Bedlam Clinics are a unique feature of the University of Oklahoma School of Community Medicine track. The two clinics, Bedlam Evening and Bedlam Longitudinal, were created in response to harsh economic times in Tulsa following the September 11 attacks of 2001. At that time, Oklahoma already ranked near the bottom of the nation in health statistics. After 9-11, Tulsa was second only to San Jose, California, in the number of jobs lost per capita, creating a dramatic rise in the number of uninsured. With nowhere else to go for primary care, those without coverage filled local emergency rooms, straining hospital budgets and staff, and costing patients much more than a regular physician office visit.
Tulsan Ken Levit – at that time President of the University of Oklahoma – Tulsa, convened a summit of local and state leaders and agencies to examine Oklahoma’s poor health status and propose solutions. Gerard P. Clancy, M.D., arrived soon after to assume duties as OU-Tulsa President and Dean of the University of Oklahoma College of Medicine’s Tulsa program. One of the first actions Dr. Clancy and other leaders recommended was addressing the needs of the working uninsured by offering free evening clinics staffed by medical students and volunteer physicians. In August, 2003, funded by private donations, Bedlam Evening Clinic, also known as “Bedlam – E,” opened with more than one hundred patients waiting in line.
In the years following, a generous donation from the George Kaiser Family Foundation allowed the redesign of the University of Oklahoma College of Medicine’s program in Tulsa. It became the OU School of Community Medicine, created with the explicit purpose of improving the health of all Oklahomans, particularly the rural and urban underserved. Bedlam – E, offering free acute and limited specialty care, became one of several community health clinics run by the OU School of Community Medicine and OU Physicians, its medical practice group. It quickly became obvious, however, that Bedlam – E could not meet the needs of those patients requiring continuous care. Bedlam Longitudinal, known as “Bedlam – L,” grew out of that need, providing an answer for those patients with chronic illnesses such as diabetes, heart and lung disease. Those who went to Bedlam – E with more serious conditions could now be referred to Bedlam Longitudinal for longer term care at no charge.
Today, OU School of Community Medicine students take leading roles in the operation of the Bedlam Clinics, supervised by faculty physicians. Bedlam – E, providing acute and limited specialty care, is open 48 weeks in the year, Tuesdays and Thursdays, from 5:30 p.m. until the last patient is seen.
Bedlam – L provides coordinated and continuous care for uninsured adults with chronic illness in the Tulsa area. Open on Tuesdays from 1:30 p.m. until the last patient is seen, the clinic provides students with a service-learning experience in team-based, interdisciplinary, evidence-based patient care. Third year medical students in the OU School of Community Medicine practice the PCP (primary care provider) role under the guidance of OU faculty from various medical disciplines. Students from the University of Oklahoma Colleges of Nursing, Pharmacy and Social Work are also part of the patient care teams. Students and faculty learn from their practice and continuously evaluate and improve the Bedlam Clinic systems of care.
“The Bedlam Clinics provide quality, continuous care to many Tulsa-area patients with chronic disease who would otherwise often be in emergency rooms with one crisis after another,” says F. Daniel Duffy, M.D., Dean of the OU School of Community Medicine. “Helping to bring their diseases quickly under control has pulled many of them from the brink of serious health crises. They often tell us they don’t know what they’d do or where they’d go for treatment or medicines were it not for the Bedlam Clinics.”
The clinics deliver direct experience in the practice of community medicine, teaching students not only patient care skills, but also exposing them to the challenges the uninsured face in obtaining access to health care.