgeon.

Results: A total of 18 studies where included. Literature addressing PRS in SRFCs is scarce, with only two studies directly examining PRS services in this setting. Shade Tree Clinic in Nashville, Tennessee, is the only SRFC that has shared its experience with incorporating PRS services. This included the management of various hand pathologies, soft tissue masses, and skin cancers. While multiple SRFCs offer dermatological services—primarily focused on identifying and excising skin cancers—plastic surgeons are well-equipped to contribute to these efforts. Additionally, most chairs of plastic surgery departments demonstrated a strong understanding of the local need for these services, though time constraints and financial limitations were cited as significant barriers to their involvement.

Conclusion: Currently, there is little evidence of plastic surgeons assisting with SRFC activities. However, incorporating PRS services into SRFCs can significantly enhance healthcare delivery to underserved populations. The Shade Tree Clinic has shown the utility and high-level utilization of plastic surgeons in a SRFC.