Integrated Models of Education and Service Involving Community-Based Health Care for Underserved Populations: Tulane Student-Run Free Clinics

A lack of insurance and underinsurance in the United States constitutes a significant national public health problem.1 In the United States, 50.7 million individuals, 16.7% of the population, are uninsured and many more experience barriers to obtaining health care.2,3 Certain population subgroups have a low amount of health insurance coverage, including ethnic minorities, residents of southern and urban locations, and low-income households.3 In Louisiana, 17.4% of the population is uninsured and the highest uninsured rate for the state is in Orleans Parish (24.3%).3 There is a substantial need for safety-net services to provide care for uninsured individuals in the United States and Louisiana in particular. Many medical students are exposed to the safety-net healthcare environment for underserved populations, either on a volunteer basis or as part of their education. Approximately half of US medical schools have at least one student-run clinic, with most serving poor and uninsured patients.4 In addition to providing a needed service to patients, these clinics have the potential to teach students clinical skills, medical humanism, systems-based practice, collaborative and multidisciplinary approaches to medicine, and leadership skills.4–6 Participating in community-based, student-run clinics has the added advantage of potentially influencing students’ choice to practice in primary care.7 The purpose of this article is to describe the clinic models, patient demographics, and services provided by four student-run clinicsVBridge House Wednesday Clinic, Ozanam Inn Weekend Clinic, Fleur de Vie at Covenant House, and Fleur de Vie in New Orleans East—and to examine the relevance of these clinics for medical education and healthcare service delivery for underserved populations in New Orleans.