Medical students get the real story on health
By Dana Goldman | Emory Health Magazine | June 29, 2012
Young doctors in Emory's medical school are going to jails, homeless shelters, community clinics, and nursing homes to better understand the health challenges of their patients.
Emory fourth-year medical student Alexis Ritvo is a go-getter with an impressive resume. She earned a bachelor's degree from Harvard and a public health degree from Emory's Rollins School of Public Health. In between, she spent time researching schizophrenia. But on a recent weekday, the future psychiatrist sat in the Grady Memorial Hospital pharmacy waiting for her number to be called. It's the place where many of Ritvo's Grady patients go to have their prescriptions filled. She arrived at 8 a.m., waited for three hours, and left empty-handed.
"I failed to get a prescription," Ritvo says. "I was 10 away from having my number called when I had to go to my next lecture." Her go-getting ability had run up against the realities of a complicated and often under-resourced public health system.
The assignment Ritvo was trying to complete by filling a prescription came about as a result of an emerging focus in Emory's medical school on social medicine. Social medicine looks at how economic, social, and cultural conditions affect health, so that health care providers can better understand and work with their patients to improve health outcomes. In the case of the Grady pharmacy, Ritvo says the lesson was clear. "I thought, gosh, if I'm having trouble, and I'm about to graduate with a medical degree, I can only imagine how some of these patients feel." She understood more clearly that cost is by no means the only barrier keeping patients from taking their medications. "We want people to be working and holding down jobs," she says, "but then they're going to have to take an entire day to get their prescriptions filled."
Lessons on the ground
In a month-long social medicine elective this spring, Ritvo and a group of medical students and residents gained firsthand exposure to many of the social determinants of health that their patients encounter.
Following individualized schedules, they toured one low-income community on the west side of Atlanta with a 97 percent unemployment rate, miles away from the nearest grocery store. They also visited homeless shelters, jails, nursing homes, patients' homes, and HIV and tuberculosis clinics. Some spent time shadowing Grady's chief of staff and chief medical officer to get a grasp of how Grady looks from the top-down. The elective also included weekly lectures on social medicine as well as lessons about legislation and lobbying efforts that affect health care. In addition to the elective, funded this year by Emory's Office of University and Community Partnerships, medical school faculty members have been integrating the lessons of social medicine into the rest of the curriculum as well as faculty development.