HEALTHCARE ENTERPRISE: Meharry’s 12 South Community Clinic

Reaching Out to the NeighborhoodThe 12 South Community Clinic is a big player in the Nashville neighborhood where it is located. It has gained traction, creditability ... and admiration  ... throughout the broader Nashville community since opening its doors in the fall of 2012.  An Idea Takes ShapeIn 2010, six students at Meharry Medical College discussed their concern about the rising numbers of uninsured Tennesseans and the way the healthcare resources in Nashville treated — or failed to treat — a significant number of them. Instead of just talking about the situation, they decided to find a way to help.Their solution was to design and create a clinic that would provide free care to an underserved community.A nucleus of medical students, led by upperclassman Rebecca Ptaff, founded the clinic to have wide-ranging, tangible implications on the community by providing top-quality healthcare, while also providing a venue for medical students to hone their skills by applying and augmenting their classroom and laboratory studies with ‘real world’ experience.“It all started with a few students who were interested in starting a free clinic so that they could cultivate a training ground for future primary care physicians and also provide access to care,” said Naomi Bitow, now co-director of Case Management. Four years later, those ideas and ideals have been incorporated into the 12 South Community Clinic. Feet on the GroundWith the support of Meharry’s School of Medicine Dean Charles P. Mouton, MD, and the faculty Advisory Board, these students — and the many others who have since joined them — have been able to establish and sustain the clinic through its first year of operation with results that would be deemed a success by any measure. Student-run under faculty supervision, the clinic was established in partnership with United Neighborhood Health Services clinic network, which has a similar mission. Since opening in October 2012, the clinic has provided an estimated $46,500 in care — $42,630 in free office visits; $3,091 in free diagnostic laboratory studies; $434 in free prescriptions; and $373 in radiology services. Clinic students and staff also work to assist patients who need additional access to diagnostics, prescriptions, specialty referral and transportation. “The services that we provide are comprehensive care, primary care for children and adults, and we refer patients to social services providers,” said Veronica Ralls, co-executive director of the clinic with Nicholas Kramer. She added, “We have recently started doing screenings for oral cancer.” And – they give flu shots. This latest preventive care service recently has been heavily publicized in local media outlets in light of this year’s deadly flu epidemic. On one recent cold evening, more than 79 patients showed up to take part in the Influenza Vaccination Program. A student, Andrews Marshall, recipient of the Martha Ingram Scholarship, funded an initiative that has allowed the clinic to provide free influenza vaccines to patients throughout the entire flu season. On this January night, the flu shots were given by 35 first- and second-year medical students who received training to administer the vaccines. The medical students, who receive no pay or school credit for working, have learned that clinics aren’t just about onsite patient care. In the clinic, they learn about connecting patients to other resources, figuring out how to help them pay for the procedures or follow-ups in hospital settings, helping patients figure out potential Medicaid eligibility, and a myriad of practical information about how the healthcare system works.The clinic is open from 6-9 pm every Thursday evening and is staffed by Meharry medical students and faculty physicians who volunteer their time. An attending physician is on site every week to oversee operations, and Jim Sullivan, MD, serves as chief clinical adviser and regular volunteer.“As our patient numbers grow, we hope to move eventually to having two physicians each Thursday night, which would allow us to see twice as many patients, and then we hope to move to two nights a week,” Ralls said of future plans. “We want to  both enhance the educational experience of students, as well as to offer top-quality healthcare at no cost to an underserved community.”The 12 South Community Clinic is located two blocks from a neighborhood that is recognized as a Medically Underserved Area Population and a Primary Care Health Professionals Shortage Area. The clinic augments these barriers to care by seeing patients with appointments and on a walk-in basis. With their evening hours, Ralls noted, “We also serve as a convenient option for uninsured and underinsured community members who often must visit an emergency department for primary care needs. All patient care and training is conducted and tracked in compliance with MMC standards of practice and in accordance with the patient-centered medical home model of care.” She continued, “Our case management model ensures individualized care for all patients.”The clinic is currently working with the Meharry School of Dentistry, Tennessee State University School of Social Work, Vanderbilt University, and other local institutions to best provide a holistic package of services for patients and to foster inter-professional collaboration and learning.