Tufts University’s Free Clinic Offers Health Care to the Needy

By Robert Sondak
Spare Change News

General health concerns, joint pains, colds and flu, confidential sexual health counseling, and case management are some of the services offered by the volunteer Tufts University Sharewood Project. These services are part of a comprehensive clinic program offering a variety of free health services to the medically underserved residents of Greater Boston.

Every Tuesday evening in the First Church of Malden on Pleasant Street next to the Malden Center T station, the Sharewood Project opens its doors to serve the health care needs of Greater Boston. The clinic operates under the supervision of Medical Director Dr. Gregory Sawin, M.D.,M.P.H. It is staffed by Tufts undergraduate students, and grad students in the fields of medicine, dentistry, and the biological sciences.

“There are students that volunteer from non-Tufts programs such as the New England School of Optometry (NESO),” said Astrid Werner, Tufts University second-year medical student and publicity coordinator for the project. “The NESO students volunteer once a month.”

On other weeks, the clinic utilizes an ophthalmology team, which is a group of med students working with a professional ophthalmologist. They focus on eye screenings, especially for patients with diabetes or other health concerns that could have an effect on eyesight.

The Sharewood Project has three main objectives. The project provides health care to those underserved, uninsured or facing an emergency; maintains a center to train medical students under doctors’ supervision; and runs a health care center whereby Massachusetts doctors can volunteer. Approximately 1,500 patients make 2,500 visits to the clinic annually.

“Since I have been volunteering, beginning in the summer of 2010, we have been averaging 25 to 30 patients a night,” said Stephen Sanoja, a Tufts University second-year medical student and the administrative director of the project. “A few nights, it can be as high as 50 patients or as low as 15.”

By 6 p.m. the clinic opens its doors and people sit in the waiting room until the front desk opens at 6:30 p.m. People are asked to fill out a medical form and select the medical services they need along with a liability form which allows the center to treat people. They receive a number and are called by the order in which they registered. The medical center utilizes a computerized record-keeping system. If you come back again, the front desk looks up your records and the medical staff reviews a copy of your records online before seeing you.

The clinic operates with undergraduate students doing initial intake and conduct triage: asking why a patient is there, taking vital signs, and escorting patients to the exam rooms.

First- and second-year medical students follow up by working with patients, recording their medical history and conducting a short physical exam. They then consult with one of the staff doctors on prescribing the appropriate therapy.

“Medical students go up to one of the attending physicians and present the patient case to them,” Werner said. “Physicians will then visit the patients, accompanied by the medical students, to conduct a thorough examination and make medical recommendations.”

Medical doctors volunteer on a rotating schedule under the direction of Dr. Gregory Sawin. Each week a group of three or four practicing doctors joins the medical staff, donating about one Tuesday evening a month. Staff doctors have the authorization to issue medical prescriptions and advise patients on what medical help is appropriate for their condition.

“The second network of doctors comes from the Cambridge Health Alliance-affiliated Malden Family Medical Center each Tuesday evening,” Sanoja said. “We get two residents each week.”

I went to the Sharewood Project in August for two reasons. I had no insurance and I was seeking a medical opinion to my pressing question: do I have cellulitis, a severe bacterial infection of the skin? After I registered at the front desk, two undergraduate students performed triage and escorted me to the exam room. This was followed by medical students doing the initial intake and conducting a short physical exam. They commented that I had an inflamed left leg. Ten minutes later, they were accompanied by an attending physician who gave me a comprehensive 15-minute exam. At the end, the doctor diagnosed the inflammation as cellulitis. I was impressed that I received two examinations — one by an attending physician who was very knowledgeable about cellulitis — and got a prescription for celaphexin, a penicillin-like antibiotic, in less than 90 minutes.

Two weeks later, I came back for a follow-up and got a comprehensive examination by Dr. Crothers, a Tufts University-affiliated volunteer physician, and Dr. Kathy Miller, the clinic medical director that night. These doctors commented that the inflammation in my left leg had not subsided adequately. They recommended that I go to the Tufts University Medical Center emergency room for an exam and to get intravenous antibiotics. I took their recommendation, spending two days in the Tufts Medical Center ER. I received six successive doses of intravenous antibiotics. The next morning I was released and given a two-week prescription for oral antibiotics.

In September, I went back every week for a physical to look at the subsiding inflammation with an attending physician. At the end of the first visit, I met with Lauren Goli, a second-year medical student and case manager. She helped me file an online application through the Massachusetts Health Plan for Commonwealth Care and I gave her copies of my writer/vendor work papers and she mailed them in. I met with Lauren the next week and was impressed that she found three registration errors while reviewing my online application. Subsequently, I had these errors corrected by calling in and requesting changes.

I am in the process of qualifying for Commonwealth Care and registering for two of their health plans. I also have found out that my extended ER visit was covered by the Health Safety Network, a program for Massachusetts residents who are not eligible for health insurance or who can’t afford to buy it.

“We have three case managers each week,” Goli said. “We average working with six to seven patients each Tuesday evening.”

Goli elaborated more about the case manager position at the clinic. “Case managers are usually medical students,” Goli said. “Case managers can also be graduate students in public health.”

Goli has been a case manager for one year and says that her career focus is in obstetrics.
The clinic also educates families and children about nutrition. The clinic runs a nutrition table that explains the food pyramid and the new My-Plate.gov program that identifies the primary food groups (starch, vegetables, fruit, protein and dairy). They also have visual presentations about portion control.

“We help to focus on educating people on nutrition, healthy shopping, reading nutrition labels, vitamins and minerals, along with the food pyramid and my plate.gov,” said Diane Larsen, Tufts University second-year medical student and the nutrition table coordinator for the project. “We talk to children and their parents.”

Larsen pointed out that Sharewood uses measuring cups, which help to show serving sizes.

“We average 12 to 18 people at the table,” Larsen said. “The clinic operates the table twice a month.”

Alice and David from Boston and Bienvenu from Malden are some of the patients that come to the Sharewood Project regularly.

“I am here tonight for a second asthma checkup,” Alice said. “I have found the clinic doctor and staff very helpful.”

“This is my second time coming to the clinic,” Bienvenu said. “I go for regular checkups and previously have brought family here before.”

Funding for the clinic comes from several sources. The Tufts student council provides funding. The city of Malden has supported the Sharewood Project through a series of public grants. The university provides financial support as well. In addition, the clinic receives a small contribution from Amazon for people who make purchases on its website.

The Sharewood Project is partnering with the Longwood Symphony Orchestra to feature a classical concert at the New England Conservatory Jordan Hall on December 3rd.

For more information on the Sharewood Project access: http://sharewood.info

ROBERT SONDAK is a Spare Change News vendor/writer. Robert studied food science and dietetics at Pratt Institute in Brooklyn. Robert has a bachelor’s degree from the University of Massachusetts Boston College of Public and Community Service (CPCS).

Robert Sondak is a vendor and a writer for Spare Change News.

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