Tulsa World: Students examine city

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Students examine city
Medical students get an in-depth, personal look at Tulsa's health and social needs.

Andrew Shacklett (center), 23, takes notes as he shadows medical student Brett Barrick, who is asking health questions of Sherry Bratton, 47, at the University of Oklahoma School of Community Medicine. SHERRY BROWN / Tulsa World

By GINNIE GRAHAM World Staff Writer
Published: 8/9/2009 2:27 AM
Last Modified: 8/10/2009 3:47 PM

First-year medical student Andrew Shacklett heard the 47-year-old Tulsa woman explain her symptoms three times.

For the previous month, Sherry Bratton said she nearly blacks out every time she lies down, and sometimes the walls seem to warp and wobble as she walks. She passed out for a few moments the night before and has had to pull over while driving.

Bratton lost her job in March and just got temporary work. She had been going to a clinic at the nonprofit Neighbors Along the Line, but her health declined beyond its capabilities. She was referred to the University of Oklahoma Bedlam evening clinic at 1111 S. St. Louis Ave.

She arrived at 4:30 p.m. on a Tuesday, and more than 50 people were in line when the doors opened at 5 p.m.

"I was in tears this morning," Bratton said. "I didn't know what else to do but go to the free clinic. I don't have any insurance. I don't have any money. And I have to go somewhere at night so I won't lose my brand new job. This was the only place to go."

Shacklett, who was observing the clinic operations, waits with her as the nurse gets details and vital signs. Third-year medical student Brett Barrick then spends more than 20 minutes reviewing symptoms and asking in-depth questions about her medical history.

Eventually, Dr. Ron Saizow is pulled in for further consultation.

"I'm ready to feel better," Bratton said. "It's very frustrating."

The next day, Shacklett explains that the doctor arranged for an MRI on her pituitary gland later in the week.

"But if something comes up, she will need to go to a specialist, who are not on staff at the clinic," he said. "She'll need to work out some sort of payment."

The experience is part of Shacklett's introduction to the OU School of Community Medicine in a one-week summer institute, meant to immerse students in the health and social needs of the Tulsa community.

"For me, north was 21st Street or 11th Street," said Shacklett, who grew up in Tulsa. "Most of our community involvement this week was spent north of Pine Street, and that was an awesome experience."

Shacklett said he chose to enter the School of Community Medicine because he is in the military and will serve at least eight years after he obtains his medical degree.

"I want to see how the civilian and private organizations view community medicine because I'll see the other side, which is a social-type system," Shacklett said. "I'm looking to see what works with the system and the pitfalls."

Life is incongruent

Each morning, participants attended an "anchoring" lecture, which set a theme and provided facts.

Students heard about the 14-year life span disparity between the northern- and southern-most sections of Tulsa, that 90 percent of premature deaths are not related to medical care, and that child abuse can impact genetics.

They found out Oklahoma ranks last in health-care system performance, children's health system and doctors per capita. Oklahoma is the only state with a worsening death rate in the past 25 years, and more than 20 percent of residents have no health insurance.

"This country every 70 years or so takes on a major civil rights issue and is successful," said Dr. Gerry Clancy, OU-Tulsa president and School of Community Medicine dean. "We may be there as far as health care. We are on the edge of something. While others struggle to reform health care, we cannot wait. We are doing something about it every day."

Students spent afternoons touring social service agencies, interviewing policymakers and medical administrators and shadowing low-income patients.

Frustration set in on a day focused on the professional moral conflict between providing care to all who need it and paying for it.

"It became the most distressing day for many students," said Dr. Daniel Duffy, institute co-director and senior associate dean for academic programs at the OU School of Community Medicine. "They felt the incongruousness in our world now."

During roundtable discussions, students debated the merits of President Barack Obama's health-care reform proposals and aspects of universal medicine.

"Politics of medicine is probably the single most important course you will take," Bob Poe, chairman of the Oklahoma State University Medical Center Authority, told participants.

"You don't want to talk about politics because you want to focus on treating patients, and that is noble. But things happening in health care are defined by politicians, and the medical community needs to be sensitive to that fact."

Physician assistant student Audra Peterson, daughter of state Rep. Pam Peterson, R-Tulsa, and a local doctor, said it is inevitable that health-care discussions will expose differing opinions.

"I have a collision of both worlds under one roof," Peterson said. "It's healthy and good to be aware of what is happening in our community. If my fellow students didn't know that health care is political, then they need to know that. We cannot choose to be ignorant of the political decisions being made."

At the week's conclusion, students found common ground to collaborate on ideas to expand on effective community programs.

Physician assistant student Nikki Howell of Nowata called the experience "inspiring."

"We need to bring medicine to the people."

UNIVERSITY OF OKLAHOMA SCHOOL OF COMMUNITY MEDICINE

The summer institute is the only one of its kind in the country to give an in-depth examination of health-care needs and poverty to students from different academic disciplines. For one week in July, 120 students interviewed low-income families, heard from policymakers and medical professionals, toured social service agencies and took part in a poverty simulation. Participants included first-year medical and physician assistant students and students from the schools of nursing, social work and pharmacy.

