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BY DAVID LAU

In print | Published November 16, 2006

While Worth Health Center offers services that peer health centers at other colleges do not, students have recently expressed concerns, specifically regarding long waiting lists for appointments with doctors and the erratic availability of transportation for students to the hospital.

In regards to opening hours, Worth Health Center is staffed with nurses 24 hours a day. “Less than 10 percent of the colleges nationwide are open 24 hours and have infirmaries,” Director and Nurse Practitioner Linda Echols said. Peer institutions such as Haverford and Smith have health centers that close as early as 5 p.m. on weekdays and are in fact closed on the weekends, although nurses are available on call after hours.

“We basically direct resources to more things that are more reflective of community needs,” Catherine Sharbaugh, director of Student Health Services at Haverford College, said. “We sort of beef up the services during the day so that we’re not spreading stuff out, and we are available on weekends, and after hours as there is an on-call system so students can call security and can speak to the nurse practitioner. It works very well as far as the system goes because no one is really left out; it’s just that the light isn’t on at the facility when it doesn’t need to be on. The key is not how many hours you are open, but the quality of the people at your service.”

At Worth, doctors are available two hours a day from Monday to Friday, and there are weekly visits by orthopedists and occasional visits by gynecologists. The doctors, who normally work at Springfield Hospital (of the Crozer-Keystone Health System), the biggest health center in the county, are also on call 24 hours a day, seven days a week. “Two hours is about right,” Echols said. “They count on nurses to be their eyes and ears. We have four [doctors] who specialize in internal medicine, and the other specializes in adolescent medicine.”

Another advantage that Worth Health Center offers to students is the relatively low cost of medicine. Worth provides medication that includes antibiotics, pain medicine, cold medicine, allergy medicine and some asthma and stomach products to students free of charge. This policy began in the 1980s, when the center became overwhelmed with the large volume of students and created the self-serving cold clinic. “People like choosing what they want,” Echols said. “The cold clinic is a convenience to students, and to us.”

The cost of providing medication does put some strain on the health center’s finances, but those costs are taken into account when the college creates the health center’s budget. “You have to be a bit creative sometimes to get it all in,” Echols said. “We use eight or nine vendors to get goods at the right price.”

Nevertheless, perhaps due in part to the poor quality of the health system in the county as a whole, students could often wait up to several weeks to see a specialist. “Routinely, some specialists such as neurologists, rheumatologists and endocrinologists can take months to get an appointment, but [they] have a waiting list,” Echols said. “Others, such as dermatologists and cardiologists, can take two to three weeks. Depending on the urgency, we can get students in sooner.” According to Echols, Worth Health Center is not alone in facing this problem, as this is more of a county-wide problem. Doctors in Crozer also face long waiting times before sending their patients to see specialists.

This difficulty in securing appointments quickly has led to some dangerous health situations involving students. Last month, a student who had a Staphylococcus infection was forced to book appointments to see specialists on her own after nurses at Worth were unable to do so in a timely manner. “Worth finally did get me an appointment, but it took much longer than it should have,” Sofia Rivkin-Haas ’09 said. “I did seek outside help. Luckily, I have a family friend who works here at the college, so she helped me find a specialist, and I made all those arrangements myself.”

In addition to problems securing appointments, Rivkin-Haas also discovered that she was expected to provide her own transportation to the hospital. “I had to explain to them that it wasn’t my friends’ job to take me to the hospital. I did get a ride, but the person who was supposed to get me was 20 minutes late,” she said. “Then, when I wanted to get a ride back to my room in PPR, I was told that Public Safety doesn’t like to do that.”

Echols admitted that providing transportation for students was one of her biggest concerns about improving the services at Worth. “We are supposed to use student drivers and Public Safety,” she said. “But I have mixed feelings about using students. Some students have no problem taking the bus, but [the transportation] needs to be a system. I don’t know what the answer is. I’ve talked myself blue.”

Owen Redgrave, director of Public Safety, estimated that Public Safety drives students to emergency rooms or hospitals approximately once a day, but said that it would be financially burdensome to hire someone specifically to drive students to nearby medical facilities. “It’s expensive to staff something that would accommodate every situation; you’d need to have a person and/or a vehicle and that’s expensive,” he said. “There could be days that go by where nobody’s needed and if someone is just there twiddling their thumbs it’s not very effective.”

Redgrave also said that Public Safety based its decisions on whether to drive students on the overall situation on the campus. “We generally only have two people on duty at any given time, and one car on the street during the daytime,” he said. “Part of the decision [to drive students or not] is based on whether we can provide adequate services for the college. If you have one person down in Crozer, and something happens at the college, then you leave 3,000 people without immediate help.”

In addition to addressing problems with providing transportation to students, Echols said that she hoped that students would be able to see only one doctor while at the school. “This provides for better continuity of care,” she said. “You don’t benefit from seeing a bunch of different people. Every time you’re starting over. We don’t have much control over that.” Potential solutions that the health center is currently considering would be to give students who go to appointments or the ER a card with the contact information of the primary doctors who work at Worth.

Echols also said that the health center would improve methods of communication regarding hygiene issues in the near future, particularly with flu season fast approaching. “We give 500 to 600 flu shots a year,” she said. “But not enough are students. There are not many central places where we can give them.”

The recently formed Clean Hands Campaign has also begun to work in conjunction with Worth to spread the word about public health issues. “Our immediate project is to improve Swatties’ hand hygiene by making alcohol-based hand sanitizer widely available on campus and by doing the advertising and education required to explain its purpose and effects,” Michael Stone ’07, co-president of Clean Hands Campaign, said. “Our medium-term project is to improve communication between the students and the administration, particularly Worth Health Center, about public health issues. Such issues include large issues like pandemic preparedness and infection tracking, medium issues like RA training and continuing hand-hygiene education, and smaller day-to-day issues like bathroom supplies and advertising space for public health information.”

Despite all the difficulties Worth faces as a health center, staff frequently receive letters or e-mails from former patients expressing their thanks. “Young alums frequently write saying they miss us,” Echols said. “Some complaints do tear you down, but a lot of folk say thanks a lot, particularly for the infirmary and 24-hour consultations.”

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