THE STAFF and administration of Student Health rarely reply to inevitable student newspaper complaints, accepting them as almost a ritual part of the University experience that reflects understandable problems in coming to grips with a difficult and often emotionally-laden part of adult life: dealing with one's health and healthcare. However, Diya Gullapalli's column of March 7 ("Diagnosing Student Health's ailments") was so inappropriate, ill-informed and frankly insulting that I felt it deserved a reply.
My colleagues and I are board-certified physicians and licensed, independent practitioners who are well-trained, experienced and highly-motivated to provide the best possible care to the students who we all appreciate, sympathize with, and usually like personally. Many of us have at least one degree from the University and feel a strong pride in our affiliation with the University as a whole and Student Health in particular.
I will try to address some of the particulars of Ms. Gullapalli's complaints. A significant majority of the illnesses that students come to Student Health for are self-limited viral infections. Some students predictably are frustrated that there is no antibiotic cure for many such infections. In part, the expectation of treatment has been fostered by medical providers over the years who have given an inappropriate number of powerful antibiotics that expose a patient to risk of side effects with little chance of benefit. This is being recognized as a nationwide problem that responsible physicians are attempting to address.
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Many times, however, there are supportive measures to help -- but not cure -- a problem. I suspect it was this symptomatic approach that resulted in Ms. Gullapalli's "assortment of inhalers, medication and blood tests."
Student Health providers are allotted and take time to understand the nature of a problem and to educate the student appropriately. Numerous students and residents who have rotated through our institution have commented that we are more thorough than the average "outside world" medical office.
In regard to the comments about the close-quarter nature of the college community, I can assure you that we are concerned about serious epidemiological issues and that is one reason why we have led the way in pro-active immunization programs for diseases such as meningitis and influenza.
Student Health has a high quality and cost-effective pharmacy that is truly the best provider of this service that I have encountered in my 15 years of post-training medical experience. The vast majority of medications that students need are available through this pharmacy. Naturally, there are occasional exceptions, as the range of medications is enormous; it is not practical to stock every one. An occasional trip to an outside pharmacy is just not preventable.
Further, it seems odd to complain about a "trek out to the hospital for a second opinion." Many people want sub-specialist care and the Health Center works hard to make appropriate referrals to our consultants available through the Medical Center and the private practice community. We work to avoid unnecessary referrals because of their cost and inconvenience, but the vast majority of students appreciate our system working closely with high-quality sub-specialists in managing more complex problems.
In regard to specific complaints that Ms. Gullapalli felt indicated "incompetence," I would note that a student nurse who has trouble finding a pulse is not worrisome. Pulses are variable, can be elusive, and healthcare providers-in-training will acquire their facility based on experience. What is important is appropriate supervision, and we have a well-developed system for supervising all our health care provider trainees. "A resident who couldn't find my spleen" perhaps means that, as in most exams, a spleen is not palpable. The spleen usually only is felt when it's enlarged due to some illness.
With regard to a lab technician having trouble finding a vein to draw blood, this is an area that can be problematic under many different circumstances. Our lab does hundreds of blood draws per week without problems, but occasional difficulty finding a vein is an unfortunate fact of life that will be encountered in any medical environment.
There's always room for improvement and we strive daily to look at ways that we can provide the most practical and cost-effective treatment for our student patients. Numerous patients, particularly those with extensive experience in other medical care environments, have told us that we do a good job and that they appreciate it.
Ms. Gullapalli is, of course, entitled to her opinion to the contrary. But when she uses world like "blunders" and "shoddy, inattentive treatment" or implies that a non-existent "cure" should have been offered for "mediocre health," she is being needlessly insulting to a dedicated and competent group of health service providers, and just plain wrong.
(Colin Ramirez is a staff physician with the University's Department of Student Health.)
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