After decades of providing temporary housing for homeless men, the Firehouse Shelter downtown has broadened its mission. Now, thanks to a program sponsored by UAB and utilizing medical students, the shelter offers its clients a clinic.
The 110-year-old red brick building at the corner of 15th Street and Third Avenue North, still boasting the letters “No 6” above its bright door, started the clinic in June 2016. Since then, the clinic, which has doubled the number of staff members on site, has treated about 130 men.
“On June 1, we began a screening clinic with the help of Dr. [Rick] Kilgore and Kelley Swatzell from the UAB School of Health Professions. We were able to begin a screening clinic for our guys, which was much-needed,” explained Kim Clark, case manager for Firehouse Ministries. “Though there are several medical facilities in the area, it is very hard for our guys to get the care that they need.”
There are transportation issues, she explained. If someone is sick, they may not feel like they have the energy to walk to the nearest hospital or clinic. Or they may not have a way to get a prescription filled once they get to the doctor’s office.
“So we just saw the need to have a clinic kind of ‘at home’ for them,” Clark said, “kind of like having your mom at home to take care of you while you’re sick.”
The biggest goal at the Firehouse Shelter is to help the men that come through the doors to obtain their goals, whether it be employment or whatever else.
“We walk the client through their goals,” said Clark. “It’s not what we want them to do, it’s what they want to do. We kind of help them put those goals into perspective and help them learn how to map it out so that they can reach those goals.”
This aim to help shelter clients with goals expanded seamlessly with the new clinic. Administrators at Firehouse Ministries quickly learned that their mission to provide medical treatment turned into something that has given these men more self-confidence.
“The guys get excited just because they see that somebody cares about their health,” said Clark. “It makes the guys feel good. And to know that, ‘Hey, I might be on all this medication, but they say if I take it right and take it for awhile, I could get better.’ Now they care about what they’re eating; now they care about their hygiene. It’s just certain things that this clinic has opened up for these guys.”
It’s not just the men seeking care that the new program has helped. According to Dr. Rick Kilgore, the UAB Physician Assistants Program director and assistant professor who helped Clark set up the program, the clinic has helped his students learn about things that they wouldn’t otherwise get the opportunity to be involved in.
Most students enrolled in UAB’s medical program are from privileged backgrounds, Kilgore said, meaning that “they don’t have much experience dealing with the homeless or the less fortunate. They get to see diseases and problems they may not get to see if they were just doing standard rotations. If put in a hospital, they’re only going to get to see a small slice of the entire healthcare system.
“The real benefit for us on the university side has been that it’s a student-led clinic. The students are doing the work and presenting it to the faculty,” he said. “The benefit to the clients is they are getting a lot of screening at no cost and they’re able to get their healthcare needs addressed very quickly.”
Kilgore said that most shelter clients can get their needs addressed within a week or less, “and with more acute cases, the next day, which cuts down on ER visits. So we’re saving a lot of money in the healthcare system because we’re able to get them in the right place quickly. They don’t know what their underlying problems are. We’re able to screen those out, find those, identify them, and get them into one of our clinics within a day or so.”
The students are benefiting from in-the-field work, learning which questions to ask, when to ask them, and how to approach finding out a deep medical history from someone who may not know the best way to describe it or who may not be good at giving a detailed medical history, something Kilgore says is common in the health industry.
They also get to develop a deeper compassion for issues to which they otherwise may not have been introduced.
“We start doing this early in training and we’re seeing an impact on students already,” said Kilgore. “Ninety percent of all diagnoses today can be obtained through a good history; you don’t even have to do a physical exam. That part should be more to confirm after talking to them. So, communication skills are critical.”
And it doesn’t stop there. Firehouse Ministries plans to expand their facilities soon and they’re looking to make a permanent clinic a part of the new architecture.
“We would definitely be able to increase the days,” said Clark. As it stands now, the clinic is only able to come to the shelter once a week and each week rotates between clinic examinations and education days.
“Right now, we only have enough room to do the clinic every other week and do health education every week in between,” she said. “There’s no use of you screening and checking and diagnosing if you’re not educating them on preventative care or continuous care of their conditions. So the health education is very important for our guys.
“It’s my ultimate goal, to make them more self-sufficient and able to reunite with families.”