50 years of caring for the Community

Doris Rehberg sits, hands folded in her lap, waiting for the doctor to examine her ear. The minutes pass, but Rehberg doesn't mind the wait. She doesn't mind the 18-mile drive to get to the Alachua County Organization for Rural Needs clinic, either.

She knows most everyone who works in the office - they often peek in her room to say hi or coo about her hat, a white number with beige flowers tacked on it - and she adores her doctor, Mimi Balch, M.D., a UF adjunct professor of community health and family medicine and a co-medical director of the clinic.

If it weren't for them, Rehberg doesn't think she would be able to access quality health care at all. The grandmother of eight wouldn't be able to afford it.

"I appreciate the ACORN clinic for taking me in," Rehberg said. "I wouldn't be getting the care I need without it. I think it's wonderful, myself."

Tucked away on a rural highway near Brooker, Fla., about 12 miles north of Gainesville, the clinic provides medical, dental and psychological care to patients, nearly all of whom live at or below federal poverty guidelines.

Since the ACORN clinic opened in 1974, faculty, staff and students from the UF Health Science Center have been there, volunteering their time to help people like Rehberg, who have little access to affordable health care or to the resources available in cities. UF medical and pharmacy students often have clinical rotations there and dental students provide much of the care in the dental clinic, under the supervision of UF College of Dentistry faculty.

But helping out in rural clinics is just one of the ways faculty and students from the colleges of Medicine, Nursing, Pharmacy, Dentistry, Veterinary Medicine and Public Health and Health Professions have contributed to the community in the 50 years since the Health Science Center opened.

There have been community campaigns to spay and neuter feral cats and special camps to help sick children realize they're not alone. But no matter what the cause, HSC faculty and students generally get involved for one reason: to help people.

The Mayo, Fla., clinic

By 1969, there hadn't been a doctor in Lafayette County for 10 years. Back then, patients with serious injuries often died before they could get the care they needed.

Newly hired to head the UF College of Medicine's department of community health and ambulatory care, Richard Reynolds, M.D., didn't recognize anything at the teaching hospital then that reminded him of what his own private practice had been like.

Establishing a clinic in Mayo, Fla., the county seat, would not only help the area's citizens but also give students a taste of life as a doctor, Reynolds thought.

"We ran it 24/7," remembered Reynolds, still a UF courtesy professor and a vice president of Boca Raton Community Hospital. "The (medical and nursing) students lived there - We saw about 5,000 patients a year."

The program was one of the first community rural health programs HSC leaders launched. College of Medicine founding Dean George T. Harrell had hoped to establish clinics in nearby communities, but several local doctors, worried about their own practices, weren't keen on the idea.

The clinic is still in Mayo, although the rural county now has a few doctors of its own.

The Equal Access Clinic

Patients usually line up outside the door before the Equal Access Clinic opens on Thursday nights. Only 15 patients are seen at the weekly free clinic, which UF medical students established in 1992.

"It's not a huge number of people, but it's something," said Adam Mecca, a first-year medical student and one of the clinic's co-directors. "We have some people who come here all the time. Without it, they wouldn't have anything else."

UF medical students began planning the weekly clinic in 1988. Four years later, with the help of faculty members and financial support from the UF Alumni Association, it opened in a Salvation Army building.

Now housed in the UF Family Practice Medical Group, the clinic also allows first- and second-year medical students the chance to work with patients. Medical students typically do not work with patients until their third year, when they begin their clinical clerkships.

"It's a huge opportunity for us and for the patients," Mecca said.

Operation Catnip

People aren't the only ones in need. Cats and kittens have problems too, namely that there are too many without homes.

In Alachua County alone, there are 36,000 stray and feral cats, said Julie Levy, D.V.M., a UF associate professor of veterinary medicine. Raised without human contact, feral cats often turn wild and form colonies in neighborhoods.

"Many of them will end up homeless or in shelters," Levy said. "That's a lot of suffering."

That's why Levy started Operation Catnip at North Carolina State University in 1994. A trap-neuter-return program, Operation Catnip allows community members to trap neighborhood strays and bring them to a monthly clinic where they are spayed or neutered for free by veterinarian volunteers. This is a humane way to battle the kitty overpopulation problem, Levy said.

Levy expanded the program to Gainesville in 1998, one year after she joined the UF faculty. So far, she and her colleagues have spayed and neutered 15,000 cats in Gainesville.

"I think this is a nice example of how UF and the residential community can work together to solve a problem," Levy said.

Hands to Love camp

For one weekend each year at Camp Crystal Lake in Keystone Heights, there's no teasing or self-conscious worrying for children born with arm or hand defects.

For one weekend, 30 children can be with kids who are just like them.

Paul Dell, M.D., a UF professor of orthopaedics in the College of Medicine, and two Shands Rehab hand therapists founded the Hands to Love camp in 2001 to give children with congenital hand differences and their families a chance to interact with each other and explore new resources.

"The main focus of the camp is for the kids to get together, meet new friends, enjoy the camp experience and play together," said Wendy Holt, OTR, a UF lecturer in the College of Public Health and Health Professions. "This gives them a chance to relax."

While there, the children can try out archery with a special device that allows them to shoot a bow and arrow, as well as a ropes course and even water skiing. The families also have access to psychologists, hand therapists, orthopaedic physicians, Many of the volunteers at the camp are PHHP occupational therapy students, who participate as family pals for the entire weekend. Dental students also come to the camp to teach children proper dental care, Holt said.

For parents, the camp also serves as prime networking ground. But mostly, it's all about fun, Holt said.

"They're amazing kids," Holt said. "To see them climb ropes and do all this stuff; they're competitive, fearless. It is always a weekend to remember."

UF Area Health Education Centers program

The UF Area Health Education Centers program isn't a special clinic or office where community members can go for help. But it is the program that links physicians, health professionals and students from every college in the HSC except veterinary medicine to medically underserved communities from Ocala to Pensacola.

AHEC, a state- and federally funded program, supports programs and clinics in medically underserved areas, in rural and inner-city neighborhoods. Because it is difficult to keep doctors in isolated, rural towns or in poor, urban areas, AHEC also helps recruit and retain doctors there, providing them with continuing medical education and linking them to the HSC and its resources.

"Many of the medically underserved communities are underserved for a reason," said Larry Rooks, an associate professor of community health and family medicine and medical director of the UF AHEC. "AHEC fills the gap and does a lot to get quality health care in these areas."

AHEC, which has programs in 40 states, was started at UF in the early 1990s, Rooks said.

Program leaders are also working on ways to diversify health care and fix future problems. The group established a Boy Scouts of America medical explorers post in Jacksonville, as well as summer camps in other areas. They also formed the Community Health Scholars program, which allows health professions students to spend the summer studying health needs in rural areas. These students work on finding solutions to health-care problems specific to rural areas.

"One thing I think the university needs to be careful of is forgetting we're a little island in a rural sea," Rooks said.

One of the rural programs AHEC supports is the ACORN clinic, arranging for faculty and students from HSC colleges to work there.

The help is needed. Most of the patients who come to the ACORN clinic have nowhere else to go. Many are uninsured, said Chris Hoffman, R.N., coordinator of the ACORN medical clinic. Without insurance, some patients would spend $500 to $600 on medicine alone.

"They're struggling to get by," Hoffman said. "They all have their stories to tell."

Patients like Rehberg are just glad someone is listening.

"They're such good doctors," Rehberg said. "Everyone is just so nice."