Hands-on medical care for Camden's neediest at Cooper University HospitalJanuary 14, 2013
Philadelphia Inquirer, by Claudia Vargas
When patient Carmello Torres walks into the clinic examining room at Cooper University Hospital, he knows the drill.
First-year medical student Sara Zaidi, dressed in a white lab coat with a statoscope hanging from her neck, has seen him twice in the previous two months.
Torres, 55, sits on the examining table, ready to answer questions about his acid reflux and a new health issue: His left hand, broken five years ago, is causing him intense pain at night.
Zaidi, a member of the inaugural class at Cooper Medical School of Rowan University, looks forward to her days at the Camden Community Collaborative Practice, a free health-care clinic the school sponsors for uninsured Camden residents. She's anxious to follow the progress of Torres and her other patients.
"I never had this kind of hands-on experience," she said last month. "It's a visceral reminder . . . of the needs that are out there."
Though 23 of Cooper's 50 medical students have chosen to live in Camden, all but one reside in apartments at the Victor Building, an oasis in a city known for its crime and poverty. The weekly clinics, which the students staff as part of their curriculum, offer the future doctors an opportunity to interact with Camden's neediest on a one-on-one basis.
Forty-two percent of the city's residents live in poverty - the highest rate in the country. Many are uninsured and rely on the care provided at places such as the Collaborative Practice.
It's an eye-opening experience for students whose own care has always been delivered by private-practice physicians.
"One thing that surprises me is how friendly [the patients] are," given the merry-go-round of doctors they see at various free clinics, said Zaidi, 23, of Closter, Bergen County. "I would be frustrated."
Cooper hopes its first-year students will stick with their assigned patients throughout the four years of school and believes all parties will benefit from the continuity, medical school spokeswoman Sharon Renteria-Clark said.
In addition to medicine, "we are teaching them professionalism," Renteria-Clark said, referring to the requirement that students wear business attire.
The clinic provides "service learning" in an environment where many patients are under severe economic and psychological stress, medical school dean Paul Katz said.
"They learn 'how do you get hypertension medicine when you don't have a job?' " Katz said. "It's a lot of social work."
Torres has horror stories about his experiences at other clinics. But he has come to the Cooper practice for more than a year, he says, and he has liked the students and primary-care residents who have seen him. Before the opening of Cooper Medical School, the clinic was staffed by students from the University of Medicine and Dentistry of New Jersey (UMDNJ).
"I'm not dumb. I know when something is not right," Torres, an unemployed mechanic, said while waiting for Zaidi and her helper for the day, resident Bert Bieler, to reappear.
In the clinic's tight corridors, white coats zip from one room to the next. Most days, the facility is home of the hospital's Department of Medicine outpatient office.
On Thursdays, it is transformed into the Collaborative Practice and inhabited by about 25 Cooper med students plus Cooper primary-care residents and attending doctors, and students from the Philadelphia College of Pharmacy.
A different 40- to 50-member staff works on alternate weeks, handling everything from check-ins to check-ups.
Anna Headly is in charge of keeping the chaos to a minimum. She has a color-coded chart that lists staff members' schedules, duties, and patient assignments.
"I'm constantly running in a circle, looking for hitches," said Headly, a doctor of internal medicine on Cooper's faculty.
In the handful of clinical rotations they've had since their studies began in August, students have seen first-hand the health and social issues of Camden's residents.
Their education continues outside the classroom. On the nearly mile-long walk from the Victor to the campus on Broadway, students see prostitutes, the homeless, and other signs of poverty and urban decay.
"It keeps you grounded in the realities of Camden," Mike Coletta, 23, of Marmora, Cape May County, said last month.
Though the students are in Camden to pursue a serious goal, most are still young, and the neighborhood offers few options for recreation.
Their experience in Camden has shown them the city has other concerns besides opening a place where hospital staff can socialize. The students say they would rather see money invested in health care and nutrition programs for the city's population.
"I don't think Camden needs a five-star restaurant," Coletta said. "Camden needs a place where people can get fresh produce."
The clinic has taught them to be sensitive to patients beyond their medical needs.
In prescribing a drug for the pain in Torres' hand, Zaidi and Bieler have to take into account his acid reflux, as any physician would. But they also must consider whether he can afford the medication if the clinic is unable to provide enough samples.
When Zaidi and Bieler return to the examining room, they give Torres free medicine, a prescription, and an X-ray order. Their effort does not go unrecognized.
"I'm very happy," Torres tells them. "You are making me better."Notes: