issue Spring 2023

Bridge to Care

By Judy Masterson
Students, faculty and staff gather to discuss cases during a mid-shift meeting at the ICC.
Photo by Michael R. Schmidt

The Interprofessional Community Clinic (ICC), which will celebrate its 10th anniversary this fall, was founded by four Chicago Medical School students as the Affordable Care Act was gaining steam in September 2013. Change and optimism were in the air, and the students — hungry for clinical encounters and eager to help people who lacked access to care — rode the momentum with the support of RFU, which continues to provide mentorship and oversight by a team of faculty and staff advisors.

The ICC, an outpatient-service offering at Rosalind Franklin University Health Clinics, provides free, safety-net care for the uninsured. It is a dynamic training ground for interprofessional (IP) healthcare teams of RFU students and faculty advisors determined to address the structural and systemic causes that undermine health. Patients can access primary care medicine, podiatric medicine, physical therapy and behavioral health care, with an option for in-person visits or telehealth consultation and follow-up care.

“Our typical patient is someone who is working long hours. Their health takes a backseat to providing for their family.”

“The ICC is a really important bridge for people who need medical attention and who need to find a primary care home,” said Melissa Chen, MD, ICC medical director and Chicago Medical School associate professor, who cited long wait lists for primary-care appointments through the public health department. “We also help our patients with health literacy and connect them to ongoing care and try to find resources if we can’t. Sometimes, all we can do is witness — just be there for people in a human way.”

Filling a Gap In Care

“Our typical patient is someone who is working long hours,” said Ashka Trivedi, DPM ’11, assistant professor and founding ICC podiatry attending. “Their health takes a backseat to providing for their family. They’re often barely managing their diabetes, because of a lack of education or difficulty accessing the medication. The ICC is filling a gap in care that’s well recognized among public health providers in our community, who are in constant communication with us to channel patients who need the one-to-one attention our students are so eager to provide.”

The clinic has been shaped and sustained through the efforts of key influencers, including dedicated faculty advisors and new waves of RFU students from numerous disciplines who share a commitment to interprofessional learning and collaborative practice, and a drive to discover and implement more equitable models of care.

Telehealth Clinic

Former ICC President Lauren Gard, MPH, CMS ’23, led a team of 15 student executive board members and committees with over 100 students during the early days of the COVID-19 pandemic, which threatened to shut down care. Together, they designed and implemented an interprofessional telehealth clinic. They developed a strategic partnership with a local library so patients could tap into a secure network. They reached out before appointments by phone to explain to patients how to set up a digital connection.

“I’m grateful for the experience and what we were able to do as a team,” said Ms. Gard, who is headed to a residency in emergency medicine at Johns Hopkins Hospital in Maryland. “It was a joy to work with faculty and future clinicians that I really admire — those who think about the whole patient and consider barriers to care.”

The ICC is an engine for deep experiential learning — about health care, about the hardships people endure, about self. It is a weekly, live demonstration of the power of interprofessionalism.

Pharmacy Indispensable to IP Teams

“Our model is truly IP,” said ICC founding pharmacy faculty advisor Khyati Patel, PharmD, BCACP. “Patients don’t usually get to see medical doctors and pharmacists together. At the ICC, pharmacy is part of the medical team. We’re part of most decision-making processes. We listen to patient cases together, provide input and recommendations on medication decisions. And we work as a team on affordability concerns, to match patients with pharmacies that can fit their budget.”

“Our model is truly IP. Patients don’t usually get to see medical doctors and pharmacists together. At the ICC, pharmacy is part of the medical team.”

The ICC is a rare opportunity for both health-professions students and volunteer faculty to work and practice together.

“The most amazing thing our faculty volunteers experience is witnessing students apply what they learn in the classroom in a real healthcare setting,” Dr. Patel said. “Per the 2016 Accreditation Council for Pharmacy Education standards, interprofessional education is a key outcome for learning — and not just IP in the classroom, but real-life, clinical IP. In the co-curricular setting at the ICC, our students get that experience with real patients and real teams.”

There are 152 student-led clinics across the country, according to Jennifer Vu, CMS ’24, former ICC clinical operations executive officer and current national coordinator for the Society of Student Run Free Clinics (SSRFC), which is creating a national database of clinic locations and their services. Ms. Vu connects members as a means to provide new and existing clinics with resources to create and expand their scope of practice.

