Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, August 4, 1993 TAG: 9308040548
SECTION: EDITORIAL PAGE: A-8 EDITION: METRO
SOURCE: DONALD R. STERN
DATELINE: LENGTH: Medium
He cautions that school clinics should not be seen as a replacement of the goal that every child have a "medical home" where he or she has a permanent, ongoing relationship with a primary-care physician. Dr. Dickens worries that school clinics may interfere with a child's treatment by a primary-care physician. He suggests that monies spent on school clinics might be better spent on other programs, such as the Child Health Investment Partnership, which links children to primary-care providers.
As a physician with a long standing interest in overcoming barriers to health care faced by children and adults in this valley, I agree with these concerns. This is why I have worked so hard to preserve and enhance CHIP, which is a private/public partnership that links children with a medical home and provides case management and family support services.
Unfortunately, many adolescents have difficulty getting to a physician's office or come from families with virtually no means to pay for medical care. All too often, adolescents, like many in our society, have no ongoing relationship with a physician. The Roanoke Adolescent Health Partnership, which will open two school health centers this fall, seeks to enhance - not interfere with - linking adolescents with primary-care physicians.
The partnership is a truly cooperative effort by public and private agencies - Carilion Health System, city Health Department, city schools and the Roanoke Redevelopment and Housing Authority. Its goal is to provide access to comprehensive, basic and preventive health-care services to adolescents, one of the most medically undeserved populations in society. RAHP was designed with input from pediatricians in Roanoke who expressed a general support for the program.
RAHP may actually enhance the primary-care physician's care by providing school-based, day-time support for adolescents who have more complex medical problems. Therefore, it will actually serve as a doorway to a system of medical care for adolescents with the private community and an enhancement of care for adolescents with complex problems.
This will be accomplished by placing nurse practitioners (nurses who have additional training and skills in clinical diagnosis and treatment) at Patrick Hentry High School and Ruffner Middle School, as well as the Teen Health Center in the Hurt Park community. When adolescents have a physician, the nurse practitioner will coordinate medical treatment with the physician. When adolescents have no physician, the partnership will seek to establish such a relationship.
In the meantime, we will strive to meet the basic and preventive health-care needs of teens who have no place to call their medical home.
Donald R. Stern, M.D., is health director for the Roanoke City Health Department.
by CNB