Taking Care of Ourselves: Healthcare for Students
Chris Montgomery, M’11
If your past medical experiences are anything like mine, you most likely avoided switching from your childhood pediatrician to an adult primary care physician for as long as was realistically possible, and then a couple years more. If so, you might be familiar with the confused glances of young parents as you tried to ignore the wails coming from their two-year-old child crying in pain from an ear infection, all in order to get that meningococcal vaccine your college admissions office required prior to matriculation.
As much fun as those visits were, the next time I found myself in need to medical treatment I was pleasantly surprised to finally experience a waiting room that was designed for someone over the age of seven. I was a freshman in college, and having sliced open my chin playing roller hockey, I needed a few stitches to close the wound. Fortunately, the student health clinic at my school was less than five minutes from the rink, and while I missed the opportunity to play with Legos while I waited for my repairs, I didn’t miss that incredibly awkward feeling that I used to get while sitting in my pediatrician’s waiting room.
As it turned out, I would only return to the campus student health clinic one or two more times during my four years in college, such as the night I ended up with food poisoning from the dining hall tacos, or when I needed to get a prescription filled for seasonal allergy medication. I was fortunate enough to avoid any serious medical emergencies, and therefore didn’t really think about what I would do if I needed more than routine care.
It was not until I was filling out my paperwork for Tufts and found out that I would finally need to go about finding a primary care physician that I realized just how convenient my college student health clinic had been. I took for granted that if I had a nagging cold or some minor accident, I could just go to the clinic and get it taken care of without any major hassle. Not having that security anymore was a wake-up call that I really was entering the dreaded "real world," or whatever you consider medical school to be.
Recently, in an effort to better understand the options for healthcare available to medical students at Tufts, I sat down with both Deans Kerle and Kuhlik. During the course of our conversation, I learned that at one point there was in fact a health clinic for students on the Tufts Boston campus. However, some time ago that clinic was discontinued in favor of a healthcare plan. I was told that many of the reasons for switching to the current system arose from students’ own concerns, namely, the discomfort of students who had gone to the clinic for sensitive personal issues during their first two years, only to see some of those same physicians on the wards or in basic clinical classes such as Patient Interviewing.
There are also some more practical reasons which favor a broader student health plan over a campus clinic. Unlike undergrad, where the student population is still relatively young and mostly single, medical school students are typically more spread out in age, and some are married or even have children of their own. Therefore, the basic health needs of students and their families are more diverse in medical school than college. In addition, Dean Kuhlik mentioned that studies tend to show that one of the most highly demanded types of care at all medical schools is mental health. The way in which the Tufts Heatlh Plan is arranged now allows for students to receive high quality mental health care in a completely anonymous way, thus alleviating past student concerns that such information would make its way into formal recommendations.
Recently, the current plan was audited in some detail by a group of students as part of a broader overall medical school licensing and accreditation study. The results of that study confirmed that students appreciate the coverage of the Tufts Health Plan, but would also like the convenience of a health clinic on campus. Both Deans Kerle and Kuhlik acknowledged that the most ideal situation would be a campus clinic where students could receive ambulatory care, and also a more comprehensive plan in the case of serious illness or unexpected trauma. However, due to the size of our campus and other limitations, such an arrangement would not be economically feasible. Therefore, after careful consideration of the needs of the student body, and in an attempt to provide the most benefit to the greatest percentage of the class, the administration determined that the current health plan was in fact the best possible option for the students. The Office of Student Affairs has arranged on-campus flu vaccines paid for by the school and student Tb tests at the TMC Employee Health clinic, but the OSA is very interested in hearing from students regarding any additional needs or concerns they might have, and in many cases has worked to accommodate students who have special circumstances.
As we all begin to realize that we can’t remain living in the relative utopia of college forever, even I have begun to see how taking more of a responsibility for my own health care has been gratifying in unexpected ways. When I scheduled my first physical with my new PCP this past summer, I decided to also get a blood lipid profile. After nearly a decade of living a decidedly “un-DASH diet,” I was interested to see what my results would be. This was probably the first time in my life when I began to wonder how the choices I had made in the past had directly affected my own health. Fortunately, everything came back within normal ranges, and evidently those years of living off of Papa John's pizza and "Natty Light" haven’t yet come back to haunt me. Even still--or perhaps more so--I was glad that I took the time to get the testing done. I felt good about establishing a relationship with a physician who didn’t wear a Donald-Duck necktie, and was reassured to be able to rely on someone to direct my medical care. As we have all have been told time and again, it is important to remind our patients to remain conscientious with regard to their health care maintenance—by eating healthy, getting annual physicals and making sure to get the right screening tests at the proper time. As a doctor-in-training, I couldn’t help but feel like a hypocrite if I weren’t taking adequate measures to do the same for myself; at the same time, I felt personally that I had taken an important first step towards monitoring my lifelong health.