“I can see more broadly what the needs are from a student perspective,” Ms. Vu said. “What they see in their community is important, including the cultural aspects. It’s shown me that the barriers our ICC patients encounter are very common among communities throughout the U.S.”

The university has worked to broaden the clinic’s support structure with the addition of experienced faculty clinicians who are collaborating with students to lead and coordinate community outreach and expand services and clinical partnerships around the work of health justice.

“The ICC provides our students access to a population they might otherwise not see,” Dr. Chen said. “But it also provides students access to the system of medical care and the effects of policies across services. They’re part of the interprofessional conversations that need to happen on an administrative level to solve problems of care.”

ICC Director of Community Services Jeffrey Damaschke, DPT ’04, MS ’03, PhD, is working to coordinate community outreach so it is intentional and sustainable.

“We’re focusing on community education that addresses lifestyle risk factors that disproportionately affect vulnerable populations,” he said.

Expanded Vision

“I love that we’re providing this level of service to our community,” said Jeff Espina, MBA, vice president of clinical services, who oversees the university’s brick-and-mortar clinics, including the ICC, as well as its outreach clinic — the Community Care Connection’s mobile Care Coach. “Our ICC student volunteers are getting experience in leading a clinic, which they can take into their future practice. They’re impacting care, making decisions as a group.”

Dr. Trivedi thinks back to a patient who arrived at the ICC with symptoms of poorly controlled diabetes. He was struggling with vision loss and mobility, after multiple amputations to one foot.

“We sat down with him, explained the disease, partnered on his care,” Dr. Trivedi said. “He’s walking better. He’s healthier. He’s happier. He’s educating his family and community that diabetes is no joke.”

That’s the power of the ICC. Patients who depend on the clinic for care help teach the greatest lessons of care.

“I think back to how we really tried to humbly provide services, how our patients have needs and how we try to fulfill those needs,” said ICC co-founder Sarah Hershman, MD ’16. “But ICC patients equally provide a service — the deepest kind of learning opportunity — and it’s so generous of them to do so.”

ICC Founders: Where Are They Now

The four medical students who co-founded the student-led Interprofessional Community Clinic (ICC) in 2013 today are physicians committed to addressing the structural forces that undermine human health. In naming them the recipients of the 2014 President’s Interprofessional Healthcare Leadership Award, then-RFU President and CEO Dr. K. Michael Welch said, “The ICC underscores our commitment to improving the health of our community, our nation and transforming the delivery of care.”

Sarah Hershman, MD ’16
Residency: Cleveland Clinic Foundation, Cleveland

Dr. Sarah Hershman practices full-service general obstetrics and gynecology. She delivers babies and performs hysterectomies, abortions and office exams.

“I like working at an academic medical center and practicing a wide range of gynecology and not having to niche down too far,” she said. “I’ve always felt that my calling is clinical, although I love working with residents. I’m 100% clinical and I really, really enjoy my work.”

Her calling echoes back to the ICC. She still finds strength in connecting with her patients, in the trust they place in her. She continues to bear witness to inequities.

“We see enormous barriers to equitable care and enormous disparities, mostly along race and class lines, that increase maternal mortality and morbidity,” Dr. Hershman said. “The barriers aren’t based in any scientific difference in humans, or in any lack of technology or capacity to provide better care. We’re trying to do medicine in a world of systemic bias.”

Interprofessional, collaborative practice is important, but it isn’t enough, Dr. Hershman said. 

“We need a social services system that makes sense,” she said. “We need a welfare system that makes sense. We need a health insurance system that is equitable and fair.

Healthcare professionals have a lot of power to advocate for equitable policies by reaching across political and social divides.”

Abortion is legal in Ohio up to 20 weeks of gestation. But there’s a mandatory waiting period and no insurance coverage. It’s almost exclusively provided by private clinics. Dr. Hershman does not currently travel to a clinic.

“In regular OB/GYN life, you are sometimes called upon to perform the procedure for a medical indication,” she said. “It’s a skillset that I want to maintain, and it’s something I would like to continue to offer my patients.”

Hannah Lee, MD ’16, FABIM
Residency: University of Colorado
Fellowship: Cedars-Sinai, Los Angeles

Dr. Hannah Lee joined the faculty at Cedars-Sinai in Los Angeles — where she completed her fellowship in hematology and oncology — because, she said, “I get to work with passionate staff, residents, fellows and medical students.”

