NEWS | November 18, 2020

Free, student-run community health clinic grapples with pandemic constraints

(SACRAMENTO)

What does a free community clinic do when a pandemic puts a stop to in-person medical services for those who can’t afford health care? You call every patient who’s been seen in the past five years and ask them how they’re doing.

UC Davis senior Matthew Tan reviews information during a special cancer screening day at Sacramento’s Paul Hom Asian Clinic. UC Davis senior Matthew Tan reviews information during a special cancer screening day at Sacramento’s Paul Hom Asian Clinic.

For the volunteers at the Paul Hom Asian Clinic, that’s nearly 2,000 people. It’s the type of personalized, compassionate care that the clinic has been delivering for the underserved community in Sacramento for nearly 50 years.

In recent weeks, in addition to calling patients, the clinic’s volunteer licensed clinicians have been seeing a limited number of them in person by appointment. The clinic has also relaunched its monthly cancer screenings. But with COVID-19 again surging, and restrictions on in-person interactions between students and patients, the clinic is only seeing about half as many patients as were seen before the pandemic.

“COVID-19 has undoubtedly changed how we think about and deliver patient care in almost every sense,” said Tim Lee, a second-year medical student at UC Davis School of Medicine. “Since April, we’ve been offering services like over-the-phone medication refills and answers to basic medical questions. Our patients have been thankful for the opportunity to voice their concerns from home. But many of our hallmark clinical services serving vulnerable patients, such as cancer screenings, cardiopulmonary and liver-ultrasound clinics, were put on hold.”

Lee said the clinic team has reimagined the delivery of health services, especially to patients with challenging health problems. Many Hom clinic patients don’t have the language skills or money to navigate a complex American health care environment. The pandemic has only made things harder.

The phone calls have been one solution. They were a good way to do both outreach and offer needed care and support.

“Without a doubt, many of our patients felt immense gratitude, even if they didn’t have any medical concerns,” said Lee.

Many patients do have medical needs and the calls have allowed the clinic to help in a range of ways. For instance, patients are getting medication refills, while keeping staff protected from COVID-19, said Alex Nella, a physician-assistant student at the Betty Irene Moore School of Nursing at UC Davis and another clinic volunteer.

Clinics need clinicians

The Paul Hom Asian Clinic is one of more than a dozen student-run clinics affiliated with UC Davis School of Medicine. They are an integral part of the school’s curriculum and have thrived over the years because of dedicated volunteers. The clinics are open nearly every single week of the year. And they always need experienced health care professionals to lend a helping hand with patients and medical students.

If you are a licensed clinician who would like to help oversee care for underserved patients and mentor the next generation of health professionals, please contact Amy Jouan at aljouan@ucdavis.edu

“We use three-way calls between the patients, undergraduate interpreters, and medical and professional students,” said Nella. “I think it’s working great for the patients, and the workers are staying safe when patients can come in by wearing appropriate personal protective equipment. It’s been a true win-win.”

Lee said the outreach calls have also reaffirmed the clinic’s vital role in supporting the local Asian community. The Hom clinic is the oldest of the free health clinics run by UC Davis School of Medicine students and UC Davis undergraduates. Since 1972, it has primarily served an Asian patient population and is open every Saturday, except holidays such as Chinese New Year.

The clinic was started by former UC Davis medical student Paul Hom and a group of Sacramento State students. He and his friends knew that many elderly Asians and new immigrants to Sacramento were struggling to obtain adequate health care. Language and cultural barriers, as well as unaffordable health insurance, made people very vulnerable.

“The feeling was that all people deserve access to good health care,” said Ron Jan, a Sacramento vascular surgeon who serves as the clinic’s volunteer medical director and has been affiliated with the clinic for more than 20 years.

“There had never been a student-run clinic at the university before this one,” Jan said.

Since its founding, Hom clinic has provided care at no cost to patients. It relies entirely on donations and volunteers. The clinic is staffed by unpaid physicians, nurses and other health care professionals. And it’s run entirely by medical students and undergraduates.

Hannah Pan is a UC Davis junior. She started volunteering as an advocate and interpreter for Cantonese-speaking patients during her freshman year. Pan now coordinates other undergraduate volunteers. Many of her fellow students plan to pursue health care careers when they graduate. She says the clinic offers true, hands-on experience for everyone who lends their time.

“I was really surprised [when I got to UC Davis] that there were clinics that were able to incorporate undergrads and have them actually make an impact in the community,” said Pan. “Because of all the amazing work of our undergrads, medical students and preceptors [licensed clinicians] who volunteer their time, we have still been able to continue serving all of our patients who have chronic conditions during this [pandemic] time.”

In addition to Cantonese, the clinic’s undergraduates serve as interpreters for Mandarin, Korean, Taishanese, Vietnamese, Mongolian and Hmong-speaking patients. These interpreters help patients feel that they are being cared for by people who understand their culture. That helps them talk about sensitive subjects, Jan said.

 “Typically, Asians do not talk openly about death and dying,” he said. “They don’t talk about psychiatric or psychological problems, or issues related to sex. But we find, privately in the examination room, you can have signs and posters that suggest it’s ‘okay’ to talk about some of these subjects.”

The Paul Hom Asia Clinic has been delivering personalized, compassionate health care for Sacramento’s underserved community for nearly 50 years.

Before the pandemic, the Hom clinic hosted regular workshops in hypertension and nutrition in addition to its primary care health services. It also provided important women’s health care services and vaccinations. It is now restarting some of those important community health activities, such as cancer screenings.

“The biggest challenge we face is to deal with the ever-increasing population that we serve,” said Jan. “How do we continue to provide quality care and at the same time teach students? Despite all the technology and devices available, there’s still a value and need for the human touch, for understanding.”

The phone calls with patients are only a temporary change. Soon, the underserved Asian community that Paul Hom and his colleagues began caring for decades ago will again enjoy that human touch and understanding that the clinic’s dedicated volunteers are so well known for.

UC Davis School of Medicine
The UC Davis School of Medicine is among the nation's leading medical schools, recognized for its research and primary-care programs. The school offers fully accredited master's degree programs in public health and in informatics, and its combined M.D.-Ph.D. program is training the next generation of physician-scientists to conduct high-impact research and translate discoveries into better clinical care. Along with being a recognized leader in medical research, the school is committed to serving underserved communities and advancing rural health. For more information, visit UC Davis School of Medicine at medschool.ucdavis.edu.