Inside an activities building in a tent community known as Tampa Hope, a computer center is doubling as a doctors’ office waiting room. Residents are filling out paperwork and talking with volunteers in green University of South Florida T-shirts.
For the past several months, medical students with the group Tampa Bay Street Medicine have been running a free clinic at the temporary housing program, offering primary care services to people living in tents. They’re trying to relieve some of the challenges that people who are experiencing homelessness face in accessing health care.
Volunteers come every other Saturday. Students do most of the legwork upfront, from patient intake to physical exams, while doctors from the region help finalize treatment plans and write prescriptions.
Some residents need help with things like monitoring high blood pressure or diabetes. Annette Carter, 58, explained to second-year medical student Kirtan Patel that she has sciatica, arthritis and a torn meniscus in one of her knees.
“And my leg went out on me, both of them, the other day so I wanna check and make sure nothing crazy’s going on,” Carter said, before Patel started checking her vital signs.
Carter moved into a tent at Tampa Hope after she was evicted from her home. Her boyfriend had been supporting her, but he died late last year.
Carter said she wants to find a job and said improving her mobility would help. Prior to coming to this clinic, she said she hadn’t seen a primary care doctor in about 15 years. Like many people without stable housing or health insurance, Carter relied on hospital emergency rooms for care.
She said she's grateful to have more consistent access to support.
"It's a great help it really is, it's a great help to me and some of the other people that are here,” said Carter.
Many of the 100 people living at Tampa Hope at any given time have multiple chronic health conditions, according to program director Cynthia Jones-Northington with Catholic Charities of the Diocese of St. Petersburg, which runs the tent community.
The clinic is just one way the program looks to address different factors that contribute to homelessness. There are also mental health counseling, job training, GED classes and other social services on site.
“So our job is to give them [residents] the life-saving resources they need in order to start to stabilize in this environment and then work to the point of transitioning back into the community successfully and sustainably,” said Jones-Northington.
Before coming to Tampa Hope, volunteers with Tampa Bay Street Medicine spent years running a similar clinic for people without housing from a sidewalk in the city’s downtown. Clinic director Lila Gutstein said having a designated space in a program that's offering these other services helps the team provide better care.
"Like the fact that we can now refer people to employment opportunities and they have a place to stay right here where we're giving the clinic, it addresses multiple barriers to homelessness and healthcare that we weren't able to do on the sidewalk,” she said.
But they can only do so much. As students examined Annette Carter behind a curtain she gasped in pain as they tested the range of motion in her legs.
“What's hurting?” they asked her. She explained she felt shooting pains all the way down each leg and couldn’t move them much. Patel and his colleagues felt “crunchiness” in each knee, signs that the cartilage was significantly worn down.
Social workers at Tampa Hope help some residents get on the Hillsborough County Health Care Plan, an insurance program for people with low incomes who don’t qualify for Medicaid or other government coverage. But Carter hadn’t finished applying so for now could only get what the team offered her for free.
As they discussed treatment options with the physician, Kirtan Patel sighed. This was a tough situation.
"Because the thing she really needs is probably like a knee replacement, and that's probably not going to happen for her. So really it’s just more symptomatic treatment now,” he said.
They prescribed Carter medicine to reduce inflammation and muscle spasms. They wrapped her knees for support and taught her how to change the bandages while they looked into ordering her a cane or walker.
Apoorva Ravichandran, who also directs the clinic, said situations like this teach students a harsh reality: not all can afford treatment in America’s healthcare system, so physicians need to adapt.
"Like in school it's very easy to say, 'Ok we're going to prescribe this perfect $10,000 medication.’ But when you're outside in the real world and you see, OK well we need a $10 solution. How are they going to go get that?” said Ravichandran.
That solution may not always be a cure, but for patients like Carter, it’s access to care that had been out of reach for so long.
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