College generously supports heart health

The final count of the College’s fundraising drive to benefit the American Heart Association (AHA) shows that CCHS contributed a total of $12,244 to the cause during the month of February. The funds from the College represent 30 percent of the total raised by the entire University of Alabama.

The University of Alabama, with its colleges and departments, raised approximately $35,000 for the AHA.

CCHS organized several fundraisers, including raffles for homemade items and store-donated items, food sales, t-shirt sales and spirit nights held at local restaurants.

The AHA fundraising activities concluded with the West Alabama Heart Walk, held at the Tuscaloosa Amphitheater on February 15, 2014. The annual walk is the American Heart Association’s premiere event that brings communities together to raise funds and celebrate progress in the fight against heart diseases and stroke, two of the nation’s top killers.

The walk in Tuscaloosa had approximately 750 participants and raised $130,000 for the association.

According to the AHA, 473 of the 1,602 deaths recorded in Tuscaloosa County in 2009 were due to cardiovascular disease and/or stroke.

CCHS Dean Richard Streiffer, MD, thanked College faculty and staff “for your hard work supporting the American Heart Association and your commitment to improving the health of our local community.”

UA Matters: Having a Healthy Spring Break

It’s almost that time of year – spring break. While it’s definitely an occasion to let loose and have some fun, anyone planning on enjoying the much-awaited break should also use some caution.

The University of Alabama’s Dr. Jennifer Clem offers several tips on how to have a healthy and safe spring break.

Some local doctors embrace concierge care model

An estimated 5,500 doctors in the United States are concierge doctors — physicians who charge patients an annual fee, usually ranging from $600 to $1,800 a year or more, in exchange for shorter wait times and more access for care.

Program lets third-year med students train in community settings

An innovative program that enables third-year medical students to train in community settings over a period of months under the supervision of experienced primary care physicians will be piloted this spring at the College of Community Health Sciences.

The Tuscaloosa Longitudinal Community Curriculum (TLC2) will expose students to community medicine with longitudinal connections to patients and providers, and opportunities to experience the broader professional roles of physicians. 090373_TERM_Rural_Medicine_161

This education model, known as a longitudinally integrated clerkship or LIC, allows medical students to live and train in a community for a period of months, be involved in the comprehensive care of patients over time and to have long-term relationships with patients’ physicians. In the most common LIC model, students each have a principal preceptor and learn working with that physician through a variety of “threaded” experiences where students follow a patient through the health-care system, along with short intensive “bursts” of learning with a specific specialty physician, and even self-directed “mini blocks” with a teacher.

“What is fundamentally different about the LIC model is that medical students meet their required clinical competencies across multiple specialties simultaneously, longitudinally and in the community setting,” says College Dean Richard Streiffer, MD. This is different, he says, from the traditional separate and sequential discipline-specific block rotations, and from the largely hospital-centric experiences of the most medical school curriculum.

“It mimics the way physicians in practice themselves learn,” he says.

Students in TLC2 will experience full spectrum care in a community environment that is reflective of where most medicine is practiced. Students will participate in continuity of care of patients over weeks or months of a disease process, and see patients longitudinally and in multiple settings, including outpatient clinics, inpatient units, emergency rooms, nursing homes and patient homes.   

“Students come to understand health and disease in the context of where their patients live and in the variety of locales where health care services are delivered,” Streiffer says. Students will also interact one-on-one with physicians in different specialties and with other health professionals.

While LICs have been part of medical education for some time, medical schools are beginning to create these programs as evidence of the effectiveness and benefits accumulates. Medical students who have participated in LICs say they feel better prepared to care for patients. Studies show that LIC students perceive better clinical education and access to patients, are more likely than students in traditional clerkships to understand longitudinal processes of chronic disease as opposed to simply managing episodes of care, and that the continuity with patients promotes patient-centered attitudes.

The length of the experience also allows time for students to become involved in the community, complete a community scholarly project, develop trusting and respectful relationships as a team member with physicians, clinic and hospital staff and patients, learn about the business of providing health-care services, and appreciate the rewards and challenges of primary care.

“One of the other benefits,” Streiffer says, “is that students who complete LICs enter primary care at a rate higher than traditional students, that being an outcome we want as it is consistent with the mission of our College.”

The College previously offered a 16-week, LIC-like program called TERM (Tuscaloosa Experience in Rural Medicine). Lauren Davidson Linken, MD, who will be an obstetrics fellow at the College next year, participated in the TERM program and says she did it “to see the medical field in a different way than I had previously seen at big tertiary care centers.”

