The first patient to arrive at the HAVEN Free Clinic when it opened its doors last November was in serious danger. The man had the highest level of thyroid-stimulating hormone that both the attending physician and medical director had ever seen. Although his condition could have been easily treated, he hadn’t sought help before because he has no health insurance. Since his visit to HAVEN, however, he has had access to medications that keep his hyperthyroidism under control.
HAVEN, a new medical clinic in the Fair Haven neighborhood of New Haven, was founded with just such patients in mind, said Mallika Mendu, co-director of the clinic with Margaret Samuels-Kalow, a fellow member of the medical school’s Class of 2008. Organized by students in public health, medicine and nursing and in the Physician Associate Program (PA), HAVEN (an acronym for Health Care, Advocacy, Volunteerism, Education and Neighborhood) provides an array of medical services to uninsured patients free of charge every Saturday morning. Each patient is seen by a team of students and a volunteer attending physician, as well as at least one of the clinic’s medical directors. A physician or nurse practitioner from the Fair Haven Community Health Center, which houses HAVEN, acts as attending supervisor. In addition, faculty from the medical and nursing schools and the PA program serve as attendings.
HAVEN differs from the Fair Haven Clinic in several ways. The Fair Haven Clinic is not free—patients are seen on a sliding scale—and it is open only on weekdays. And HAVEN incorporates Yale faculty, who serve as attendings and provide pro bono specialty referrals. In this way HAVEN hopes to reach a population for which few medical services are available.
Most patients come in with multiple unmanaged chronic diseases such as diabetes and hypertension, said education coordinator and medical student Corinna Levine. The students run an education program that provides general information about diseases and their management, which supplements the instructions the patient receives from the attending physician.
Patients also receive a social work consultation about agencies that provide assistance with such nonmedical issues as housing. Cynthia Correll, the clinic’s social work coordinator and a second-year medical student, said that most patients are unaware that they may be eligible for public health insurance programs. Applications are complicated and often not available in Spanish, the language spoken by most of the clinic’s patients. To overcome the language barrier, the clinic staff includes student interpreters.
HAVEN receives funding from all the Yale health professions programs and is seeking grants from community sources. Yale-New Haven Hospital is donating laboratory services and clinic organizers have built up a stock of medicines to give to patients.
For the students, the clinic is a way to help others. “There’s a real need in our own community,” said first-year student Rachel Solomon.