It was 9:30 p.m., an hour after the DAWN Clinic had already closed, when David Choi and his fellow volunteers saw her: an elderly woman in a nightgown and slippers making her way down Dayton Street. Her foot and knee were bleeding, she didn’t understand English, and she had no idea who she was or where she was going.
Choi, a third-year pharmacy student at the Anschutz Medical Campus, spoke to the woman in Korean and guided her inside the DAWN Clinic. The clinic volunteers then cleaned her wounds, tracked down her retirement home manager, and returned her safely to her home. The volunteers later learned from the police that if they hadn’t been there to help the woman, she would have been dropped at an emergency room and, unable to provide her name or address, filed as a missing person and retained until she could be identified. Instead, the woman returned safely to her bed, happy and, thanks to the DAWN Clinic, healthy.
The DAWN (Dedicated to Aurora’s Wellness and Needs) Clinic is a student-staffed free clinic that serves uninsured adults from the Aurora community every Tuesday evening, offering free medical, physical therapy, and dental services. Every week, Anschutz students from the School of Medicine, Skaggs School of Pharmacy and Pharmaceutical Sciences, Colorado School of Public Health, College of Nursing, and School of Dental Medicine band together to serve their Aurora neighbors and learn what it means to provide quality health care to a population in need.
The clinic is housed in the Dayton Street Opportunity Center, a community resource gold mine with education, job training, counseling, and health care resources. Both the Opportunity Center and the clinic have been a joint effort, created by the Fields Foundation and Primary Care Progress with partners like the Mosaic Church of Aurora who want to see the community get more help than a new prescription can offer. Joseph Johnson (right), a chief resident in Internal Medicine with the CU School of Medicine and medical director for the DAWN Clinic, says he can only do so much with pills and advice. This community, he says, needs more, and the DAWN Clinic is there to provide that.
“We’re trying to create as much opportunity in as confined an area as possible,” Johnson says. “We’re trying to give patients the skills to navigate the system and be successful in the future. We won’t just say, ‘Sorry you’re homeless, here’s some insulin that will spoil since you can’t refrigerate it.’ We can do more. In addition to addressing their immediate medical needs, we can provide housing navigation, provide healthy eating education, and establish lasting relationships that will change lives.”
Serving the Uninsured
It’s 15 minutes before the clinic officially opens for the evening, and there are already three people waiting in the clinic’s bright waiting room. Evelia Perez doesn’t speak much English, so when she checks in she is assigned an interpreter to assist her throughout her visit. Perez learned about the clinic at her child’s school and, not having a regular doctor since she moved to the United States from Mexico 13 years ago, came to the clinic in its second week. Based on complaints of pain in her shoulder, she is matched with a Physical Therapy student who assesses her needs. By the end of the evening, Perez will make follow-up appointments for the next two weeks.
“I have no insurance, so I haven’t seen a doctor in seven years,” Perez says. “When you don’t have insurance and you have an injury or pain, there’s nothing you can do. I’m so thankful that now I have a place to come to for help.”
Just as the clinic is run on volunteer’s time, all of the clinic’s equipment was donated by the community. Everything, from the wheelchairs and exam tables to the plastic gloves and thermometers, was donated by other primary care clinics, local physicians, and organizations like Advocates for World Health. The various schools on the Anschutz Medical Campus collectively contributed $20,000 to enable the clinic to acquire the Advocates for World Health shipment valued at $147,000, and one local physician donated approximately $15,000 worth of equipment that could have been sold elsewhere. The clinic is built on the donations of people who believe in what the DAWN clinic is doing. Watching the patients like Perez, it’s hard not to.
State Rep. Rhonda Fields (D-Aurora, right), one of the creators of the Opportunity Center, located in her home district, says what the clinic is doing is especially important for the Aurora community, which is composed of refugees and immigrants representing more than 190 different languages. Many of them are undocumented, Fields says, and 56 percent of them are still uninsured. Now that population has a place to go for help.
“I believe that health care is a right, not a privilege,” Fields says. “That’s the model of this place. This is a place where everyone can feel welcome. If they come, we will help them. There is no wrong door.”
A Working Classroom
The DAWN Clinic is not only there to help patients, but to give students from the Anschutz Medical Campus a place to practice the skills they learn in school. Throughout the night, the students are the first point of contact for the patients, but every patient will also see a licensed professional before the end of their visit. Across the hall from the exam rooms is the Krugman Care Hub, named after former CU School of Medicine Dean Richard Krugman, MD, a strong supporter of the clinic. Inside sits a group of licensed professionals—doctors, physical therapists, psychiatrists, and Anschutz faculty there to serve as preceptors for the evening.
The Care Hub functions as a kind of hands-on classroom for the students. After a student spends time assessing a patient’s needs, they enter the care hub and present their findings to the group of preceptors: the patient’s profile, reason for visit, results of physical, and the student’s diagnosis. The preceptors ask follow-up questions and then one preceptor whose specialty is best suited to the patient’s needs accompanies the student back into the exam room, where together they will develop a plan of action for the patient. It’s individual mentorship between professionals and students that results in growth for the students and relief for the patients.
“This is a welcome break from all the theory and hypothetical projects of school,” says Andi Coleman, a recent graduate of the College of Nursing and now a new-graduate resident nurse (RN) at University Hospital. “I’m getting real-life experience, and I’m doing something that matters. What we’re doing here is real, and this community really needs us. It’s amazing to know we’re actually making lives different.”
Coleman says she has also loved working closely with students from across the disciplines, a collaboration that the traditional classroom cannot always provide. In the clinic, medical, pharmacy, behavioral health, physical therapy, nursing, dental, and public health students all work together. Together, they serve their community, and in the process they learn what the other disciplines are capable of.
“The primary care system can be so fragmented,” Choi says, “with every health care provider working in their own silos, paying no attention to what the other providers are doing in the silos right next door. Here, we’re working together as a team to provide holistic care that serves patients well and keeps them from falling out of the system.”
A Lasting Difference
Johnson says the collaborative, innovative practice environment of the clinic will not only help the patients that walk in their doors, but will also bolster the primary care system moving forward, better equipping and motivating the future workforce to meet the rising demand in Colorado’s urban communities. The students in the clinic feel so empowered to help their community that, Johnson says, in the future they will demand an employer who practices in a way that they now value, creating a primary care system that’s focused on delivering quality care to populations in need.
“The DAWN Clinic was just an idea, and now it has grown into the single point of access in Aurora where uninsured patients can receive quality care,” Johnson says. “My mission is to prove not just to students, not just to the university, not just to the community, but to the world that we can provide professional primary care in a cost-effective manner, and that we can make a difference.”
Choi, the pharmacy student who helped the Korean woman on the clinic’s first night, says you don’t even have to come in the clinic to feel the hope radiating from it. He says that first night after he helped the elderly woman home, he was walking back to the clinic when he saw the lights of the Opportunity Center from a distance for the first time. The center’s sign was shining like a beacon all down Dayton Street, letting everyone know that the center, the clinic, is there to offer hope—letting Aurora know people are there to bring change.
Published: April 13, 2015