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25 Years of JeffHOPE Clinics

07/31/18

Student Volunteers Shape Patients’ Lives—and Their Own

JeffHope

Committee members and medical team volunteers preparing supplies and documenting patient encounters at Our Brothers Place.

In January 1993, a group of Jefferson medical students opened a free clinic to serve the homeless men staying at St. Columba shelter, a shuttered West Philadelphia church that had been converted into a safe haven by the leaders of a burgeoning organization called Project HOME. Granted permission to take over the vacant choir loft, the aspiring physicians had sought equipment donations and enlisted the help of Mercy Vocational High School students, who installed drywall, a door, and a sink, and built a medication closet. With setup complete, the students were eager to see their first patients.

They waited. And waited. And waited some more.

Lara Carson Weinstein, MD ’95, now an assistant professor of Family and Community Medicine at SKMC, was among that group of enthusiastic volunteers. “Nobody came upstairs,” she remembers. “Nobody.”

The men’s disinterest in receiving free healthcare initially baffled the students, who eventually grasped the reality: These men had experienced such hardships that they no longer trusted anyone. Weeks passed without a single clinic visitor before James Plumb, MD ’74, a Department of Family and Community Medicine faculty member who was advising the students, encouraged the group to go downstairs and start some conversations. So they began joining the residents for meals, listening to Phillies games on the radio, and playing cards and checkers with them.

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Lara Weinstein, MD ‘95, assistant professor Family and Community Medicine, examines a clinic patient while another JeffHOPE volunteer observes.

Gradually, the men opened up.

“This turned out to be the most important thing we could have done in learning to be physicians—meeting patients on their terms, in their space, and letting them lead the way in determining what they needed,” Weinstein says. 

Since that first clinic opened 25 years ago, JeffHOPE (Health, Opportunities, Prevention, Education) has bloomed to encompass six weekly clinics staffed by 500 medical students and 100 faculty members (primarily residents) who provide basic healthcare and education for up to 5,000 homeless individuals annually. Conceptualized in 1991, JeffHOPE began with Jefferson students—overseen by Plumb—consulting with local outreach experts to assess the homeless population’s care needs and barriers. 

“Homelessness is not an issue that physicians from an academic health center can solve,” Plumb says. “I insisted that we meet with people who had devoted their entire careers to this effort to learn where there were gaps we could fill. This whole thing is about partnerships.” Plumb notes that these early efforts cultivated a particularly close connection with Project HOME and its co-founders, Sister Mary Scullion and Joan Dawson McConnon, who remain involved with JeffHOPE today. 

Over time, JeffHOPE’s clinical focus expanded to include educational, advocacy, and laboratory work. The fully student-run group has also become more multidisciplinary, with peers from Jefferson departments such as Physical Therapy, Occupational Therapy, Couple and Family Therapy, Pharmacy, and Public Health providing services alongside their SKMC counterparts.

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Committee members and medical team volunteers preparing supplies and documenting patient encounters at Our Brothers Place.

JeffHOPE was founded to support an underserved population whose members suffer from countless acute and chronic health conditions, but student volunteers say they get as much from the organization as their patients do.

“We’re applying our clinical skills but also learning intangible things that can’t be taught in a book-based or lecture-based curriculum: how to meet patients halfway, how to put judgment aside and connect with people who are very different from us, how to recognize our own limitations as human beings,” says Anna Carleen, a third-year SKMC student and one of JeffHOPE’s 11 student directors.

Carleen emphasizes that rather than providing all of the care that visitors need, JeffHOPE clinics are simply a starting point. “We are constantly looking at what our role in the community should be and how we can do it better. Our mission is to be a bridge between the healthcare system and individuals experiencing homelessness,” she says. “There are many socially conscious organizations in Philly, and we try to be very self-aware about the part we play among them.”

Connecting patients to comprehensive care is critical because lack of access is one of the biggest problems JeffHOPE patients face. Even those staying in shelters where residents are likely to have jobs and health insurance—such as ACTS (Acts Christian Transitional Service), a facility for women and children—often do not obtain primary care services.

“There are very real barriers to getting to an appointment during the day, like not having childcare or not being able to miss work, so they just don’t go,” says third-year SKMC student Sara Edwards, director of JeffHOPE’s ACTS clinic and formerly a patient educator who counseled women on issues including sexual health, birth control, nutrition, smoking cessation, and mental health. 

Edwards recalls a time when she ran into a former ACTS resident in Jefferson’s OB-GYN lobby. The patient had been pregnant while at ACTS and had hesitated to seek regular prenatal care; JeffHOPE volunteers had counseled her intermittently and had persuaded her to go to the hospital when she experienced symptoms of pre-eclampsia. The chance encounter in a physician’s office thrilled Edwards, as it demonstrated not only that the woman had delivered a healthy baby but also that she was seeking regular care at a postpartum visit. “It was great to see her following up with her OB after giving birth. For someone working in patient education, this was the dream scenario.”

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Clayton Ruley (Prevention Point Philadelphia employee), Denis Huang, Elissa Cashman Dalton, Sol Feuerwerker, Storm Portner, and Jeremiah Davis at Prevention Point Philadelphia

Now director of the Center for Urban Health at Jefferson, Plumb continues to serve as JeffHOPE’s faculty adviser but stays behind the scenes, empowering students to take the lead in making decisions and running clinics. 

“Once we found there was a need and figured out what we could help with, we had to harness the empathy and compassion of frequently burned-out medical students—but recruitment has never been a problem,” he says, noting that volunteering grounds students as well as physicians in a way that eases the weariness wrought by the grueling demands of academic medicine.

He also explains that seeds planted by JeffHOPE in the early 1990s have grown into an even broader care system for homeless and low-income Philadelphians. In 2015, the opening of the Stephen Klein Wellness Center marked the expansion of health services that Project HOME and Jefferson had been collaborating to provide in North Philadelphia for more than two decades. Located at 22nd Street and Cecil B. Moore Avenue and named for lead donor Stephen Klein, the Center is federally qualified—meaning funding from a Health Resources and Services Administration grant enables the treatment of patients regardless of their ability to pay—and is staffed by Jefferson faculty and residents, many of whom are former JeffHOPE volunteers.

Weinstein echoes Plumb’s sentiment about the importance of partnerships in carrying out JeffHOPE’s mission.

“People who go to medical school tend to be pretty confident, but volunteering with JeffHOPE is really humbling,” she says. “There are social workers, nurses, and outreach workers out there in the field every single day and night working with this population. The more exposure we have to those people who really know what’s going on and what these folks need, the more we can check ourselves and our egos. JeffHOPE has taught us that doctors are not always the experts, and we need to work as part of a bigger team.”

Save the Date for a JeffHOPE Celebration

SKMC is hosting a celebration of JeffHOPE’s founders, patients, and community partners on campus this fall. We hope you will join us for a panel discussion on social justice and advocacy followed by a reception.

When: October 17, 2018

For more information, contact the Office of Student Affairs at 215-503-6988 or skmc.student.affairs@jefferson.edu.