For Love or for the Love of Money?

Many medical schools boast that their students and faculty serve in homeless clinics, thereby selflessly helping the outcasts of this world. But, just how selfless and helpful is it?

It has come to AITSE’s attention that some of these clinics are more of a money-making venture for the schools than a service to the community. That is, students are instructed to do a 10-minute assessment of each homeless person, but not to treat them, even when they could, simply because this would take too much time. Thereby, the school can claim the maximum number of per patient fees from the government.

What about those patients who urgently require treatment? They are given referrals to physicians who “may accept” Medicaid. Of course, since the patients are homeless, it is less than likely that they will be able to phone, make an appointment, and go to these providers, assuming they can even find one who treats Medicaid patients. But, the faculty tell the medical school students that this is not their problem–they are only there to do assessments and referrals.

One student told AITSE that she bucked the system and cleaned a severely infected leg wound, then gave the person sample antibiotics. If she had not treated them, they could have lost their leg or even died. The social worker sent the student a thank you note; the supervising faculty member gave her a warning.

Is this teaching the students integrity in medicine? Viewing people as money-making opportunities instead of fellow human beings? Of course, one could argue that spending a lot of time on one person meant that others could not be seen, that a homeless person is unlikely to continue the care making the initial treatment a waste of time, and that the school has a right to make money however they can (all arguments the student heard). Her response–”I want to treat patients the way I would want my father to be treated.” And that is integrity.