Evaluating the Impact of a Student-Run Clinic on Expanding Access to Gynecologic Care for Uninsured Patients [36G

Abstract

INTRODUCTION: Significant disparities in access to gynecologic services persist for uninsured women, who are far less likely to obtain preventive screenings against breast or cervical cancer than insured women. Safety net institutions reduce health disparities, but gaps in service provision for gynecologic services remain. Student-run clinics, or clinics coordinated and staffed by medical students that are supervised by licensed physicians, provide preventive services at rates similar to other safety net institutions. METHODS: A retrospective chart review examined the prevalence of gynecologic issues addressed by a student-run women's clinic at a free clinic in Providence, Rhode Island and quantified the service provision provided to this population of uninsured, predominantly Latina women. RESULTS: Between May 2015 and 2017, the women's clinic saw 138 patients over 171 encounters during 48 clinics. Most visits included Pap smears or mammograms (85.2%). Other prevalent issues were abnormal uterine bleeding (23.9%), contraception (13.0%), abnormal vaginal discharge (12.3%), and infertility (11.6%). The clinic provided 83 Pap smears, 35 STI tests, 19 vaginitis screens and referrals for mammograms (n=42), colposcopy (n=7), and sub-specialists (n=14). Culturally sensitive interventions were designed to address linguistic and social barriers to care for patients seeking subspecialty care. CONCLUSION: Student-run clinics can effectively deliver gynecologic services to safety net populations. With their unique access to faculty preceptors and funding, medical students can play a significant role in expanding the specialty services available to uninsured patients. Safety net institutions should consider empowering medical students to create student-run specialized clinics under appropriate supervision to address the needs of their patient populations.