Doctors Serving People: Restoring Humanism to Medicine through Student Community Service

Chapter 7: Empirical Estimates of Patients and Clients Served

118 Medicine has indeed delivered effective answers to some health problems and it has found the means to lessen the symptoms of many others, but by and large we remain with the necessity to do something about the incidence of disease, and that means a new partnership between healthservices and all those whose decisions influence the determinants of its incidence. —Geoffrey Rose, The Strategy of Preventive Medicine The task of accounting for those people served by RCSIP is an interesting one. First, on the basis of my decision to limit and discuss in detail four very different and particularly revealing types of programs, I excluded a number of other activities that were just as important to the participants and the people they served. Second, for this assessment I have included all twenty-four programs that had been undertaken during the decade of the 1990s (see table 1). Third, there was no way to keep track of every individual seen in the twenty-four projects that ran between three and ten years of the decade of analysis. Fourth, at that time RCSIP had neither the personnel nor the funds to keep such records, let alone analyze them. Nonetheless, it is possible to offer estimates based on the evidence we have. Empirical Estimates of Patients and Clients Served Chapter 7 Empirical Estimates of Patients and Clients Served 119 Table 1 Rush Community Service Initiatives Program Projects, 1990–2000 Project Title Purpose AIDS RAIDS Teaching safe sex and AIDS prevention in inner-city schools Big Sib Befriending HIV-positive infants and children in institutional care The AIDS Prevention Magic Teaching AIDS prevention to Show youngsters Clinic St. Basil’s Free People’s Clinic Developing a general medicine clinic in the Englewood community St. Basil’s Free People’s Establishing a prenatal and gynecology Clinic clinic in the same community CommunityHealth Providing primary care to a large Latino population Franciscan Homeless Clinic Providing acute and primary care to the homeless Pilsen Homeless Shelter Delivering primary and acute care to the homeless Health Henry Horner Pediatric Training local residents to serve as case education Asthma Program managers and advocates for asthmatic children Rush Health Educators Initiating health promotion training in schools Deborah’s and Mariah’s Place Providing health education and support for abused and homeless women Tutoring Henry Horner Tutoring Tutoring and counseling children after and school mentoring Buddies Developing personal friendships with chronically ill children Casa Juan Diego Tutoring Mexican children in the Pilsen community Special Refugee Young Gang Working with refugees in Bosnian, Prevention Guatemalan, and Haitian communities Horizon Camp Becoming involved with disabled children at summer camp Youth Link Promoting patient education for adolescents at Stroger Hospital Casa Guatemala Conducting screening and health evaluations with recent immigrants Frazier Elementary School Providing health education and disease Health Clinic prevention by an interdisciplinary team (Continued) 120 Doctors Serving People RCSIP served four general medicine clinics where patients were seen at least one day a week for eight years: St. Basil’s, CommunityHealth, Franciscan, and Pilsen. The only realistic way of estimating the number of patient contacts is to establish ranges as a basis for calculating averages. The following formula was used in making estimates for each clinical setting: the range of the number of patients seen in one day times the number of days in an average year of operation times the number of years the project had been in operation. The mean number of contacts is reached by dividing the range by two. Applying the formula to the Rush General Medicine Clinic at St. Basil’s serves as an example: between 8 and 15 patients were seen on one clinic day over an average of 42 days per year for 8 years; this number is then divided by two to determine the mean: (8–15) ⫻ 42 ⫽ (336–630) ⫻ 8 ⫽ (2,688–5,040) ⫼ 2 ⫽ 3,864 Using the same formula, with slight variations in numbers of patients seen and clinic days per year, we arrived at the following averages and ranges: CommunityHealth 5,000 (4,000–6,000), Pilsen 3,456 (3,072–3,840), and Franciscan 3,240 (2,880–3,600). On the basis of these very conservative estimates , the average and total range of patient contacts for the four clinics over eight years is calculated at 15,560 (12,640–18,480). The actual number of patient contacts was probably much higher, but these estimates were...