The DO | In Training | Training Ground

TUNCOM partners with new clinic to help students learn to care for the disabled

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An artist's rendering shows the garden at New Vista's upcoming residential facility and clinic in Las Vegas. (Illustration courtesy of New Vista)

Patients with developmental disabilities face unique hurdles to accessing medical care, beginning with simply getting to and from the doctor’s office. It can also be challenging to find a physician who is comfortable working with them. Some physicians haven’t treated this population before and don’t know their needs, says Kelly DeGuzman, the CEO of New Vista, a nonprofit that provides housing and skills training to individuals with disabilities.

The Touro University Nevada College of Osteopathic Medicine (TUNCOM) in Henderson has partnered with New Vista to create a residential facility for people with developmental disabilities with an on-site medical clinic in Las Vegas. New Vista will develop the clinic and residences, and TUNCOM students and faculty will provide care in the clinic.

DeGuzman hopes the partnership with TUNCOM will expose more physicians-in-training to this population’s distinct needs. She recently accompanied a man who is blind and deaf on a visit to a neurologist. Those who are blind and deaf communicate with their hands, she says. For instance, this man will touch a person’s face to recognize him or her. At the clinic, the nurse balked when he touched her face. Then the physician came in.

“He said, ‘We can’t help you. Why is he touching everything?’ ” DeGuzman says.

Although she doesn’t see this type of behavior often, DeGuzman found the encounter appalling and filed a complaint with the state medical board.

“This is part of the reason we want a better education for physicians,” she says. “They wouldn’t even touch him.”

Partnership will help students

Officials at New Vista contacted Touro University Nevada for advice in designing the complex’s medical facility, and the two parties realized they could help one another by working together.

Dr. Forman

“This is potentially a model for other institutions to duplicate if we can prove this is an efficient and successful way of managing a population of fragile individuals.”
Dr. Forman

The clinic will likely be fully operational by summer 2013, DeGuzman says. The residential complex will house 76 people, mostly those age 50 and older, and the clinic will serve them and other individuals with developmental disabilities in Clark County. DeGuzman expects 6,000 patients to visit the clinic annually.

After the clinic opens, TUNCOM students, under faculty supervision, will work directly with the clinic’s patients, says Mitchell D. Forman, DO, the dean of TUNCOM.

“Students will make the initial assessment, discuss the case with their faculty supervisor, order appropriate labs and other necessary studies when indicated, and make recommendations for treatment,” Dr. Forman says.

This is the first partnership between a medical clinic for individuals with developmental disabilities and an osteopathic medical school that Dr. Forman is aware of. Many medical schools, including osteopathic medical schools, don’t have a required curriculum for teaching students how to treat this patient population, Dr. Forman says. He hopes students and faculty practicing in the clinic will learn new strategies for working with this population, which the faculty can then incorporate into the curriculum for all students.

Unique needs

Relatively short and rushed physician visits are one of the most prominent challenges patients with developmental disabilities face in navigating the health care system, Dr. Forman says.

“This does not allow individuals who have a more difficult time communicating to articulate their needs or to receive adequate time to be counseled and educated about their health and treatment,” he says.

By working directly with this population in the clinic, TUNCOM students will have the opportunity to see and learn about this population’s needs firsthand, Dr. Forman says.

TUNCOM students will also have a chance to work with Touro University Nevada nursing, physician assistant and physical therapy students in the clinic and practice coordinating care with a team, says Andrew Eisen, MD, associate dean of clinical education at Touro University Nevada.

“If you look at the core competencies of the AOA, one of those is systems-based practice,” Dr. Eisen says. “We think this project contributes directly to that.”

In the future

After working with the clinic for a few years, Dr. Forman hopes to make recommendations to other osteopathic medical schools on adopting similar programs or incorporating clinic time with patients with developmental disabilities into their curricula.

TUNCOM’s partnership with New Vista’s clinic will also allow faculty to do outcomes research to study the benefits of this care model, Dr. Forman says.

“This is potentially a model for other institutions to duplicate if we can prove this is an efficient and successful way of managing a population of fragile individuals,” he says.

While many health care professionals have much to learn about treating individuals with developmental disabilities, Dr. Forman says osteopathic medical students have a solid foundation to work from.

“Osteopathic medical students and DOs practice a type of medicine that is patient-centered, promotes healthy lifestyles and incorporates a hands-on approach to medical care that is particularly helpful in dealing with fragile patient populations,” he says.

One Response

  1. robert migliorino,d.o. on March 1, 2013, 2:36 p.m.

    D/D is quite challenging. As a prior Director for a 1700 bed facility in Indiana,trust that they will do well. However it looks like a reversion to 25 years ago before the ARC declared these facilities evil & demeaning & had them placed in group homes!

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