Tips for medical students pushing for change in homeless health care

Often the biggest challenge homeless people face after being hospitalized is finding a place to rest and recover. There are some programs that address this problem by combining clean and safe spaces with necessary support services, such as case management and nursing services. Unfortunately, these programs often face political, financial and social headwinds.

A taped educational session for the 2022 AMA Annual Meeting will explore what is most important about medical leave programs and what medical students can do to promote their acceptance and effectiveness.

The session was sponsored by AMA Medical Student SectionA representative body of the Association of Medical Student Interests and Issues.

Medical respite programs are post-disaster places for homeless people “who no longer need to be in the hospital but don’t have a place to stay and recuperate, like you and I do,” said senior director Barbara DiPietro, Ph.D. Policy for the Homeless Council on National Health Care. Such programs “provide a short-term convalescent residential unit after hospitalization for people who do not require advanced care such as skilled nursing.”

Part of what defines medical palliative care is that a lot of medical training doesn’t involve caring for the homeless, said David Munson, medical director of the Street Team for the Homeless Program at Boston Healthcare.

“People don’t notice – they don’t appreciate – the injuries that patients go through,” Dr. Munson said. “Respite programs are beautiful because the care is provided by people who are really deep and interested and understand this work. You can create an environment where people who are uncomfortable in hospitals, who are constantly being discharged from hospitals, can really sit down and feel comfortable in a respite program.”

Still, there are many barriers to providing medical respite care, including stigma, DiPietro says. If you ask around, you’ll be told at least 12 different reasons why this crowd shouldn’t be worth your time or money or resources or, or, or…”

As part of a broader policy End homelessness, the AMA promotes research on the funding, implementation, and standardization of medical respite care for the homeless. Learn more about the AMA’s policy on ending homelessness.

Explore the AMA Center for Health Equity and the AMA’s strategic plan to embed racial justice and advance health equity.

Medical students are in a unique position to embrace medical leave programs with their ideals and passion for the medical profession.

“The No. 1 thing you can do is use your privilege and use your credibility,” DiPiero said, adding that medical professionals listen to medical students in a way they don’t listen to others. “We need a structure of value in medicine that blocks all these blind boundaries that are consciously created and they must be consciously pulled.”

The second is knowing evidence-based models to draw on, such as trauma-informed care, says David Woody III, PhD, LCSW-S, president and CEO of Bridge Homeless Recovery Center in Dallas. These include communication models.

“When your patient is actively involved in understanding what’s going on and how their healing experience is going, things go much better,” Woody said.

The third is to get out of the classroom and find out who is providing care for the homeless in your community.

“Someone is doing it at some level,” Dr. Munson said. “Ask and then go out and spend some time with those people. Drop them and see what it’s like to take care of someone after they leave the hospital, take 12 meds and come back to the shelter and still have the wound. stay on the road”

Read about the other Highlights from the 2022 AMA Annual Meeting.