The ICC taught Dr. Lee that it takes a team to care for a patient or a community, and that she learns best by teaching others.

“It’s important to be challenged by learners,” she said. “That helps you become a better educator and a better physician. That interaction, for me, is really precious.”

Dr. Lee practices in an affluent ZIP code of West LA that borders city neighborhoods of far more modest means. 

“My patients come from diverse backgrounds out of the giant pool of Los Angeles, where there are plenty of underserved populations,” she said. “It reminds me of how RFU in North Chicago sits next to high-income ZIP codes. The ICC started with our recognition that people lacked access to care in an area that was both resource-rich and a medical desert. The challenge was to try to pull resources and funding to help the underserved population. That’s a skillset we had to learn and that really stayed with me.” 

The ICC also taught Dr. Lee that interprofessionalism is essential.

“Wherever I practice, I always tell my colleagues that we’re here to have fun. It’s a way for us to break down barriers, to see each other as individuals who share a common goal to care for our patients. That attitude has served me really well, and it stems from RFU, a very open community of different professions, where you really get to know each other and get the chance to work together.”

Svetlana Kozlovich, MD ’16
Residency: Johns Hopkins All Children’s Hospital, St. Petersburg, Florida
Fellowship: Medical College of Wisconsin Affiliated Hospitals, Milwaukee

Dr. Svetlana Kozlovich works as a neonatal intensive care physician with a private neonatology group that serves greater Southeastern Wisconsin — home to some of the most underserved, medically-complex populations in urban and suburban Milwaukee.

“I resuscitate, I run codes on the most vulnerable, premature babies,” Dr. Kozlovich said, apologizing for a yawn after a late night with struggling newborns at Aurora Sinai Medical Center. “I rely on my team members. I depend on their strengths and capabilities. I know what our respiratory therapists, nurses and nurse practitioners can do, and I know when to call out for help. Our teamwork is vital to every baby’s outcome.”

Dr. Kozlovich speaks as a clinician and a mother. Her son was born with a congenital heart defect — dextro-transposition — in which the two main arteries carrying blood from the heart are switched in position.

Born on St. Patrick’s Day, 2020, baby Paul was rushed to the NICU, underwent a balloon septostomy at the bedside, followed by open-heart surgery at three days old. Dr. Kozlovich was still in fellowship. COVID was descending, and Children’s was limiting parent visits.

“I don’t think until that moment I recognized that parents are a part of the critical care team,” she said. “The support we’re provided, whether it’s a breast pump or child care or adequate parental leave, can make a difference in our babies’ outcomes, because it relieves some of our stress and allows us to be truly present. We should all be advocating around those social determinants of health.”

Today, Paul is a happy, healthy 3-year-old.

“I know we are privileged to have received such wonderful care at Children’s, and I am privileged to be part of that care,” Dr. Kozlovich said.

Jenny Hua, MD ’19, PhD
Residency: Cook County Health/Northwestern University Feinberg School of Medicine
Internship: Icahn School of Medicine at Mount Sinai, New York City

Dr. Jenny Hua is piloting a Long COVID Clinic for Cook County Health and, as part of her residency, earning a master of public health degree. 

“Putting together a new clinical service, there are lessons from the ICC that I still think back to,” Dr. Hua said. “It was my first experience collaborating across specialties, across professions, and it really helped me understand the complexity of health care.

“Long COVID is a very complex, serious illness that requires multidisciplinary care,” she said. “I’ve been able to get support from county services, including infectious disease and family medicine, which has been critical in offering rehabilitative services for our patients.”

Dr. Hua was not long into her first residency at Elmhurst Hospital in Queens, New York, when the first wave of the coronavirus erupted in mainland China. 

“I was trying to raise awareness that the virus was probably already in New York City, and from the looks of it, we were not prepared in terms of training or PPE,” she said.

“There were three times as many beds for people in Manhattan, while our hospital was becoming the first epicenter of the pandemic in the U.S.,” she said.

She resigned from her program and took up activism, spending a year working with community-based organizations around the city. She was accepted into her current residency, which trains equity-focused public health practitioners, in 2021.

“There are fewer hands on deck than at the ICC,” Dr. Hua said. “But we still have to hit the ground running and help patients who need immediate attention.”

Dr. Hua soon began challenging inequities in access to care.

Judy Masterson is a staff writer with RFU’s Division of Marketing and Brand Management.