UAB students run clinic for the underserved in downtown Birmingham

By Nathan Turner Jr.

For the Birmingham Times

Rachel Daniell takes a medical history for Vicky Willis, a patient who came in to Equal Access Birmingham clinic to get medication. Equal Access Birmingham is a student-run free clinic that provides continuity of care to the medically underserved. The clinic in located in Church of the Reconciler on 2nd Ave North and 14 Street. (Walt Stricklin, special to The Times)
Rachel Daniell takes a medical history for Vicky Willis, a patient who came in to Equal Access Birmingham clinic to get medication. Equal Access Birmingham is a student-run free clinic that provides continuity of care to the medically underserved. The clinic in located in Church of the Reconciler on 2nd Ave North and 14 Street. (Walt Stricklin, special to The Times)

A 54-year-old patient has come to the Equal Access Birmingham (EAB) clinic, located in the Church of the Reconciler on 14th Street North, complaining of high blood pressure and depression issues. She has no health insurance and is unable to purchase prescription medication that would alleviate her conditions. But here, at this University of Alabama at Birmingham (UAB) Medical School–run facility, she has found respite.

“[The medical staff] is working me into today’s schedule—and it’s a Sunday,” says Vicky Willis, a former receptionist and staffer at a Birmingham advertising agency.

She and her husband, Luke, a boilermaker and ex-paramedic, have slept on park benches in recent years after he lost his job. Luke also needs treatment for depression, she says.

Vicky also touts another benefit of the EAB clinic, which is housed in a converted storefront building: “It’s located in a church, a place you can trust, a place with a security guard. You can eat here and feel safe.”

The Willises are among a small stream of EAB visitors seeking care on this particular Sunday. Their complaints range from high blood pressure to constant headaches to heart palpitations.

Serving the Underserved

A group of dedicated health care providers staff EAB’s chronic-care clinic, which was founded in November 2012 to provide basic primary care to residents in the Jefferson County Housing Authority Shelter Care Plus program. EAB is operated through the Office of Undergraduate Education at UAB and run by medical students from the UAB School of Medicine.

Working with EAB exposes future physicians to clinical and socioeconomic factors that contribute to health disparities. In this way, a much larger goal is accomplished: Medical students are trained to provide high-quality care and support an underserved population, giving them the opportunity to work with and learn from their community, according to UAB.

According to UAB, 153 medical students and 30 physician volunteers took part in the EAB clinics between 2014 and 2015.

Dr. Gaurav Parmar, on duty at the clinic on the day Vicky Willis visited, said much more must be done to address the primary care needs of the poor and homeless.

“It is a shame that we take care of the world’s problems and always [claim we] can’t afford to pay for more cost-effective health care,” said Parmar, an instructor fellow in the UAB Department of Vascular Surgery.

Dr. Gaurav Parmar does paper work in between helping UAB medical students at the Equal Access Birmingham clinic as they take medical histories before he sees the patients. (Walt Stricklin, special to The Times)
Dr. Gaurav Parmar does paper work in between helping UAB medical students at the Equal Access Birmingham clinic as they take medical histories before he sees the patients. (Walt Stricklin, special to The Times)

Broad Range of Services

The EAB facility runs three clinics that operate on different days of the week. The chronic-care clinic operates on Sundays from 1 p.m. to 5 p.m. and is managed by UAB medical students with oversight from physicians on the school’s faculty. The acute-care clinic, which began operating in the fall of 2015, is open on Wednesday afternoons. And the mental-health clinic is available once a month on Saturdays. Patients need a referral from either the acute-care or chronic-care clinic to be seen at the mental-health clinic.

Most EAB patients come from a number of area shelters, including Firstline, Firehouse, and Pathways.

“From January to June, we have had 278 patient encounters,” said Shejuti Paul, a second-year UAB medical student from Florence, Ala., who volunteers as the clinic’s development director. “We call them encounters because some people come in multiple times for colds or other primary-care issues.”

