Clinic Takes Cues from Community to Meet Health Needs
It’s a Monday night and dozens of Penn students are flooding into a West Philadelphia church basement. In the fellowship hall, amongst a piano, tiny stage, and kitchen, students eagerly set up tables, chairs, and portable carrels, sift through paperwork, and lay out medical supplies.
A weekly meeting—dubbed “circle up”—starts at 6:30 p.m., just as patients trickle in upstairs. It’s time to hear the agenda from Penn Nursing student Lauren Ziegelman, clinic coordinator of the evening.
“Eleven people have signed up for tonight’s clinic, and additional walk-ins are welcome. Remember, patients can sign up on the door of the church, over the phone, or online. Flip the numbers over when a carrel is in use. If someone has high blood pressure, ask if they’d like a warm handoff to the folks at the hypertension clinic next door. Translation services are available. We have free flu shots and PPD skin tests available, and someone from Service Link is here to help patients sign up for Medicare and Medicaid.”
The meeting lasts about 15 more minutes, and then it’s time to get to work. It is a pretty typical—albeit bustling—night at the United Community Clinic (UCC).
Formed in the mid-1990s, the UCC is a free health clinic coordinated by Penn students from the Medicine, Dental, Nursing, and Social Policy & Practice schools, as well as undergraduates in a variety of disciplines. Running from 6 to 9 p.m. every Monday, except on holidays, it calls home the First African Presbyterian Church, at 4159 W. Girard Ave., about two miles from Penn’s main campus.
Services include health physicals, acute care, dental care, eye care, social work resources, and health insurance assistance.
“We’re serving a population that typically needs care immediately, maybe a physical for work or their kid needs an exam to play sports, and even if they don’t have health insurance, they can receive these services at UCC,” says Timothy Lee, a soon-to-be medical school student who’s been volunteering at UCC—formerly as an undergraduate student and now as a Penn staff member—for four years.
In another room in the basement is a hypertension clinic, also part of UCC, called HHBC, short for Healthy Hearts Bridges to Care, helping patients treat their high blood pressure. Its goal is to stabilize patients with hypertension care and connect them to long-term providers.
From its inception, the UCC was founded with the intention of having a multidisciplinary approach to health care.
“I love the collaboration with the different teams,” says Laura Balin, a master’s of social work student who volunteered at the clinic for about two years. “It’s really important, and what it’s like in the real world. After graduate school, when I go into the workforce, it all becomes integrated. It’s rare that I’ll just be working with other social workers.”
Serving the East and West Parkside sections of West Philadelphia first and foremost, the clinic is open to everyone whether they’re insured or not. It’s unique—and necessary—for its location, right smack dab in the community, and for its after-work hours. There are no bells and whistles at the UCC, and that’s with intent.
“A lot of people are put off by large health institutions in general, but they’ll go to their local, trusted church,” says Brian Work, one of the UCC’s four directors, and also an assistant professor of clinical medicine at Penn. “We don’t want a big, fancy clinic space. We want to be in a church and if we expand, I want to be in another church.”
A physician or nurse practitioner proctors every patient interaction and gives general guidance at the clinics.
“But really, it’s all student-run,” says Heather Klusaritz, another clinic director. “Students are charged with the operation of the UCC, the day-to-day, making sure we have supplies, making sure it happens.”
Students also lead the UCC’s community engagement work. That might be in the form of the annual “Bike Rodeo,” teaching youth about bicycle safety, or a health fair. It may also mean attracting interest to the UCC in other ways, while always remembering to listen to the community’s needs first.
“No matter what your profession, skill set, or experience is, the most important thing is talking to the people you are serving and lifting them up,” says Lee. “A lot of times in leadership roles in college, we learn to shout the loudest and say the most. When it comes to community health care, that doesn’t make any sense. It’s not a solution if the community doesn’t have a say.”
Rebecca Abelman, a fourth-year medical student at Penn, says the UCC has a long history of partnering with the community. In fact, it’s by talking with the community that they’ve been able to alter, and also add, different offerings—such as the HHBC.
“We have to always be making sure the clinic is continuing to fulfill the needs of the East and West Parkside community, and looking for other areas of growth,” says Abelman, who formerly served as the UCC’s community outreach coordinator.
That’s why, every couple years, the UCC runs a community needs assessment, where students knock on neighbors’ doors and attend community events, to gain an understanding of what people want from the clinic.
“We take a look at the results—for instance the last one, concluded in 2015, pointed to a need for mental health services and substance use help—and decide how we can further our programming,” says Abelman.
Just as UCC’s mission is to help unmet health care needs in the community, it’s also to create a top-notch educational experience for students, notes Klusaritz, who also serves as the associate director for Penn’s Center for Community and Population Health.
“Students need to see community-based health care,” she says. “If all our future health care providers only train in the wonderful facilities of Penn Medicine we have here on campus, then they won’t have exposure to communities where health happens. We want them to understand the social determinants of health, and to know how to work with community partners to increase health care.”
If students train in underserved communities, they are more inclined to practice in them in the future, Klusaritz adds.
“Life is tough and life does not operate on curves like it does in the lecture hall,” Lee says. “It’s imperative that we understand when going to practice medicine, it’s not going to be about grades. People make decisions to sacrifice food to get health care. Being involved in the UCC was a really necessary dose of reality, and it was really pivotal in my decision to keep pursuing medicine.”
Abelman seconds Lee’s statement.
“Volunteering at UCC was by far the best thing I’ve done while in medical school,” she says. “It’s definitely one of the biggest for me in terms of teaching me about what kind of physician I want to be.”