Oct. 8, 2009

Delivering hope and care

VCU medical and pharmacy students partner with CrossOver Ministry to deliver care to Richmond’s underserved populations

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By Sathya Achia Abraham

VCU medical student, Shira Goldstein, checks the blood pressure of a patient at the CrossOver Ministry clinic on Cowardin Avenue. Image courtesy of Hal Tyler Photography.
VCU medical student, Shira Goldstein, checks the blood pressure of a patient at the CrossOver Ministry clinic on Cowardin Avenue. Image courtesy of Hal Tyler Photography.

Each Tuesday night this fall, the free clinic on Cowardin Avenue in downtown Richmond will be bustling with activity as eight second-year students from Virginia Commonwealth University schools of Medicine and Pharmacy lend their hands to care for some of the city’s medically underserved populations.
   
Through a partnership with CrossOver Ministry, a nonprofit organization that provides health care to the uninsured of greater Richmond, these students will gain a hands-on experience in the practice of medicine as they care for patients and provide them the treatment they need to manage chronic and acute illnesses like hypertension, diabetes, arthritis and back pain.

“We have a vision to do things differently in how we educate our students. We’ve created a new teaching model for these students so that they are able to truly practice medicine, and focus on continuity of care – not just act as observers,” said Steven Crossman, M.D., associate professor in the Department of Family Medicine and medical director for the International/Inner City/Rural Preceptorship, or I2CRP, through which the medical students are participating in the collaboration.

“The students conduct patient screenings, and the intent is that they will see the same patient in a couple of weeks for follow-up. Caring for the patients and working alongside other students, preceptors and supervisors gives them insight into different perspectives, and the students learn to become better educators through these experiences,” said Crossman.

VCU medical student, Trevan Rankin, works with a patient at the CrossOver Ministry clinic on Cowardin Avenue. Image courtesy of Hal Tyler Photography.
VCU medical student, Trevan Rankin, works with a patient at the CrossOver Ministry clinic on Cowardin Avenue. Image courtesy of Hal Tyler Photography.

The partnership comes at a time of dire need for many – the recession has caused a significant increase in uninsured people. CrossOver Ministry reports it saw 4,200 patients in the past 12 months, an increase of 1,200 over the same time period last year. Also, in the same 12-month period, patient visits have increased from 17,000 to more than 25,000. Many of the community organizations involved in the health care safety net are stressed.

“When our CrossOver team sat down together, we knew we had to do more with less money. Students from the VCU Departments of Family Medicine and Internal Medicine had traditionally done a one-month rotation with us – so the idea for these students to come in blossomed from that. The VCU Family Medicine Department stepped-up to run the clinic on Tuesday nights – which has been a big help for us to reach our goals and allowed evening hours for our patients – which they really like,” said Daniel M. Jannuzzi, M.D., a family physician and CrossOver Ministry’s medical director.


While the students take a lesson in compassion and hope, they also grow as fledgling physicians and pharmacists. On most evenings, there are typically 12 patients seen by the care team, which includes four medical students, four pharmacy students, Spanish-speaking interpreters, a supervising pharmacist and two supervising physicians. The students learn first-hand how to lead a visit and practice medicine as a team.

Sallie Mayer, Pharm. D, M.B.A., an assistant professor of pharmacy who leads the pharmacy student contingent in this collaboration, has had the opportunity to work closely with many of these student teams and has watched them grow and become more confident and excited about their profession.

“The pharmacy students and residents work collaboratively with the medical students and physicians and they learn that these are their patients and their clinic. They write notes in the patient’s charts and follow-up with the same patients at a later date – they take responsibility for patient care and start to practice like a provider,” said Mayer, who has volunteered her time and clinical pharmacy expertise to CrossOver Ministry since the beginning of 2009.

Derek Mires and William Coleman look on as Sallie Mayer demonstrates blood glucose monitoring at the CrossOver Ministry clinic on Cowardin Avenue). Image courtesy of Hal Tyler Photography.
Derek Mires and William Coleman look on as Sallie Mayer demonstrates blood glucose monitoring at the CrossOver Ministry clinic on Cowardin Avenue). Image courtesy of Hal Tyler Photography.

And it’s becoming apparent to Crossman and Mayer that their students take home with them a broad scope of skills, knowledge and understanding that cannot be learned in the classroom alone.

“Having the opportunity to work with medical students is both unique and eye-opening. Collaborating with them has provided a new perspective regarding patient care and it will definitely shape me into a better-rounded pharmacist,” said Lauren Cox, a second-year pharmacy student.

“Additionally, I feel fortunate to have the opportunity and the privilege of volunteering my time and efforts to such a wonderful place like CrossOver. In this particular setting patient care is first and foremost and being surrounded by such a kind and caring team of health professionals and staff has helped me realize the gravity and importance of providing quality medical care to those so who need it the most.”