Incorporating the principles of the patient-centered medical home into a student-run free clinic

Abstract

As the health care delivery landscape changes, medical schools must develop creative strategies for preparing future physicians to provide quality care in this new environment. Despite the growing prominence of the patient-centered medical home (PCMH) as an effective model for health care delivery, few medical schools have integrated formal education on the PCMH into their curricula. Incorporating the PCMH model into medical school curricula is important to ensure that students have a comprehensive understanding of the different models of health care delivery and can operate effectively as physicians. The authors provide a detailed description of the process by which the Weill Cornell Community Clinic (WCCC), a student-run free clinic, has integrated PCMH principles into a service-learning initiative. The authors assessed patient demographics, diagnoses, and satisfaction along with student satisfaction. During the year after a PCMH model was adopted, 112 students and 19 licensed physicians volunteered their time. A review of the 174 patients seen from July 2011 to June 2012 found that the most common medical reasons for visits included management of hypertension, hyperlipidemia, diabetes, gastrointestinal conditions, arthritis, anxiety, and depression. During the year after the adoption of the PCMH model, 87% were very or extremely satisfied with their care, and 96% of the patients would recommend the WCCC to others. Students who participate in the WCCC gain hands-on experience in coordinating care, providing continuity of care, addressing issues of accessibility, and developing quality and safety metrics. The WCCC experience provides an integrative model that links service-learning with education on health care delivery in a primary care setting. The authors propose that adoption of this approach by other student-run clinics provides a substantial opportunity to improve medical education nationwide and better prepare future physicians to practice within this new model of health care delivery.

Keywords:

• medical education
• patient-centered medical home
• medical students
• service-learning
• student-run free clinic

Acknowledgments

The authors regret to advise of the passing of Dr Anne Kastor prior to publication. This paper is dedicated to the memory of Dr Kastor for her years of service to the WCCC. The authors wish to thank Dr Alvin Mushlin and Dr Olaf Andersen, both of Weill Cornell Medical College, for their insightful editorial suggestions. The authors are grateful to the physicians and students who have volunteered in the WCCC and the patients who allowed us to participate in their care.

Disclosure

The Weill Cornell Community Clinic receives funding from Weill Cornell Physicians Organization, Weill Cornell Internal Medicine Associates, Weill Cornell Medical College, and NewYork-Presbyterian Hospital in addition to private donors. MCR previously received and JBS, and JDS receive funding from NIH MSTP grant T32GM07739 to the Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD–PhD Program. CBF was supported by Grant Number 1P60MD003421 from the National Institute on Minority Health and Health Disparities. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

JBS is presently director of the WCCC; MCR and JDS were directors of the WCCC. JL and MMR were board members of the WCCC. ASK and CH report no conflicts of interest in this work.

This work received approval from the Weill Cornell Medical College Institutional Review Board.