My Shadowing Day

Asalamwailakum again,

Bayanihan clinic has shown me the side of medicine veiled to those of us who have insurance and adequate access to primary care physicians. Underserved medical care is characterized by a lack of resources, unsteady funding, inadequate facilities, limited time, lack of trained personel, and many other limiting factors. My shadowing day at Bayanihan clinic really showed me the type of facilities these community clinics must use. Bayanihan has to share the same clinical facility with another community underserved clinic called Health for All; thus, two clinics operate out of the same exact facility. This facility isn't luxurious, in fact, its small and very old and uses donated equipment, which by the way is used and dated. Care is delivered by a medical preceptor however it is delayed by the fact that the clinic, in order to be free and supported by the U.C. Davis Medical Center, is academic, which translates into the preceptor having to teach medical students and undergraduates at every step of clinical process. The teaching process ends up taking much more waiting and examining time per patient than we would experience at private clinics, limiting the number of patients which can be seen within one clinical day. Also, the clinic can only afford to deliver free services every Saturday, which means that patients must wait multiple weeks for check-ups and follow-ups. Clerical and clinical mistakes also occur more frequently because basic blood pressures and intake is conducted by undergraduates who vary in their experience to take vitals and other parameters essential for diagnosis; which is expected because Bayanihan is a teaching clinic. Unfortunately, as with all teaching clinics and hospitals, patients must accept the risk of misdiagnosis and lower quality clinical care as a result of the learning curve. For example, if a student is not proficient in measuring various vitals, the medical preceptor may miss essential information for proper diagnosis of diabetes or hypertension. Private clinics and hospitals, on the other hand, exclusively employ trained personnel such as registered nurses, phlebotomists, etc, significantly lowering the rate of accidental misdiagnosis or mistreatment. However, one must note that the learning curve phenomenon occurs at any academic institution where medical professionals are in the process of learning their art. In fact, the repercussions at an academic undergraduate clinic are less due to the fact that medical students and undergraduate intakes have preceptors double-checking their work, which in turn reduces the likelihood of a diagnostic mistake.

I just want to note that I didn't write this to criticize the clinic or it's services. My main point was to reveal the realities of medical care when one doesn't have insurance. Without clinics like Bayanihan there would be many patients out there unable to obtain any type of medical care, which is why the clinic is an essential part of the Sacramento community. Also, clinics like these are needed to train future medical professionals who understand the plight of low income populations, and have gained the experiences and exposure to come up with viable solutions for these communities.

Ws,