KU med students bring health care to high school

Inside Wyandotte High School, the buzz this time of year generally focuses on graduation and summer break.

But on Wednesday, teenage small talk shifted to health care and doctor’s appointments.

Students quietly lined benches outside a new clinic inside the school. Some just wanted to find out what the clinic was all about; others waited to talk with medical students about acute and chronic conditions.

Their bill? Free.

The clinic opened earlier this month as part of a pilot project pushed largely by University of Kansas Medical Center students including Beka Mullen, who saw a dramatic need for adolescent health care in Wyandotte County. A similar clinic also opened at Northwest Middle School in the Kansas City, Kan., district.

At the clinics, students can receive sports physicals and immunization shots. They can be treated or referred for conditions like strep throat and mental health problems. Along the way, medical students will educate high school students on nutrition, exercise and teen pregnancy, among other topics.

“Because the school-based health centers are so uniquely positioned, literally in the schools, you’re able to do prevention unlike any other center because you’re there,” Mullen said. “You can have a whole focus of preventing the disease before you even get it . We don’t want to be treating diseases; we want to be preventing them in the first place.”

The National Assembly on School-Based Health Care reports that such health clinics are widespread on the coasts and in some Midwestern states. But the concept has yet to gain traction in Kansas or Missouri. Mullen said she believes these are the first of their kind in the area.

The clinics come as Wyandotte County leaders try desperately to improve residents’ overall health. The county consistently ranks among the bottom on the County Health Rankings published by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation.

The rankings — the most recent of which were released earlier this month — consider several factors, including teen pregnancy, children living in poverty, physical inactivity, number of fast-food restaurants, diabetes screenings, education, access to recreational facilities and more.

“Wyandotte County has poor health. It just kind of forced everyone to take a look around and say we have to do something different. We have to think different,” said Mullen, a Wyandotte County resident.

The only school expense was the donated space, district officials said. Medical grants will help pay for supplies. Medical students and attending physicians donate their time.

The clinic is modeled after JayDoc, a free clinic also staffed by medical students in Kansas City, Kan. Given that, Wyandotte students named their clinic BullDoc, which is a play on the school’s Bulldog mascot.

Attending family physicians at the medical center must approve any treatment and diagnosis at BullDoc, just as they do at JayDoc.

Medical students and KU physicians also have relied on several Wyandotte students to help get the project started.

Wyandotte health teacher Robbie Howard said his students barely said a word when they first heard about the clinic.

Eventually the health students began to ask questions and offer ideas. Many of them want to be doctors, nurses and veterinarians someday, so they agreed to schedule appointments and market the clinic to students.

The Wyandotte students also stepped in when adults got a few key details wrong.

The teenagers told teachers and medical students that the plan would fail miserably if they launched the program by just sending a registration form home for parents to sign. It would never make it home.

Instead, Wyandotte students conducted a marketing campaign, explaining the clinic during announcements and telling their friends face to face. The forms then went home with students who were more motivated to bring them back. The teenagers talked to teachers, knowing that they might be able to approach some students as well.

Parents or guardians must sign the release form and agree to let their child be seen with or without the parent there.

About 200 of the 1,200 students had registered earlier this week. It’s an ideal way to start the clinic during the initial pilot, Howard said. This month the clinic is open every other Wednesday at Wyandotte; the other Wednesdays the clinic is at Northwest Middle School.

Right now the clinic is seeing every student who has completed the registration form. They want to get students in the door and explain the services so they feel comfortable returning when they have a medical problem later.

The plan appears to be working. Several students who came for the introductory appointment ended up sharing ongoing problems that required follow-up visits.

Senior Rosa Favela isn’t surprised. The 17-year-old figured many students would take advantage of the free services.

“I see young girls pregnant,” she said.

She knows they probably don’t want to talk about it with just anyone. But a doctor — someone who could help — might be a safe sounding board.

Reproductive health is bound to raise some eyebrows. But so far the only concern expressed about the matter came mostly from community members during a recent forum. Several people asked the medical students to help prevent teen pregnancies and sexually transmitted infections.

Mullen said she fully expects those issues to come up given that more than a dozen young women at the high school were identified as pregnant during the last school year alone.

“We realize that those are some of the major reasons that Wyandotte County is among the least healthy counties in the state,” Mullen said.

Medical students said minors will be treated the same way they would at a private pediatrician’s office. Medical students will follow all the state laws that dictate when and how a minor can receive hormonal birth control or be treated for sexually transmitted diseases without parental consent.

Mullen said she wants parents to be involved as much as possible.

“The parent doesn’t want some sort of secretive clinic that they don’t know about it,” she said.

And, she said, a doctor could never expect a child to get the necessary prescriptions or treatment for conditions like depression unless a parent understands.

The clinic isn’t intended to replace the school nurse. The medical students and doctors can diagnose patients and then offer treatment including medicine.

At Wyandotte, nurse Karen Dewberry is one of the clinic’s biggest cheerleaders.

“I think it’s a great opportunity not only for our school but for the community because so many children now do not have medical homes,” Dewberry said this week.

She often suggests to parents that children be seen by a doctor. But if a parent doesn’t have health insurance, she knows it’s difficult to do much about a problem.

Dewberry already has a list of students who need to be seen when the medical students return.

Nationwide, about 2,000 school-based health clinics serve nearly 2 million students, said Kyle Taylor, outreach and engagement assistant at the National Assembly on School-Based Health Care.

Taylor said the clinics operate differently in each community. The concept has proved largely successful, he said, because the medical advice is reaching adolescents at a critical time in their lives.

By addressing health problems, Mullen and school administrators think the clinic could make a difference in academics and especially absenteeism.

Schools across the country have reported that those using their health clinics have decreased absenteeism and increased performance over the long term. A group of researchers in the Bronx, New York, found a reduced rate of hospitalization and increased attendance among students with asthma. Other researchers found marked gains for students with mental health problems, according to research compiled by the national assembly.

Wyandotte Principal Mary Stewart said she spends a lot of time telling teachers that students need to be college- and career-ready upon graduation. Health is a component in that.

“What employer wants someone who is sick all the time?” she asked. “You have to know how to live a healthy lifestyle. You cannot keep a job if you’re sick all the time.”

She’s realistic that this will not be a cure-all. But she hopes it will be a start.

“We’re being strategic and we’re not moving fast,” she said about the clinic’s progress. “We think we’re on to something that’s going to help our kids in the long run.”