Bedlam Evening Clinic and Physician Assistant Longitudinal (PAL) Student Clinics are unique educational features of the OU-TU School of Community Medicine Physician Assistant (PA) Program. Bedlam Evening Clinic was 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 flooded local emergency rooms, straining hospital budgets and staff, and costing patients much more than a regular physician office visit.
One of the first actions that OU-Tulsa President Clancy and other leaders recommended was addressing the needs of the working uninsured by offering free evening clinics initially 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 2008, the PA program was founded and PA student training was quickly incorporated into the innovative, interdisciplinary Bedlam E clinic.
Bedlam E provides acute and limited specialty care and is open 48 weeks in the year on Tuesdays and Thursdays from 5:30 p.m. until the last patient is seen. The clinic provides PA students and medical students with a service-learning experience in team-based, interdisciplinary, evidence-based patient care. 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 their systems of care.
In January 2012, the PAL Student Clinic was created at Morton Comprehensive Health Services in north Tulsa to provide more opportunities for care to the underserved population in northeast Oklahoma. This free clinic, now at the OU Family Medicine Clinic, is managed by second-year PA students under the guidance of PA faculty and OU supervising physicians. PA students serve as the primary care provider for patients with chronic illnesses such as diabetes, heart and lung disease. The patients receive excellent care and willingly donate their time to provide a hands-on opportunity for student learning of diagnostic and management strategies for chronic health conditions. The PAL clinic is part of the second-year PA student curriculum. Students provide continuous care to their own panel of patients on Tuesday afternoons from 1 p.m. to close.
Today, OU-TU School of Community Medicine’s PA students and medical students take leading roles in the operation of the Bedlam and PAL Clinics, supervised by faculty clinicians. “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., former dean of the 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 healthcare.