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Training Doctors to Think Beyond the Clinic

A photo collage of a person holding an exercise weight and a photo of nutritious food in containers.

Why It Matters

Interactions between doctors and patients only last about half an hour. They take place in a clinic, far removed from patients’ day-to-day lives. But health is what happens beyond the walls of the clinic or hospital. It’s having a good education, nutritious food to eat, a safe place to sleep and a supportive community.

To improve the whole health of a person, physicians must partner with those with the power to create healthier living environments and behaviors. In the Austin metro area, thousands of nonprofits provide resources to improve health in the community. But many doctors are unaware of the services available or are unsure of which patients qualify for support.

What Dell Med Is Doing

A new program integrated into Dell Medical School’s two-year Primary Care, Family and Community Medicine Clerkship embeds all 50 second-year med students with local nonprofits. Students select one or two organizations and spend an afternoon working alongside case managers, social workers and other nonprofit employees. Through these experiences, students learn about community resources and gain insight into how a patient’s living environment and circumstances affect their care.

The program’s partners include AIDS Services of Austin, Austin-Travis County EMS, the Austin Resource Center for the Homeless, Community First! Village, Central Texas Food Bank, Health Alliance for Austin Musicians, Austin Harm Reduction Coalition and Meals on Wheels Central Texas.

“Our program helps students see the role community resources play in the health of patients, especially those without private insurance and without means,” says Alex Garcia, Ph.D., the clerkship’s associate director for community engagement. “Seeing where patients are coming from makes students better docs. It makes them more aware of patient challenges and more adept at working collaboratively to achieve better health.”

Seeing where patients are coming from makes students better docs. It makes them more aware of patient challenges and more adept at working collaboratively to achieve better health.

Alex Garcia, Ph.D.

Francisco Barrios, Class of 2020, spent an afternoon working at the food bank for AIDS Services of Austin. While providing the center’s clients with healthy food, he heard the struggles they face because of their diagnosis.

“There’s a stigma, and they feel shunned from other communities,” he says. “AIDS Services of Austin gives them a home. It’s a community that wants them to thrive despite this grave condition. It shows them that you can still eat healthy and live your life, even with an AIDS diagnosis.”

Barrios also accompanied staff from the Central Texas Food Bank on a visit to a local elementary school to talk to students about nutrition.

“I enjoyed talking with them about important topics like calories, limiting sugar and eating a balanced diet,” he says. “Many of the students were Hispanic and African-American. I’m Hispanic myself, and I grew up in a poor area of Houston. When I was a kid, no one ever talked to me about how to eat healthy.”

Virginia Waldrop, another second-year student, worked with a case manager with Meals on Wheels. While visiting clients, she learned about a mini nutritional assessment tool to assess people at risk for malnourishment and gained a new series of questions to ask patients about their nutritional status.

“I became much more aware of geriatric patients’ risk for malnourishment,” she says. “It’s not something you can see by just looking at a patient. You have to ask the right questions.”

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How You Can Help

At Dell Med, we’re training physician leaders who are dedicated to transforming health in our community. But six figures of debt often stand between bright students and pursuing their dream of becoming doctors.

Scholarships break down financial barriers and provide students with the freedom to pursue their passions and work with our community during med school. You can help us continue to provide tuition support for every student by making a gift to scholarships.

Summary

Both Francisco Barrios and Virginia Waldrop, the Dell Med students, agree that it’s critical for physicians to have ample knowledge of community resources in order to make appropriate referrals.

“Social services outside the clinic have the potential to make a big impact on patients’ lives — perhaps a greater impact in many cases than traditional medical services,” Waldrop says. “Services like Meals on Wheels can provide the frequent interactions necessary for supporting behavior change. And they can focus on meeting patients where they are — in their home environment — and helping to improve that environment.”

Students in their second year of medical school spend most of their time in rotations in local hospitals and clinics. Barrios says the program gives students much-needed exposure to what happens after patients leave the hospital or clinic.

“It’s nice to see people not just as patients, but as people with conditions who are trying to live their daily lives,” he says. “This experience allowed us to talk with people eye to eye, outside of the hospital where patients are scared and looking to doctors for answers.”