Medicine Clerkships in Public Libraries Take Care to Communities
People trust their libraries. They rely on them as community hubs where they can find information and access to technology – and as a safe after-school haven for children. In some predominantly African-American or Hispanic Cleveland neighborhoods, one of the 28 public libraries in Cleveland may also be easier to reach than health care for people with limited access to transportation, says Lisa Eulinberg, HomeHEALTH manager for the NEOMED-Cleveland State University Partnership for Urban Health.
For the past two years, until COVID-19 closed the libraries, all of these factors made for satisfied customers at 10 Cleveland Public Library locations across the East Side, West Side and downtown, where 27 Northeast Ohio Medical University medicine students brought them health education and screenings.
Third-year College of Medicine students completing family medicine clerkships through MetroHealth (both through NEOMED’s Rootstown campus and the NEOMED/CSU Partnership for Urban Health) participated in the “Take Charge of Your Health” program, along with a few fourth-year students. In all, 1088 health screenings (for blood pressure, glucose, pulse, oxygen and BMI) were conducted.
Participating gave medicine students a firsthand example of trust and the personal touch in medicine.
Jared Cheatham, a rising fourth-year student, tells the story of meeting a veteran at the South Branch library who hadn’t had a doctor’s appointment for more than two years. “Despite having uncontrolled hypertension and a family history of heart disease, he was unable to access care through the VA here in Cleveland after relocating from San Diego. After taking his vital signs [the students and] the team from MetroHealth provided the vet with contact information to establish care at Metro. The vet expressed his gratitude and wished us all good luck.”
Eulinberg uses Rice branch library, located in the Buckeye-Larchmere neighborhood near Shaker Square, as an example. The branch sits just two blocks from a MetroHealth hospital, where patients can go for screenings. But the library is a community hub, situated next to a school. It had plenty of business for its screening and educational services provided by Colin Crowe, M.D., a bilingual (Spanish/English) family medicine physician affiliated with MetroHealth Medical Center, with the students assisting her, Eulinberg says.
“A lot of times, people become so nervous when they are in a doctor’s office. They’re in a hierarchy and they don’t ask the questions they need to, because they are uncomfortable. But because we were doing those blood pressure checks in the library, people felt almost like they were in their home,” says Eulinberg.
Even within the safe space of a library, establishing trust takes time, says Eulinberg, who was present for the programs. “Sometimes we would have people who would watch us for months, and then use our services. They would say, ‘We see how you interact with people, and we see you are reliable.’ From there, they might start getting blood pressure checks — and from there, be more open to making appointments with physicians.
Benefits to the giver and the receiver
Participating in the medical education/health screening programs benefits medicine students in many ways, says Eulinberg.
Interacting with people in their own neighborhoods, students saw more clearly how the social determinants of health affected them. Transportation, food insecurity, income insecurity and lack of access to technology are typically some of the biggest hurdles for the populations served in this program. Jared Cheatham calls it “one of my most memorable experiences of third year,” noting that “I not only got a chance to explore some of Cleveland’s libraries, but I also got the opportunity to interact with a number of people who I wouldn’t have met if not for the health screenings.”
For Eulinberg, one of the most satisfying aspects of the program was the chance to expose neighborhood children to the role models of students on their way to becoming physicians. “If you haven’t seen many physicians, you can’t dream of becoming one,” said Eulinberg. “Seeing the NEOMED students showed them, this is something you can do.”
Next steps to provide community health education
The in-person health programming with NEOMED students came to an early end, due to the COVID-19 pandemic, but an online successor is being planned. Eulinberg is working with MetroHealth physicians Erron Bell, M.D.; Mary Massie-Story, M.D.; and Colin Crowe, M.D., along with Sonja Harris-Haywood, M.D., an associate dean of the NEOMED College of Medicine, to develop a virtual model of health education. The group is creating short educational videos on a variety of health topics, including chronic disease management, that library patrons will be able to access from a link on the library’s website.
NEOMED’s “Take Charge of Your Health” program will take place Mondays, Wednesdays and Fridays from 10 a.m. to 12:30 p.m. The start date was not available at the time this article was written. For details and updates, visit the Cleveland Public Library website.
Photo: Inside the Rice Branch of the Cleveland Public Library