Texas City clinic trains medical students and residents, provides primary care for underserved
Every morning at 8 a.m., faculty physicians, RNs, residents and medical students gather in a conference room at UTMB’s Community Adult Clinic in Texas City to discuss the patients scheduled for the day.
This is the TEAM (Texas Excellence in Academic Medicine) clinic—and collaboration is evident everywhere. What makes this clinic unique is the education component. Opened in August 2014 as a Section 1115 Medicaid Waiver project, it’s a patient-centered medical home model that trains medical students and residents.
“We have these bright, talented and partially trained learners who can help deliver care—and they are eager to be more involved,” said Dr. Steven Lieberman, senior dean for School of Medicine Administration, who helped come up with the idea for clinic. “Over the last 20 years, the role of students and residents in patient care has been marginalized, and they have become much more observers rather than active participants. That’s not good for their education.”
Under physician supervision, students at the TEAM clinic provide patient care and experience continuity and responsibility. The 2015–2016 class includes 12 medical students, three physician assistant students and four primary care residents who each follow their own panel of patients for at least a year.
“Students see patients multiple times over an extended period and establish that intimate physician/patient relationship, which is critical, and students absolutely love this,” said Dr. Premal Patel, assistant professor of Internal Medicine and medical director of the TEAM clinic.
The clinical outcomes they’ve seen early in the first year, which have focused on diabetes, have far exceeded their targets. Patient satisfaction has also been overwhelmingly positive.
“The patients they see are part of a vulnerable population, so they really benefit from the intense kind of counseling they get from students and faculty—it’s like there is a core team of people who have surrounded themselves around these patients,” said Patel.
Danny Linscomb is a patient at the TEAM clinic. He’s gotten to know students, staff and faculty physicians well since first coming to an appointment last December.
“I wasn’t apprehensive knowing students would be working with me. They come in with a fresh mind, eager to do their best and make sure you are feeling your best,” said Linscomb. “They even call me between visits to make sure I’m doing OK and getting the medications I need. When I come into the clinic, I’m always greeted with, ‘Hey, Danny!’ It’s not, ‘Who are you?’”
Students like fourth-year SOM student Hikma Jemal have been working with Linscomb continuously over the last year.
“What makes this clinic different from traditional medical school is that I have some patients that I’ve been following for more than a year and I get to see their progress,” said Jemal. “This experience stands out from all the other rotations I’ve done. If students just rotate from place to place each month, they don’t know how their care impacted a patient’s life. But here, you get to see it and you learn from experience.”
Patel hopes the TEAM clinic will increase interest in primary care, as the shortage of primary care providers is expected to worsen as the population ages and grows. Patel and Dr. Judy Rowen, associate dean for Educational Affairs, developed an educational program for students so they have a half day each month to get together and learn about a topic. The program is called Student Continuity of Practice Experience, or SCOPE. It’s been so popular, it has now expanded beyond the TEAM clinic to UTMB Family Medicine, St. Vincents and Pediatrics clinics.
“We really want this to be a place where students from all disciplines come together to improve the health and lives of our patients,” said Patel. “The TEAM clinic experience will benefi t students whether they go into primary care or not. By the time they graduate, they are comfortable in an outpatient clinical environment, understand roles and take ownership over their patients. That will serve them well no matter what they decide to do.”