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At college health centers, students battle misdiagnoses and inaccessible care

brantlybrantly 4319 replies78 threads Senior Member
Big investigative report by Washington Post. I thought it was very good and reflects the experience of one of my children at a large university.

https://www.washingtonpost.com/investigations/2020/07/13/college-health-centers-problems/?arc404=true
To assess the landscape of student health services at roughly 1,700 four-year residential campuses, The Post interviewed more than 200 students, parents and health officials and examined thousands of pages of medical records and court documents and 5,500 reviews of student health centers posted on Google.

[ . . . ]

Student health centers are akin to the Wild West of medical care. There are no national regulations, and most are not licensed by states. Only about 220 campus medical clinics of the thousands nationwide are accredited by outside health organizations as meeting best practices, according to a Post analysis. In one case, Georgetown University stated on its website that its student health center was accredited but removed the claim after being asked about it by reporters.
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Replies to: At college health centers, students battle misdiagnoses and inaccessible care

  • momofsenior1momofsenior1 10391 replies122 threads Senior Member
    I posted this in another thread but I wonder if we wouldn't find the same level of dissatisfaction and misdiagnoses if we looked at regular MD, urgent care, and ER visits.

    We've been nothing but happy with PUSH, the Purdue health center. They have always gotten D seen in a timely fashion and she's always been treated appropriately. Lots of parents complain on our FB group that they under-treat but it's because they are cautious about prescribing antibiotics. IMO, rightfully so but lots of people say that it's better to go to minute clinic because they'll just prescribe.

    The one complaint that seems valid at many schools is about mental health support because schools are overrun with higher demand than they can meet.
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  • brantlybrantly 4319 replies78 threads Senior Member
    I posted this in another thread but I wonder if we wouldn't find the same level of dissatisfaction and misdiagnoses if we looked at regular MD, urgent care, and ER visits.

    Good point.
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  • CorinthianCorinthian 1818 replies63 threads Senior Member
    I think that student health centers mostly function sort of like an under-resourced urgent care center. They hopefully do okay with common place issues and maybe some medication management. But I doubt most are adequately staffed or equipped for significant diagnostic purposes. You have to hope they do a good enough job referring cases for outside consultation. I worry tremendously about how they will handle Covid-19 cases, although at least we know they'll all be on the lookout for them.
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  • bluebayoubluebayou 28057 replies208 threads Senior Member
    Corinthian wrote: »
    I think that student health centers mostly function sort of like an under-resourced urgent care center. They hopefully do okay with common place issues and maybe some medication management. But I doubt most are adequately staffed or equipped for significant diagnostic purposes. You have to hope they do a good enough job referring cases for outside consultation. I worry tremendously about how they will handle Covid-19 cases, although at least we know they'll all be on the lookout for them.

    From a practical standpoint, COVID should be easy to handle for the student health center. Ostensibly, all colleges will be on a testing binge. So, as long as they are smart enough to order a test and handle it properly, one just then needs to follow the written college protocol for COVID.
    I think that student health centers mostly function sort of like an under-resourced urgent care center.

    On weekends, the beds also serve as a sort of drunk tank where kids can 'sleep it off'.

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  • compmomcompmom 11866 replies82 threads Senior Member
    In many states, Medicaid pays full costs of medical care, so the blanket statement that students on Medicaid avoid care due to cost is not true. One of my kids was on Medicaid and had a $350k bill that was paid entirely.

    Health centers should send students to the hospital if there is something going on that needs further diagnostic procedures or care.
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  • natty1988natty1988 842 replies12 threads Member
    My D never had any problems at her university health center, then again she was lucky enough not to have any major medical issues. S just finished his freshman year and only needed the health center once in the first semester when he had a cold. His second semester on campus was cut short due to the whole covid thing. He said everything went well.
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  • MassmommMassmomm 4241 replies85 threads Senior Member
    The moral of this story is to teach self-advocacy to your kids. College health services are not there for chronic care. They are patch 'em up, send 'em off centers. They can also function as triage centers to ship really sick kids off to the hospital. But kids need to be persistent when something doesn't seem right, as they aren't set up to diagnose serious health problems.

    When my daughter was a senior, she developed a severe ache in her right arm. It worsened over a couple of days and she went to health services. They brushed her off and said it was likely an overuse injury, as she had just begun lifting weights. The following day, she was in agony and she noticed that her right arm appeared to be swollen. She consulted Dr. Google, went back to health services, and insisted that they measure her arms and compare the measurements. They did so and immediately put her into a campus police car and sent her to the ER. She had a DVT in her subclavian vein and spent two days in the ICU.
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  • bluebayoubluebayou 28057 replies208 threads Senior Member
    Massmomm wrote: »
    The moral of this story is to teach self-advocacy to your kids. College health services are not there for chronic care. They are patch 'em up, send 'em off centers.

    Exactly, expecting the college health care clinic/infirmary to act like a 5-star tertiary medical center is beyond naive. It demonstrates little critical thinking and a complete ignorance of health care by the authors of the article. WaPo has plenty of peeps on staff that understand health care issues -- the editor shoulda run it by them prior to publishing.

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  • kiddiekiddie 3880 replies242 threads Senior Member
    At the college my daughter attended the health center was the one service that I would give a failing grade to. They were woefully understaffed and offered no mental health services (or so little that it was impossible to get). Luckily it is in a city with probably the best medical services available in the country.

    I do think that they, along with most University Health Centers, will need to perform different functions in the COVID age. It will mostly be testing (and actually their lab testing was the only reliable service they had) and then they will be following very specific protocols based upon test results.
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  • momofsenior1momofsenior1 10391 replies122 threads Senior Member
    D's school has separated covid testing/tracking/care/quarantine from the health center. It's a total different entity.
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  • compmomcompmom 11866 replies82 threads Senior Member
    I would hope they would be physically separated!
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  • KnowsstuffKnowsstuff 7580 replies35 threads Senior Member
    This is why if your kids need "extra care" checking out the health /mental health services at a school are as important as the school itself. Also for lower extremity problems.. Minute clinics are usually a waste of time. They end up referring out anyway so your paying twice has been my experience as a doc.
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  • Eeyore123Eeyore123 2062 replies25 threads Senior Member
    People complain about higher education cost but expect world class amenities.
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  • brantlybrantly 4319 replies78 threads Senior Member
    Eeyore123 wrote: »
    People complain about higher education cost but expect world class amenities.

    This is not what this article is saying at all. Obviously, there's not going to be a full-service medical center on every campus. The point is that they need to recognize when it's appropriate to refer out instead of playing the odds that a stiff neck is just a muscle spasm.
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  • natty1988natty1988 842 replies12 threads Member
    @momofsenior1 that is the same complaint I remember seeing on the FB group for parents for my kid's schools. The student health center isn't good because they're cautious about prescribing antibiotics. I think that's a good thing. You don't need antibiotics for everything. Just prescribing antibiotics is not good.
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  • natty1988natty1988 842 replies12 threads Member
    @brantly My D's school was good at referring kids out if they needed more extensive care from what I heard. That said, we never thought of the student health centers as being full service. If one our kids had a chronic illness, we might have found them a local primary care doctor or specialist in the town where they go to school...
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  • roycroftmomroycroftmom 4597 replies40 threads Senior Member
    In 99.99% of cases, a stiff neck is indeed a muscle spasm. If you want ER level diagnostic testing for any possible minor complaint that has a remote possibility of being something major, costs will skyrocket. Every fever could be meningitis, every cough could be TB.
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