SOCIAL EM & POPULATION COMMITTEE
Checking our own biases is the initial step, ensuring they don’t hinder us from treating them with the same dignity and respect as any other patient.
physical examination, differential diagnosis, developing a plan, and executing it on-site.
At the end of each event, when services are concluded, we transcribe all paper charts into the electronic EMR of our community clinic partner, and the paper documentation is securely shredded. The upcoming mobile clinic aims to streamline this process, hopefully with the incorporation of EPIC, mirroring the efficiency of an ER visit. This transition enables us to track this transient patient population more effectively, monitoring outcomes and identifying revisits across the community. The seamless connection between street medicine and our emergency department allows us to correlate patient history, providing valuable insights for comprehensive and coordinated care.
Street medicine is not a novel concept, and precedents already exist for handling such situations. Following established practices and standards of care ensures a seamless and ethical approach to delivering medical services in diverse environments. SP: Community support is very important, especially from a fundraising perspective. How can we continue to educate the community in general about the importance of street medicine and get our non-medical community involved? VC: To effect change, community education is pivotal. By highlighting the importance of addressing homelessness and sharing statistics, we paint a picture that transcends individual immunity.
This could be anyone in our community—a neighbor or a family member. Examining healthcare outcomes reinforces the idea that neglecting this vulnerable population results in increased emergency department visits, placing a significant financial burden on the healthcare system. Data supports the notion that a preventative approach is not only humane but also cost effective. Institutions recognize that preventing ER admissions can ultimately save resources and taxpayer dollars, as hospitals often absorb the cost of treating uninsured patients.
SP: There are some concerns regarding the lack of structural oversight that can be in place with no legal logarithm or law regarding functionality. How would you address these individuals that are worried about this? VC: Firstly, there is literature that states the protective Good
Samaritan law plays a pivotal role. In my perspective, whether you encounter a patient in a clinic, an ER, or on the streets, the only difference lies in the environment. The patient remains the patient. If you adhere to the standard of care you would provide in any other setting, it remains consistent. For instance, if someone presents with chest pain and raises concerns for care out of the limitation of the environment, I’d promptly call an ambulance, just as I would in an outpatient clinical setting. Historically, this patient population has been appreciative of our outreach efforts. Their gratitude is evident, considering that this may be the only form of care they receive. Maintaining a standard of care similar to any clinic or emergency department ensures a positive interaction. Understanding your limitations as a physician is crucial—recognizing when the situation exceeds your capabilities and requires additional help. The patient retains the capacity to decide whether to proceed with care, allowing them to decline treatment, akin to an AMA process. We document thoroughly, explaining all associated risks and providing instructions for the patient to call 911 if they change their mind, a procedure consistent with any other patient encounter.
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COMMON SENSE MARCH/APRIL 2024
Educating the community on these approaches is crucial, emphasizing the potential for creative solutions without relying solely on tax dollars or government funding. This is an opportunity to cultivate awareness and support for street medicine, fostering champions who advocate for our patients across the social spectrum. Embracing the innovative nature of reaching those in need is essential. The surroundings may change, but the patient remains constant. Let’s educate ourselves, our communities, and champion the transformative potential of street medicine.