IU School of Medicine Student Portal

Elective Title: 02YF709 — PRIMARY CARE - UNINSURED AND UNDERSERVED

Description:

Matthew 25 Health and Dental Clinic is a free clinic with a mission to provide primary care to the uninsured residents of Allen County, Indiana, who live at or below 125% of the poverty level. The student will be exposed to a variety of advanced pathology at Matthew 25 Health Clinic. Patients present to the clinic with multiple significantly advanced diseases due to their lack of timely access to traditional primary care. As a result, they present with more advanced and a greater number of medical and psychiatric problems than the average primary care patient who has access to standard medical care. The student will directly witness the impact of economy, environment, health policy and advocacy, law and oversight, and social influence on patient health and the delivery of primary care to underserved patients. Through interaction with such complex patients, the student will also learn how to improve the care of such patients using resources available through the free clinic and other local safety net services. In addition to the advanced complex medical conditions at the free clinic, the clinic provides care to patients from a diverse background of cultures, spirituality, social influence, and health literacy. Through the evaluation and management of the patients, the student will recognize the impact of culture, spirituality, social influence, and health literacy on the delivery of health care to such a population. In addition to the above activities, the student will acquire experience with law and oversight issues related to the operation of a primary care clinic in Indiana. As the Medical Director of the clinic, Dr. O'Hara will have the opportunity to discuss law and oversight issues with the student to complete the requirements for the Social and Community Contexts of Health Care competency.

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Learning Objectives

• 1) Describe the challenges of providing primary care to patients with no insurance, Medicaid, Medicare, or other financial resources (SBP3)
• 2) Recognize the barriers affecting EACH patient encounter: culture, economics, housing, transportation, health literacy, food security, health policy and advocacy, social influence, and spirituality, and record these barriers along with the primary concern for the visit in a journal (SBP2)
• 3) Use evidence based resources to develop evaluation and management plans for the complex patients and to broaden his or her primary care knowledge base (PC3)
• 4) Describe how to deal with the culture, economics, environment, health literacy, health policy, social influence, and spirituality in a positive manner to improve the health of the patients and preserve his or her own professional and emotional health (SBP2)
• 5) Demonstrate awareness and value of community resources through a reflection on the role barriers play in determining a patient's health and identify community resources which provide the relevant support (SBP2)

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Assessment

• Clinical Performance Evaluation Form (Students will keep a journal of patient experiences throughout the elective experience. In a de-identified manner they will record each patient they interact with along with any significant barriers impacting the patient encounter: culture, economics, housing, transportation, health literacy, food security, health policy and advocacy, social influence, and spirituality. Students will identify one patient from each day to perform a literature review to broaden their primary care knowledge base and record their findings in the log. In addition, the students will choose 6 patients, at least one representative of each group below, whose health has been affected. Complete a reflection on the impact of the barriers and identify solutions to overcoming the barriers identified. 1. Poverty, access to transportation; 2. Barriers of culture, language or literacy; 3. Health policy, insurance regulation, malpractice concerns; 4. Mental health issues, social stresses, interpersonal family conflicts and isolation)

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Enrollment Information

Prerequisites: 3rd or 4th year status; Medicine and Surgery clerkships must be completed.

Availability with Max Students per Month:

Apr	May	June	July	Aug	Sept	Oct	Nov	Dec	Jan	Feb	Mar
0	1	0	1	1	1	1	1	0	1	1	1

Duty Hours: 40

Time Distribution: 65% Clinical, 35% Library/Research

Elective Type Category: CP - Clinical Practice

Notes and Enrollment Information:

Add/Drop Contact Person: Sharon Roberts (robeshar@iu.edu) THIS ELECTIVE DOES NOT PARTICIPATE IN THE INITIAL SENIOR MATCH All Fort Wayne electives must go thru the Fort Wayne campus coordinator Sharon Roberts (robeshar@iu.edu or 260-257-6833).

Third Year Elective? Yes

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Interprofessional Skills and Service Learning

Interprofessional Collaborative Skills: Yes

Skills Description: Yes - students work with nurse practitioners, physician assistants, and social workers

Service Learning Included: Yes

Detaials for Service Learning: