Lessons From a Clinic for the Homeless

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Abstract
Objective. —To present the educational opportunities provided by a model clinic for homeless persons. Design. —Descriptive. Patients or Other Participants. —Patients are those who are cared for at Camillus Health Concern clinic for the homeless in Miami, Fla. Other participants include students, residents, and faculty affiliated with the University of Miami (Fla) School of Medicine. Intervention. —Affiliation of the clinic with the medical school has shifted the clinic from a pure service model to an education and service model. Main Outcome Measures. —Numbers of patients and encounters are presented, as well as student and resident rotations, numbers, and hours. Results. —Shifting to an education and service model has increased productivity of the clinic while providing a unique, multifaceted educational experience to students, residents, and faculty. Conclusions. —Those factors that contribute to the success of this education and service model include the professional satisfaction that results from providing care to patients who previously have not had access to health care; a team approach that includes faculty, students, nurses, and social workers; an environment that fosters clinical judgment rather than expensive tests; and the opportunity to teach social responsibility in the process of providing health care. We encourage other schools to consider the development of clinics for the homeless as alternative ambulatory training sites. (JAMA. 1993;270:2721-2724)