The EAB clinics treat a broad range of conditions, such as diabetes, high blood pressure, depression, and anxiety. No pain-killing medications or drugs that can be used for illicit means are stocked, said Paul.

Although the clinic is a student-learning facility, it also teaches clients how to access other medical benefits, Paul said.

“Navigating the health care system can be scary and confusing,” she said “It’s a good way to get patients connected to other resources that they are unable to identify unless they are in the medical system.”

Volunteer Spirit

The EAB clinic accepts volunteers from schools or programs outside UAB, too. Participants include students from the Samford University School of Pharmacy, the Auburn University School of Pharmacy, the UAB School of Dentistry, the UAB School of Optometry, and the UAB School of Health Professions (occupational therapy, physical therapy, and social work). Undergraduate volunteers serve in support roles, such as check-in and dispensary assistants.

Danielle Stallings, a third-year Samford University pharmacy student, finds enjoyment in her work at EAB.

“It’s great being able to help provide others with proper care,” said Stallings, 23, who adds that a recent clinic visitor praised the staff for giving him a life-saving checkup that revealed serious blood-clotting issues.

Michael Goetsch, 25, a second-year UAB medical student from Huntsville, Ala., points out that many of the clinic’s visitors lack jobs, and his twice-a-month volunteer work gives him a chance to help them address some of their problems.

Salman Kamal, a third-year UAB medical student, lauds the program for giving students deeper insight about the formidable health challenges of inner city poor and homeless patients.

“It is an all-encompassing [exposure] that will help make us better physicians,” said Kamal, a Tuscaloosa, Ala., native who was clinic outreach director last year.

Kamal has found that it is difficult for poor residents living in shelters to deal with medical issues while wrestling with life in such facilities. For instance, if clinic patients are instructed to eat healthier, their dietary choices often are very limited. They must eat what they are given, no matter how unhealthy it might be.

Clinic Director Rachel Daniell, 23, a second-year UAB medical student from Douglasville, Ga., said many poor and homeless people are afraid of costs in the medical system, so they fall through the cracks because they cannot afford health insurance and some doctors do not accept Medicaid. But, she adds, while many clinic visitors may shy away from dealing with medical problems, they often will relent under doctor’s orders.

This direct approach to care is beneficial for patients—and volunteers, too. Daniel says working with the clinic allows her to express her own Christian faith and foster new relationships.

Heather Minton, a 2nd year medical student talks to Shima Dowla, a MD - Phd student at UAB, talk in the reception area of Equal Access Birmingham's clinic. (Walt Stricklin, special to The Times)
Heather Minton, a 2nd year medical student talks to Shima Dowla, a MD – Phd student at UAB, talk in the reception area of Equal Access Birmingham clinic. (Walt Stricklin, special to The Times)

Like Family

Abdul Ali Velji, 69, began visiting UAB’s Health Smart Clinic downtown in 2012. That facility referred him to the EAB site for lab work because he lacks health insurance.

“I was too old to find work, and even Obamacare was too expensive,” said Velji, a native of Pakistan who has worked off and on as a convenience store clerk in the area for several years.

Velji, who is unemployed, has been an EAB regular since 2013. In addition to visiting monthly to pick up free prescriptions for his various ailments, he encourages others to utilize the clinic’s services. Every week, Velji, a Homewood resident and member of the Ismaili Muslim Center, accompanies fellow members of his Oxmoor Road prayer hall to the clinic to fill their prescriptions. Most of them also lack insurance because of high premiums, he said.

Velji raves about the EAB clinic and how it embraces those who are uninsured.

“It is a very good place,” he said. “You can’t imagine how it is such a big help, how cooperative and understanding they are. They are very good and treat us all like family.”

This article incorrectly stated when the acute care clinic began. The clinic opened in the fall of 2015. This article has been updated to reflect the correction.