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POINT OF VIEW

Student Health Care is a Top Priority
Student Health Service has a new director, a new look and new goals

BY POLLY WHEAT, M.D.

DR. POLLY WHEAT
Eighteen months ago, Student Health Service started undergoing major changes in the way it serves students. Dr. Robert Lewy, along with a dean's advisory committee, started redefining the mission of Student Health Service and its service and financial models. Here, Dr. Polly Wheat, director of the Student Health Service, who recently joined Student Health Service, writes about these changes and future goals.

If you have visited Student Health Service lately, you probably noticed some major changes from the last time you visited. You will have noticed that the waiting area looks different, that there are new staff members, and the way we handle your care is changing. We hope the end result of these changes is an all around better experience each and every time you visit us.

About 18 months ago, Student Health Service underwent a major reorganization. At that time, administrative responsibility for the service was transferred to Robert Lewy, M.D., senior associate dean for Health Affairs, who immediately set out to redefine its mission and goals. Under Dr. Lewy's leadership, Student Health Service has developed a student-based mission and completely reorganized its service and financial models. Our new mission statement exemplifies this commitment to providing high quality health services to students: The Student Health Service at the Columbia University Medical Center is committed to advancing the health of each student, and to promoting a healthy campus community.

First-year occupational therapy student Sylvia Huang with Dr. Polly Wheat, the new director of Columbia's Student Health Service.
With such a broad approach as our mission, we have adopted several strategic goals to guide us, such as: Serving as a model of exceptional services for future health care professionals; offering easy access to services; providing a wide spectrum of medical, dental, and mental health and counseling services to support both the health of each student and the health of the campus community; and fostering active student involvement in health service programs.

The root meaning of the word "health" is whole. We must care for the whole person, cognizant of physical, emotional and spiritual needs – all of which comprise health. We must also treat the whole person in her or his community. We all have many identities – our work, our cultural background, our family role, our religion and so on. The Student Health Service seeks to provide excellent individualized care, aware of the particular needs of health professions students, while being sensitive to each person's individual, social, and cultural needs. To paraphrase our first strategic goal, we want to give you the kind of model care we hope that you will provide to your patients.

So, what is changing?

• We have increased the number of board-certified primary care physicians on staff – and encourage you to pick one of us to be your ongoing provider. On the other hand, when scheduling conflicts prevent you from seeing your regular clinician, we are a small service and can effectively cross-cover for each other.

• We have a new answering service to respond promptly when you have emergency health needs after hours.

• We have reorganized the schedule to make more appointments available and to improve patient flow. We encourage you to make appointments whenever possible, but urgent appointments are available through nurse triage. You can also see a nurse for routine medication refills.

• The Center for Student Wellness is now the "official" outreach arm of the Student Health Service, capable of providing its services to all schools. We are in the midst of a search for a new assistant director of the Center for Student Wellness, who will also collaborate with the clinicians of Student Health Service to provide individualized health education services.

• We will be participating in the American College Health Association health assessment survey so that we will be able to refine and expand our health promotion services to best meet your needs.

A sample of other new services available now: Evaluation and treatment for disordered eating and eating disorders; smoking cessation counseling with medications as indicated; and Mindfulness Meditation-Based Stress Reduction training – based on the work of Jon Kabat-Zinn. We plan to begin this program next semester.

One area of care we take very seriously is that of occupational exposures. Occupational exposures are a medical emergency. We have updated and streamlined access to a state-of-the-art evaluation that allows us to more effectively treat you. We will soon be distributing wallet-sized cards with occupational exposure first steps to all students.

Besides offering new services, one of our goals mandates easy access to services. This includes finding all possible ways to save you money. For example, we have recently begun providing a number of common medications on site for a $5 or $10 copay – cheaper and more convenient than if we sent you out with a prescription. (See our website, www.columbiahealth.info for a full formulary listing with prices). We also have updated our onsite contraceptive options to offer oral contraceptives from each major class, as well as the two new delivery methods – the patch and the vaginal ring. The copay is $25 for a three-month supply.

The service is also working to reduce the cost of student health insurance. This year, based upon the active input from the Student Advisory Committee, we eliminated the $100 deductible, removed the cost to students for certain routine laboratory tests and expanded the coverage for certain mental health conditions. Even with these improvements in coverage, our premium increase did not exceed the industry average. We can now also offer optional coverage for up to one year if a student must go out on approved medical leave. Of course, all aspects of the health insurance plan are under constant review and ongoing discussion with the Student Advisory and Dean's Advisory Committees.

We firmly believe that your input is essential to providing high quality service. We have an active Student Health Advisory Committee, with representatives from each of the schools, that meets on a monthly basis. We also actively seek feedback, positive or negative, from students via the suggestion box in the waiting room, email from the website, or a call or email to me (mw219@columbia.edu). In the latter part of this year we will be distributing a student satisfaction and needs survey, which will then be part of our annual assessment.

Plans for the future include an expanded new office suite located on the ground floor of the Hammer building; estimated time for this transition is two years. We will then be able to offer expanded services – dental, for example, and on-site facilities suitable for health promotion activities such as yoga and meditation. We will also be moving to an electronic medical record, especially designed for student health, to improve our efficiency and ability to manage data.

A milestone of our improvements will be achieving national accreditation as an ambulatory care center. This process is already under way but will probably not be completed until our move into our new quarters.

The ongoing development and improvement of Student Health Service must be a partnership between the students and all of us involved in providing services. We actively seek your collaboration and input. We recognize, daily, that students on the CUMC campus are bright, articulate and have exceptionally high standards. As partners we will be able to achieve a standard of excellence that we as staff could not accomplish on our own.

Please get involved. We need you!

Dr. Wheat, assistant professor of medicine, comes to Columbia from Barnard, where she served as the director and medical director of the Barnard College Student Health Service for 12 years. She can be reached at mw219@columbia.edu.


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