“I was surprised by the variety of cases I was able to be involved with and the variety of physicians I was able to work with, all in one small town. I had the opportunity to work with family medicine, obstetrics, pediatrics, internal medicine, general surgery, dermatology and pathology,” says Linken, who is completing a family medicine residency at the University of Massachusetts.

She recalls a patient she cared for while in the TERM program. The patient was diagnosed with an incarcerated ventral hernia by her family physician and referred to a local surgeon. Linken assisted the surgeon with the patient’s consultation and scrubbed in for surgery. Later, she and the pathologist looked at the patient’s specimen slides under the microscope. This longitudinal, multidisciplinary, “threaded” experience is not feasible in the usual rotation model of medical student education.

“This experience came up in all of my residency interviews, and it was great to tell how I had been affected by the relationships I developed with my patients – relationships that can only develop in a continuity setting, a setting that does not exist in the standard medical school curriculum.”  

The College’s TLC2, which will begin as a pilot program in May, will have other special curriculum components in primary care leadership, community engagement and population health that will be delivered through onsite and teleconferenced seminars throughout the nine-month experience. Admission to TLC2 is through a competitive selection process and limited to six students in the first year. Pilot placements are in both rural and urban Alabama communities.

The College, which also functions as a regional campus of the University of Alabama School of Medicine, provides the third and fourth years of medical education and clinical training for a cohort of School of Medicine students, emphasizing education that aligns with the College’s mission to improve the health of Alabama’s population and provide primary care physicians for the state. But TLC2 is not just for students interested in primary care.

“We know that this type of program will prepare future physicians with vigorous general professional clinical training,” Streiffer says, along with skills in community engagement, leadership and population health, enabling them to be highly qualified for residencies and future practice in fields in addition to primary care, including emergency medicine, pediatrics, general surgery, OB/GYN and psychiatry.     

College faculty, resident visit Cuba

Three faculty members from the College of Community Health Sciences and a resident physician from the College’s Family Medicine Residency traveled as part of a University of Alabama team to Cuba for six days in January 2014 to learn about that country’s healthcare system. Cuba Cropped

The group learned about the structure of the Cuban healthcare system and how it delivers care, particularly at the community level; established relationships with the Cuban Health Ministry and Medical Science University; and explored the development of a “pipeline” with the Latin American Medical School in Havana. Such a pipeline would assist medical students in Havana to make summer visits to UA and the College and graduates to consider the College’s Family Medicine Residency. The pipeline could also offer the Latin American Medical School in Havana as a medical school option for Alabama students, perhaps those from underserved and Black Belt communities.

“The Cubans have systematically built a rational, resource-frugal, yet effective healthcare system that ranks just below the United States in the World Health Organization rankings despite drastic differences in resources, infrastructure and philosophy,” says College Dean Richard Streiffer, MD, who participated in the Cuba trip.

He says like the mission of the College, the Cuban healthcare system is based on the family medicine-nurse team and neighborhood-centered primary care, as well as on a strong public health orientation.

“Cuba has largely eliminated the severe disparities of access, advancing the overall health of their population to near that of the United States and all at a fraction of the per capita costs seen in the United States,” Streiffer says. “The lessons potentially to be learned from collaborating with the Cuban healthcare and medical education systems seem particularly applicable to Alabama, a state with more than its share of health disparities, poor outcomes and resource-poor communities.”



Clem accepting new patients at UMC-Warrior Family Medicine


Jennifer Clem, MD

Jennifer Clem, MD, has joined University Medical Center-Warrior Family Medicine and is accepting new patients. To schedule an appointment with her, call (205) 348-6123. She will see patients on Monday afternoons and all day on Thursdays.

Additionally, Dr. Clem is an assistant professor in the Department of Family Medicine at the University of Alabama College of Community Health Sciences, where she instructs resident physicians in the College’s Family Medicine Residency. The College also functions as a regional campus of the University of Alabama School of Medicine.

Clem joined the College last year and previously worked for Indian Health Service in a comprehensive health care facility in Chinle, Arizona, where she provided inpatient and outpatient care on the Navajo Nation. She earned her medical degree from the University of Alabama School of Medicine and completed a residency at the University of Michigan Department of Family Medicine. She is board certified in Family Medicine. 

University Medical Center-Warrior Family Medicine, located at 971 Fairfax Park, is a second location of University Medical Center, the area’s largest multi-specialty practice, which serves both the University of Alabama and the West Alabama community. The College of Community Health Sciences operates both.

University Medical Center-Warrior Family Medicine was formed last year after H. Joseph Fritz, MD, and his practice, Warrior Family Practice, joined the College. Dr. Fritz, who has been in private practice in Tuscaloosa since 1978, continues to see patients at University Medical Center-Warrior Family Medicine.