Students, administrators reflect on state of University Health Services
Mary Bernard | Tuesday, April 17, 2018
Two weeks before finals in the spring of his junior year, senior Brian Pulawski fell off his skateboard and landed on his hand with his thumb bent underneath it.
He continued on to class, assuming the injury was no more than a sprain. However, by the time his 75-minute Biochemistry class had ended, his hurt thumb had swollen to twice the size of the other, and he decided to visit University Health Services.
“There were like two or three people in front of me that were sick with colds,” Pulawski said. “I thought it was absurd that, here I have this more serious injury … and they couldn’t see me sooner. Even a couple people in the waiting room were like, ‘You can go ahead of me,’ but it didn’t happen that way.”
After a wait of about an hour, a physician looked at Pulawski’s hand and said he did not believe it was broken. In order to verify, the physician would need to see an X-ray.
“Their X-ray tech was out, so the next time I could get an X-ray would be like three days from [then],” Pulawski said. “So instead I went to the South Bend orthopaedic clinic down the road … and they saw me right away.”
The X-ray at the clinic determined that Pulawski had in fact broken his thumb and would require surgery to heal properly.
Sharon McMullen, RN, MPH, director of UHS, said many previous complaints UHS received pertained to issues such as extended waits and unavailable providers.
“Before this year, the top three student complaints were about the $5 walk-in fee, not being able to see a provider and long wait times,” McMullen said in an email.
UHS underwent a reorganization this year to try to tackle some of these problems.
Several students across campus, including sophomore Josh Morgenlander, said there is still a negative perception of UHS despite the changes, and those changes might not have addressed what students believe to be UHS’s greatest issues.
“I feel like misdiagnoses, belittling ailments and ridiculously long wait times are the most commonly-cited problems with UHS,” Morgenlander said. “I’m curious to know how many of the ridiculously long wait times are from people who actually scheduled appointments versus people who just walked in.”
McMullen said the changes to UHS in the past year are a direct result of student feedback.
“Our recent reorganization addressed each of these concerns by updating our fee schedule, which eliminated the walk-in fee, adding a 6th Primary Care Provider and expanding appointments and implementing an urgent care model,” McMullen said.
She also noted the new urgent care model has decreased wait times for patients without an appointment by over 60 percent since 2016.
However, it can be difficult to tell whether the students’ complaints are actually valid, Morgenlander said.
“I don’t know how much of what people say is based off of their actual experiences,” he said. “Maybe a few people have bad experiences, and then they mention it to their friends, and they talk about it in the Keenan Revue and then it’s general campus lore to say that [UHS] is awful.”
The one time Morgenlander went to UHS with an illness, he was impressed by the level of care and its efficiency, he said. He scheduled an appointment ahead of time because of a persistent cough. Within an hour, a doctor had listened to his breathing, taken an X-ray of his lungs and diagnosed Morgenlander with pneumonia. Immediately after, Morgenlander went to the pharmacy where he picked up his prescription of antibiotics.
“If I had something that I felt was a serious sickness, I would not be nervous about scheduling an appointment and going in there again,” he said.
Positive experiences such as Morgenlander’s are not as rare as the prevalent negative attitudes toward UHS might suggest.
Sophomore Maria Rossi went to UHS her freshman year with what she thought might have been tonsillitis, she said.
“I remember, at the time, not being super happy with the amount of attention that was paid to me by the doctor,” Rossi said. “I was with the actual doctor like two minutes, nothing else.”
The doctor performed a strep test, which came back negative, Rossi said. He then recommended that Rossi be tested for mono, which is done with a blood test.
“For a 19-year-old, I’m super scared of needles,” Rossi said. “I don’t even know why.”
Rossi went to have blood drawn but did not end up having the blood test because of her fears, she said.
“I was sitting in the tech’s chair for 40 minutes with two nurses, and they were nothing but patient the entire time,” Rossi said.
Rossi has been back to UHS a few times and has always had particularly good experiences with the nurses, she said.
“I really remember the nurses having very good bedside manner,” Rossi said. “They’re just really sweet, really patient. I never felt rushed or anything.”
McMullen said the UHS staff is a great asset.
“Without a doubt, the best part of UHS is our staff who are committed to living out our vision of exceptional college health care, infused with our Notre Dame values, to foster lifelong well-being,” McMullen said.
Cindi Schwartz, RN, BSN, the assistant director of clinical Operations for UHS, said that UHS is constantly striving to improve.
“The UHS staff and providers genuinely care about the wellbeing of our students,” Schwartz said in an email. “We are constantly looking at survey results, data and most importantly, listening to the students. We strive to provide the best care to every student and provide education to them for the moment and for their future.”
UHS does hope to improve its ability to help students traverse the health care system, McMullen said.
“I think we could improve in the area of helping students navigate the sometimes tricky waters of health care, and I look forward to the continued development of our new Clinical Case Management program, which coordinates care of students with complicated medical conditions, and provides student outreach,” she said.
Sophomore Lindsay McCray noted that for many students, UHS might be the first time they are visiting a physician without a parent or guardian present.
“I think one of the big problems is that people don’t know how to navigate the health care [system],” she said. “Often, friends don’t understand what’s going on. That’s partially on the patient to ask questions, and that’s partially on the doctor to make sure the patient thoroughly understands what’s going on.”
There are simple changes that UHS could make to improve students’ ability to advocate for themselves, McCray said.
“I mean, just putting sheets of paper in the waiting room [would help] … like, here are my symptoms, here’s when they started, here’s the medications I’m on and here’s my list of questions,” she said. “Cause you’re going to be in the waiting room anyway.”
Beyond patient education, building a relationship with the health care staff can help students, McCray said. When utilizing the walk-in system, students cannot control which physician they visit.
“I’ve found two doctors that I really like and trust, and I make it a point to go and see them,” McCray said. “That’s helpful for me, because I already have a relationship with them … and it’s helpful for them because then they’re not flying completely blind. They have some kind of history.”
Sophomore Amber Grimmer has been to UHS because of a fever and to have blood drawn. In her experience, she has noticed that the staff do not always seem to cater to their population, she said.
“It’s kind of a conflicting thing,” Grimmer said. “They assume you have mono, because you’re a college student and you probably caught the kissing disease, but then they also assume that you don’t drink cause you’re under 21.”
Grimmer and McCray believe it should be common practice for UHS doctors to tell their patients about each prescription drug’s reaction with alcohol, regardless of the patient’s age.
Patients receive follow-up questionnaires after their UHS appointments where they can leave comments. The responses are taken seriously and UHS tries to improve according to the students’ feedback, Schwartz said.
“There have been many changes in the last couple of years that I feel show the commitment of UHS to become what our students need,” Schwartz said. “As a provider and educator of health and wellbeing, we can continue to grow and learn and help our students to do the same.”