Background

Escalation began unexpectedly as I talked with Jane--one of my new friends at the Transition Projects--about a blood pressure clinic. A reflexive promise to look up the date for the clinic later caused her more distress. Her stiffening gestures and rushed speech demonstrated a greater need that I was clearly not understanding. She continued saying that she just wanted to know when she should go to the hospital. It was in that moment I realized she did not have access to physicians like the endocrinologist I had seen who could counsel her on these matters.

I remember rushing my own speech when fighting the health system to find a diagnosis for chronic ailments. Evidently, having legs that felt heavier than iron and no muscular adaptation to move them was not a unique enough symptom to lead to a diagnosis let alone a treatment. After countless visits with multiple specialists--all of whom most likely received a note in my chart warning them of persistence--I finally met an endocrinologist who took the time to listen. He sat with his chin resting in his palm, deep in thought, before counseling about further testing, possible diagnoses, and therapeutic options.

Now, after many more doctors who were willing to listen, I bounce around places like the transition projects exuberantly trying to recruit people like Jane to participate in our educational workshops and clinic days. Yet, moments of tension stemming from desperation remind me that not everyone has access to doctors who can counsel them through their health concerns.

Significant public health problems stemming from health disparities include access to healthcare. The student-run clinic can ameliorate this discrepancy if run smoothly. Unfortunately, services such as blood pressure clinics fall through when miscommunications arise, clinic operations are inefficient, or volunteers are unable to attend. A framework to support evaluation will help students identify these issues in clinic function and services. Subsequently, the implementation of continuous quality improvement work based on these evaluations will be more sustainable to bring people like Jane hope and healing similar to my own.