The School of Community Medicine at OU-Tulsa was established two years ago with a $50 million gift from the George Kaiser Family Foundation to improve public health in Oklahoma, particularly in vulnerable and underserved areas.

Living Mural Quotes

Institute participants created a room filled with quotes and photos from the interviews of more than 70 officials from insurance companies, hospitals, social service agencies, medical practices and government agencies. Here are some examples:

“Bad medicine is killing people everyday.” — Dr. Jack Somers, chief medical officer for CommunityCare managed Healthcare Plans of Oklahoma.

“Reform is necessary but it needs to be carefully crafted.” — Dr. Donald Baker, Hillcrest medical Center

“Laws and government are meant to maintain the status quo.” — Julie and Jerry Gustafson, Tulsa Advocates for the Protection of Children

“Our patients don’t want a handout, they want health care.” — Ed martinez, Community Health Connection

View the students' presentations

Area Help and Health Assistance for Tulsa

Community and Neighborhood Development Liaison

Community Health Athletic Mentoring Program

YoYo96 Prevention through Preparation

Healthy Hornets

Health by Utilizing Brotherhood

Life Skills: You can do it!

ServiceShare Foundation

Shock, Ah! and Hug

Spanish Immersion Elective

The IFFCOSM

Understanding at a Deeper Level – Health, Health Care, Access, Poverty, Accountability, Tension, Frustration, Progress, Boldness, Thankfulness….

Ginnie Graham 581-8376
ginnie.graham@tulsaworld.com By GINNIE GRAHAM World Staff Writer

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	Report Comment Check It out, Tulsa (8/9/2009 2:57:56 AM) She had to go to a free clinic and if her problems are too big...she needs to figure out how she can make payments to a doctor! Wow! I thought that noone has to go without health care...everyone can get treatment!
	Report Comment 2ndjoyce, BA (8/9/2009 6:26:44 PM) "Our patients don't want a handout, they want health care." I loved this article and because of this program these students have the opportunity to experience one more valuable step along their journeys to becoming great doctors.
	Report Comment tulsaGuy, (8/9/2009 7:32:40 PM) Quit smoking, lose weight... section (any section) of town would see great health gains.
	Report Comment Smedj, Tulsa (8/10/2009 1:30:31 AM) People who so ardently oppose health-care reform should read this article. But I don't seen any of them on here.
	Report Comment sarahloulou3, (8/10/2009 1:39:07 AM) I sure hope you're being sarcastic when you say everyone can get healthcare. Not everyone has the ability to "find a way to pay" when u dont even have 5 dollars extra a month, how are you supposed to pay for a doctor? I have insurance and recently I had an incident where my insurance was dropped by my company on accident. I went to the ER for a serious medical condition, and they said they needed to admit me. When they tried to run my insurance and it didnt work...I was "suddenly all better" The healthcare in the country is a joke.
	Report Comment Thunder196, Tulsa (8/10/2009 2:01:00 AM) We need health care reform so bad. We need it in all areas. Medicare should not be excluded. It needs overhauled. It is outdated and expensive.
	Report Comment Check It out, Tulsa (8/10/2009 2:02:23 AM) Yes I was being sarcastic! I was baiting the idiots who spout lies about health care reform! They say everyone can get health care now! I have been turned down more times than I can count!
	Report Comment Thunder196, Tulsa (8/10/2009 2:19:15 AM) Check It Out I will say I was surprised when I read your first comment. Glad you came back and cleared it up.
	Report Comment Check It out, Tulsa (8/10/2009 2:34:14 AM) Oh Thunder! You would not believe what we have been through with doctors and hospitals in this family over the last few months! I want the idiots who keep popping of against their own best interests, to shut up and let the reform get in place! Americans are suffering needlessly and going bankrupt behind negligent practices! I feel like a casualty of war and I know I am one of the good people in this world....why am I not good enough to get health care! I was born with some of the problems I am dealing with! I cannot get insurance and I cannot keep up with the twenty thousand a year I am putting in to paying off the collection agents that the doctors sell my debt to after 30 days! I can see why people are killing themselves and their families. The hopelessness is so overwhelming! The sleeplessness is a real B#t@h too, as evidenced by my presence on this board at 2;30 in the morning!
	Report Comment Few Clothes, Austin, TX (8/10/2009 12:13:07 PM) I hope they aren't shot in a drive by while they are here.
	Report Comment WhoseLeft, Tulsa (9/3/2009 4:48:45 PM) Here is the heart of this article: They [the students] found out Oklahoma ranks last in health-care system performance, children's health system and doctors per capita. Oklahoma is the only state with a worsening death rate in the past 25 years, and more than 20 percent of residents have no health insurance. Now, of course, I understand why we don't need no gvment plan.

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