Care on Call

By Claire Vail, Senior Content Writer

This story originally ran on March 5, 2007.

BOSTON -- It's a bitter February night in Malden, Mass., and the volunteer staff at Sharewood, a free health clinic housed inside the city's First Church, is debating whether the cold will keep patients at home. But when the doors open, three people are already stamping off the chill: a man with a severe chest cough and a young couple who cling tightly to each other's coats.

The patients won't have to wait long to be seen. Gathered behind the church auditorium's stage are more than 30 Tufts first-year medical students, each hoping for the opportunity to treat a live human being. Even the chance to conduct a routine physical is welcome experience. According to Jeff William, a first-year medical student and Sharewood's administrative director, from a student's perspective, every case is worth hundreds of classroom hours.

A volunteer-based clinic run by Tufts students and supported by Tufts' family medicine residency program, Sharewood has been held every Tuesday from 6:30 to 9 p.m. in a publicly accessible location -- first in Boston and now in Malden, just a few miles from Tufts' Medford/Somerville campus. Since its inception a decade ago, Sharewood has had over 2,500 visits from 1,500 different patients.

Under the close supervision of staff physicians, students dispense an impressive range of acute care to anyone who walks through the door, including specialized services such as psychiatric counseling, STD testing and laboratory screening. Curtained cubicles guarantee patients as much privacy as possible, and students take pains to create a warm, welcoming atmosphere. Tonight, a student has plugged her iPod into a set of speakers, and soft jazz echoes through the hall.

Because Sharewood is a teaching clinic, appointments take approximately 90 minutes, during which patients are seen and examined by a team of two students and a single resident, supervised by an attending physician. For patients, the prospect of free first-rate health care and medication appear to make the wait worthwhile. On average, nearly half of Sharewood's patients are repeat visitors.

"Most people seem to understand that we're still learning and are willing to put up with longer waits than they might have at a physician's office," says William. "Every patient who comes to Sharewood is helping to train a future doctor or healthcare professional."

Established in 1997 by Tufts medical students who named it after Robin Hood's legendary Sherwood Forest, the clinic "takes" from the haves, in the form of legitimate donations of equipment and pharmaceuticals from medical schools and hospitals, and gives to the have-nots, who make up the increasing number of urban and suburban residents without health insurance.

Malden's mayor, Richard C. Howard, applauds the clinic for serving the entire community, especially the city's diverse immigrant population, which includes a growing number of Asian, Hispanic, African and Arabic residents.

"Sharewood is an enormous help for people who would normally not get that kind of care," says Howard. "Malden is home to a significant number of immigrant families in transition, so we're the kind of community that can really support and benefit students of family medicine."

For the past five years, the city of Malden has helped support Sharewood through a redevelopment grant. Other financial support comes from the American Association of Medical College's Caring for Community grant and the Tri-City Community Action Project (TRICAP), which refers patients to Sharewood on a regular basis.

Despite the grants, the clinic has had to struggle to find a home. In January 2001, Sharewood nearly shut down after losing its site location. Dr. Joseph Gravel (A'82, M'86), Sharewood's medical director and assistant clinical professor in the Tufts School of Medicine Department of Public Health and Family Medicine, eventually found a friend in the Centre United Methodist Church. But when the church closed last fall, the clinic was forced to move yet again.

"I knocked on a lot of doors, but most places didn't have the space available for us," says Gravel. "First Church in Malden Congregational volunteered to let us set up in their facility. They had a sincere desire to do a good thing and they see serving the community as part of their mission. If they hadn't said yes, I don't know what we would have done."

Gravel, who is also the program director of the Tufts University Family Medicine Residency at Cambridge Health Alliance, believes the clinic has helped to curb the public's general cynicism about doctors.

"I've had patients who have said that Sharewood restored their faith in the medical profession. It's a really wonderful demonstration to the community that there are medical students who are getting into the profession with the purpose of helping people instead of just making money."

Dr. Jeffrey Glassroth, vice dean of the Tufts School of Medicine, says that Sharewood is a key component of the school's mission.

"It is an outstanding teaching and learning opportunity but, at the same time, is a way for our students and the school to give back to our community," he says. "This is truly active citizenship."

For students, Sharewood is invaluable clinical experience early in their education, but it's also a chance to help relieve suffering, which many say is the fundamental reason they choose medicine as a career.

"It's an opportunity to help people directly," says Benjamin Caplan, another first-year medical student who has overseen routine health exams, treated skin diseases, and administered flu vaccines. "Because we're so new to medicine, we tend to see things from a patient's perspective."

"Working at Sharewood recharges the volunteering physicians' batteries from seeing the students' idealism and enthusiasm," affirms Gravel.

Nationally, the number of men and women who choose to practice primary care has been declining over the past decade, as many students pursue higher-paying specialties.

But according to Gravel, Tufts University School of Medicine is bucking the trend.

"The past several years, Tufts has actually had a significant number of students going into family medicine. I think this is partly because medical students at Sharewood work closely with family medicine residents, who provide great role modeling," he explains. "They get to see really dedicated, competent physicians at work."

Jeff William agrees.

"Tufts makes an effort to get students thinking about their role in the community, both now, as medical students, and in the future, as physicians. No matter what specialty we ultimately choose, family medicine or otherwise, we can look back at our experiences at Sharewood and remember how important giving back to the community is."