A Culture of Challenge
Leahy Clinic, Student Volunteers Treat Patients, Not Statistics
While lawmakers continue to debate Medicaid, Medicare and general healthcare reforms, for some people affordable and accessible healthcare is not a debating point, it is a daily necessity. The Leahy Community Health and Family Center (LCHFC) is dedicated to addressing that need in the Scranton area. The center is a free clinic offering primary healthcare services to the uninsured residents of Lackawanna County. It offers such services as a medical clinic, a nutrition clinic, a physical therapy clinic, a counseling clinic, a smoking cessation program, a strong bones program, and a peacemakers program. The clinic strives to provide high-quality care in a welcoming, respectful and compassionate environment.
In addition to offering medical care, the clinic also offers opportunities for teaching, research, learning and service to University of Scranton faculty, students and volunteers. This partnership between the center and the University promotes both the Lackawanna County Medical Society’s commitment to improve access to healthcare for the uninsured, and the University’s Jesuit tradition of educating “young men and women for and with others.”
Statistics support the need for a free clinic such as the LCHFC:
- According to the Census Bureau’s “Income, Poverty, and Health Insurance Coverage in the United States: 2009” report, the number of uninsured people increased from 46.3 million in 2008 to 50.7 million in 2009.
- The adultBasic health insurance program for Pennsylvania has expired, putting 42,000 low-income people in a position of going without health insurance or having to pay far more for their coverage.
- In 2009, the city of Scranton had 8,153 (11.7%) medically uninsured residents and Lackawanna County had 17,833 (8.7%) medically uninsured residents.
Statistics without faces are often that, numbers disconnected from the reality of the suffering and difficulties of living without access to healthcare. In the LCHFC, the statistic becomes a person; it is here that the person is treated with dignity and that person’s illness or condition is addressed. It is here that student volunteers, who often have never been confronted with the culture of poverty – except for a sound bite on television – experience what classrooms present as theories. Guided by Andrea Mantione, LCHFC director and a certified registered nurse practitioner, and Maria Vital, administrative assistant, these students serve as clerical workers, translators and all-purpose clinic volunteers. Many are not here for credit. Although many are healthcare profession students in the Panuska College of Professional Studies, other volunteers come from the College of Arts and Sciences as well.
To maximize its use, the center is also utilized for physical therapy and counseling clinics when the healthcare clinic is not open. Students from the Physical Therapy and Counseling and Human Services departments offer these services. The facility provides additional programs to the community: a smoking cessation program, a strength training program for men and women over the age of 40, and an afterschool anti-bullying program for children ages 9 to 13. Students also run a food pantry and clothing closet for those in need. Given the variety of programs offered by the center, University students have a variety of opportunities to teach, research and learn from their experiences there.
Student volunteers are well prepared for work at the clinic. According to Mantione, “All students who volunteer are required to attend a two-hour orientation offered once a semester, provide child abuse and state police clearances at their own expense, sign a confidentiality statement, and undergo HIPAA♦ training.” In addition, all the professional aspects of working in a health clinic are addressed.
For the student volunteers, so much more occurs than just helping the professional staff. The volunteers are on the frontline of dealing with marginalized members of the community, and it is in their interaction with uninsured members of the community that these young men and women learn the most. These volunteers see the homeless, unemployed, poor members of the community. But the people who utilize the clinic don’t see themselves as marginalized or needy. Consequently, one of the challenges of the clinic and the student volunteers is to deliver healthcare while understanding and the addressing social and cultural identities and broader needs of the patient.
For example, Cara Brindley ’12, a nursing major and student volunteer coordinator, recounted the story of one individual who had bronchitis. The doctor instructed him to stay out of damp conditions and fill a prescription for his cough. As she and the patient talked, she found that he was homeless and lived in a cardboard box. The possibility of staying out of a damp environment was not feasible and filling his prescription not possible. In the little time Brindley met with this man after his interview with the doctor, she saw his challenge and attempted to help him solve it. Just treating the illness was not enough for this patient. His social and personal condition revealed that more must be done.
Trust is central to the operation and success of the clinic. The patients must trust the staff personally, as well as medically. Paulina Maida ’12, a biology and Latin American studies major, finds that part of the clinic’s success is that students have learned “to be understanding and not to be judgmental, professional and yet warm.” These are the qualities that make their endeavors successful. She acts as a translator for Spanish-speaking patients and often has been faced with relaying intimate details of a patient’s life to the doctor. Her command of the language makes the patients feel as if they will be understood. Her warmth and empathy allow the clients to overcome cultural and gender barriers so she can give the physician a clear picture of the patient’s needs.
Understanding cultural differences and how they impact the delivery of healthcare is an important lesson for the student volunteers, and pre-professionals in healthcare disciplines begin to see how their intercultural skills support their clinical skills. Joel Braverman ’11, a nursing graduate, says the clinic helped him recognize and respect cultural differences.
Volunteering at the clinic gave him an opportunity to understand the community and helped to make him a part of that community. It has also provided him with the opportunity to “do an assessment and check it against a professional’s [assessment].” His experiences in the clinic were extensions of his classroom learning.
Students also learn how cultural differences affect issues beyond healthcare. Brindley has volunteered for service project trips in the past. She noted she expected to see poverty in the areas she visited, but “didn’t expect poverty to be here.” Her experiences have challenged her to think more deeply about poverty and immigration issues, especially in areas closer to her home.
These students, and those who will follow, learn to apply theory to action and adapt their knowledge to best serve their fellow human beings. Adolfo Nicolas, S.J., Superior General of the Society of Jesus, stated, “In Jesuit education, the depth of learning and imagination encompasses and integrates intellectual rigor with reflection on the reality together with the creative imagination to work toward constructing a more humane, just, sustainable, and faith-filled world.” This is the challenge and goal of those who work in the University’s Leahy Clinic.
♦HIPAA refers to the patient privacy and confidentiality provisions of the Health Insurance Portability and Accountability Act.
To learn more, visit scranton.edu/pcps, then click on the Leahy Community Health & Family Center link on the left.
Director, Leahy Community Health and Family Center