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Task forcerecommends health service reform

By Lakshmana Rao

A task force on the health of MIT students has recommended broad changes in available health services. Task force recommendations address the issues of waiting time for student appointments, personal physicians for students, health education and penalties for missed appointments.

The recommendations are currently under serious consideration by the Medical Department, said Mark A. Goldstein, chief of pediatrics and student health services and chairman of the task force.

The task force, appointed by Director of Medical Services Arnold N. Weinberg during the summer of 1990, consisted of six Medical Department doctors. The task force met several times during the fall of 1990 and submitted its final report in March 1991.

"Student representatives from the Undergraduate Association and the Graduate Student Council were invited to some of the meetings of the task force. The student responses generated by the medical survey conducted by the GSC and UA [during the fall of 1990] were also used to arrive at the final recommendations," Goldstein said.

The GSC/UA medical survey solicited comments from students about the MIT medical facilities through a questionnaire distributed on Registration Day in Fall, 1990. Results of the survey indicated that some students were dissatisfied with staff and doctor attitudes toward students, inconvenient hours of operation of clinical facilities and the severe penalties for missed appointments.

Provisions made for

additional female doctors

Goldstein said that the Medical Department has made arrangements for two female medical fellows from the Division of Adolescent Medicine of Children's Hospital in Boston to visit MIT four afternoons a week.

"This arrangement makes more female practitioners available to MIT students and also helps reduce the waiting time for student appointments. The waiting time for patients to see doctors in specialized areas such as ear, nose, throat or eye care is unfortunately long in any hospital," he said.

Goldstein said that the Medical Department currently assigns each student a personal physician. "We feel very strongly that your best medical care is done when you have your own personal physician whom you see from time to time, rather than going from person to person. To facilitate this, we have made at least one appointment slot of each doctor every morning available for visits by their assigned students," Goldstein said.

Extended appointment

hours recommended

The task force also recommended that MIT health services be made available to students from 5 pm to 7 pm for several days during the week. "We recognize that this is an important point and requires some serious consideration. It requires restructuring of our operations so that all the staff and facilities are available at these extended hours. This is a very viable possibility in the future," Goldstein said.

Goldstein defended the present policy of fining students $20 for missed appointments, saying that it was designed to teach students responsibility. Goldstein noted that no fee is charged if students call ahead of time and cancel their appointment, and said he feels that most students abide by these rules.

Goldstein also admitted that some waiting for doctors after the appointment time is inevitable due to unpredictable emergencies and delays with previous patients.

New feedback

mechanism considered

Goldstein strongly favors the creation of an ongoing Institute committee which would meet regularly to discuss students' concerns about MIT medical services. Such a committee would augment the current feedback system, in which students may meet with the patient advocate physician or lodge a specific complaint with the Medical Director. Goldstein said the committee would include both students and representatives from the Medical Department. "I would like to pursue this idea and see what students think about it," he said.

The Medical Department is also responsible for improving health education on campus and is seriously considering increasing student involvement in this endeavor. "There is a tremendous scope of students getting directly involved in this activity. At the University of California at Berkeley, one literally sees hundreds of students teaching and acting as resource persons in this area. There is no reason as to why we cannot do that here," Goldstein said.

Concerns of international

students addressed

The international students' office and the Medical Department are making special efforts to overcome communication barriers between international students and medical care providers.

Goldstein and International Student Advisor Milena M. Levak are conducting sensitivity sessions for the medical staff to help them understand the special concerns of international students.

"These are awareness sessions that educate the participants about the cultural differences, the differences in voice inflection, [foreign students'] special body language, etc. We conducted a few such sessions last spring, which were attended mainly by the administrative staff of the Medical Department," Levak said.

Currently there are no plans to include doctors in the above program, she added.