The culture of medicine has changed and a new generation of medical students has noticed this insidious path to disgruntlement. Reimbursement rates dominate conversations among health care professionals. Physicians are slowly burning out while younger faces are tempted away from humanitarianism by lucrative lifestyle specialties. Bureaucrats, technology, and increasing health-care costs have transformed the doctor-patient relationship, and students pick up on the increasing frustration in the profession.
The few oases of “pure” medicine are dwindling. Outside of a handful of rural family docs, the culture at most clinics and hospitals now focuses on efficiency and cost-effectiveness. The constant escalation of health-care costs and the numerous opportunities to profit have shaped the new business of medicine, making it less of an Oslerian public service and more an industry analyzed on CNBC and Bloomberg.
Like many medical students around the nation, I have been fortunate enough to volunteer at a student-run free clinic, a place without billing codes or collection experts. Such charitable clinics exist only to serve, not to profit. Our patients are often the most vulnerable and most forgotten by the health care system. The clinic’s greatest successes are not the result of prescribed antibiotics. Instead, they come from a sympathetic ear and a compassionate touch.
For many of us — students and physicians alike — financial gains were not the reasons we entered the field of medicine. We’re here to help, to heal, and to listen to our patients in need.
Charitable clinics offer a venue to practice medicine this way. They serve not only the patients, but also the health-care providers. They remind students (and physicians) of the joys of patient care. In a community-clinic setting, the focus returns to the patient, her hardships, and building relationships. Patients aren’t just charts, illnesses, or ICD-9 diagnoses. They’re the humanistic story of why we became doctors.
At the student-run Lubbock Impact/TTUHSC Free Clinic, my education was not convoluted by health-care reform or reimbursement codes. It was the place where I heard my first breath sounds, caught my first murmur, and wrote my first progress note. The clinic provides much more than education. Most importantly, it provides inspiration. Our experiences there serve as regular reminders of the reasons we spend our twenties nose-in-book. We’re not just learning about treatment protocols; we’re learning about the doctors we hope to become and the medicine we hope to practice.
My experience is not unique. At least 50 medical schools have student-run clinics, where students engage in patient care early in their careers. But student-run free clinics are in a permanently precarious position.
Whether a physician, a student, a donor, or a community member with a voice, each of us can make an effort to encourage an environment that centers on the patient. Student-run free clinics shape the future of medicine for the better and provide health care to those most in need.
Within these clinics, medical students, nurses, physicians, and patients alike constantly see the humanitarian reasons for joining the medical field. The dream of public service trumps the dream of big houses. Here, we still have an oasis: a pure form of medicine.
Justin Berk is a medical student. This article originally appeared in Texas Medicine.
