Student-run free clinics are sponsored, not-for-profit forms of community-level outpatient care. Student volunteers are involved in nearly all aspects of clinic operations while under the supervision of volunteer doctors, pharmacists and other health care professionals. In addition, literature supports the general attitude among student volunteers is that volunteering at these clinics improves their clinical skills holistically.1 As a medical student, I am a firm believer in practice, so the ability to listen, establish and grow a quality relationship with a patient during a medical school rotation is a priceless opportunity to improve my clinical skills. However, unlike practice questions or flashcards, which are almost infinitely available, patient exposure can vary between rotations. I believe student-run free clinics provide a form of supplementary practice which further hones clinical skills and knowledge.2 Most importantly, the overall benefit of student-run free clinics is for patients who depend on these clinics for medical care. In fact, literature supports significant patient satisfaction with their improvement in health after establishing care at a student-run free clinic.3

Within my local Kansas City, MO community, there are multiple student-run free outpatient health clinics, each sponsored by their respective medical schools or institutions. Each one provides a source for outpatient care and health maintenance to the urban population of Kansas City. The convenience of providing health care to people in close proximity to the clinics helps promote health awareness. However, data suggests there are significant gaps in socioeconomic levels between counties within a 100-mile radius of my community.4 Despite the differences, these counties are at higher need for subsidized health care costs and would therefore benefit from the increased availability of a student-run free clinic. An effective solution to address these health care disparities is to implement a mobile student-run clinic.

Mobile health clinics (MHC) provide the ability to create a form of satellite medical facility which opens access to a wider demographic of people who may not have convenient access to transportation. However, before I further delve into a positive-toned analysis of MHCs, it is worth noting there are two forms of mobile health clinics which I am focused on: vehicle-based mobile health clinics (VMHC) and satellite facility mobile health clinics (SFMHC).

Both MHC variants have the potential to serve a broader demographic community. However, VMHCs provide the convenience of not having to set up clinic equipment in multiple locations prior to starting to see patients that day. Moreover, the psychological aspect of having a consistent layout of a clinic environment in VMHCs improves work-flow efficiency compared to SFMHCs, which may need to move clinic equipment between the satellite facilities. This places a greater burden upon clinic volunteers and reduces work-flow efficiency. On the other hand, VMHCs can be more comfortable for both patients and volunteers by being inside a physical facility instead of a large vehicle like a van or bus. Regardless, the ultimate benefit of reaching a wider audience compared to the status quo is the most important aspect found in both MHC variants.

The ability of MHCs to target specific neighborhoods creates a potential gateway for a patient to seek further medical care. Let alone, the unique ability to connect within the community is beyond the scope of medical care. There are MHCs which also serve to provide social assistance, clothing and friendship to a patient. 5 With regard to clinic operations, literature shows that MHCs are also cost-effective. According to the Mobile Health Map, which tracks over 800+ MHCs in the U.S., there is nearly a 120% average return on investment for mobile health.5-6 This is pertinent when considering whether a student-run student-health clinic wants to opt into going mobile. More importantly, however, is the cost-savings that occur for the patient themselves due to requiring fewer emergency department (ED) visits. Many communities which face various socioeconomic barriers rely on an ED as a primary source of health care access. This implies that a number of ED visits could have been managed through outpatient care, which would have a significantly lower financial burden on these patients. 4-5

Finally, this brings up the question: Why now? After experiencing over a year of the COVID-19 pandemic, outpatient care is as important as ever before. In addition, our society has become more comfortable with telehealth, and we have encouraging developments in geospatial tracking. MHCs can serve a complimentary role with telehealth care and can utilize geospatial data to determine individualized and specific care across communities. This makes our health care delivery as convenient for patients as ever before.

This article was authored by Som Prabh Singh, a medical student at the University of Missouri Kansas City School of Medicine. Twitter: @SomPSingh

References

1. Simpson, SA et al. Long JA. Medical student-run health clinics: important contributors to patient care and medical education. J Gen Intern Med. 2007;22(3):352-356.
2. Singh, SP et al. Mechanisms of action by antimicrobial agents: A review. McGill Journal of Medicine. 2021;19(1).
3. Ellett, JD et al. Patient satisfaction in a student-run free medical clinic. Fam Med. 2010;42(1):16-18.
4. Rumalla, K et al. Student-Run Free Clinics: A Local Solution to Healthcare Disparities. Kansas J Med. 2019.
5. Yu, SWY et al. The scope and impact of mobile health clinics in the United States: a literature review. Int J Equity Health. 2017;16(1):178.
6. Impact Report. Mobile Health Report. https://www.mobilehealthmap.org/impact-report