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Trainee-Authored Letters to the Editor

Caring Outside the Clinic

Price, Meghan; Doshi, Pratik; Kim, Ju Young

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doi: 10.1097/ACM.0000000000003963
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To the Editor:

Times of crisis do not create disparities; rather, they exacerbate the problems already engrained in the system. During the COVID-19 pandemic, everyone—from trainees to providers—has been forced to face drastic changes to the system. As we adapt, it is critical to consider ways to address these inherent challenges.

It is essential that medical trainees understand the communities for which they will ultimately care. However, studying in classrooms sequestered on university campuses and rotating through inpatient wards of tertiary hospitals often create divides between trainees and the roots of the conditions that bring patients into their care. As medical education has relied on more virtual curricula over the past year, students have been further distanced from the communities they will treat. There is a need for innovative, community-driven programs that allow students to understand the needs of their future patients and appreciate the socioeconomic factors that govern health.

Older adults have historically been a marginalized population, with more limited access to health care, treatments, and resources compared with younger populations. Disruptions in regular social services and community support programs during the pandemic have exacerbated this existing disparity. To address this negative impact on older adult health, we partnered with 2 community organizations (Duke Division of Community Health Benefits Enrollment Center and End Hunger Durham) to create the Senior Well-Check Call program, which is managed by a volunteer force of medical and undergraduate students. Through this program, our volunteers make phone calls to vulnerable senior community members to assess their basic and prescription needs, financial stability, and food insecurity.

As medical students, we initially engaged in this effort to understand how people were adapting to the pandemic; however, as we consistently heard about older adults who were struggling to pay for basic necessities, we felt compelled to expand the movement. We leveraged relationships with local food pantries and student organizations to provide services such as emergency deliveries of food and household supplies. We harnessed platforms such as NCCare360, a novel social services platform operating across North Carolina, to identify services that were still available during the pandemic. Our volunteer force is currently contacting nearly 200 seniors per week and helping provide regular weekly food and other essential emergency deliveries. These well checks, among other efforts, allow medical students to become more involved in their communities, practice talking to community members about important yet sensitive issues, and develop new learning methods that can be continued even after the pandemic is over.

Acknowledgments:

The authors would like to thank their community partners and the amazing team of dedicated Duke student volunteers who made this effort possible. Specifically, they would like to acknowledge Liliana Marin at the Benefits Enrollment Center; Jacquelyn Blackwell at Feed My Sheep Food Pantry; Betsy Crites at End Hunger Durham; and Duke medical students Kathryn Benson, Jack Leschisin, Sandra Au, and Seth Flynn for the support and leadership they have provided to the program.

Copyright © 2021 by the Association of American Medical Colleges