Relevant Read

A relevant and important article about the homeless population in Tampa published in the Tampa Bay Times last March, 2018:

LOST: Almost two dozen homeless men and women died last year in Hillsborough. Who were they? How did they fall so far?

TBSM Humanities - A Brief History

In 2012, the Tampa-St. Petersburg area was known to have the highest homelessness rate in the country. According to a report by the National Alliance to End Homelessness from that same year, for every 10,000 residents, 57 individuals were homeless [1]. Since then, Tampa organizations have mobilized to provide innovative solutions to reduce the rate of homelessness in Hillsborough County. Students at USF launched Tampa Bay Street Medicine (TBSM) in 2017, in the midst of this movement to reinvest in the local community.

While homelessness has decreased every year since the National Alliance report was published -- the 2017 census counted 1,549 homeless individuals, compared to a total of 2,275 in 2012 [2, 3] -- the importance of TBSM’s initiative remains. Fifteen percent of the Tampa homeless community are chronically unsheltered and receive little to no medical care. Through street and mobile van runs, and a free clinic in downtown Tampa, TBSM aims to provide homeless individuals with the care they need and thereby reduce community costs by addressing these individuals’ health concerns before they escalate. Through our medical and social work outreach and research, we advocate for our patients and for improved healthcare equality in Tampa.

TBSM Humanities is an initiative to provide students, providers, and patients affiliated with TBSM opportunities to reflect on and elucidate the challenges that characterize street medicine. Providing a robust experiential education in whole-person care and health navigation, this care exchange is intimate and crucial. We hope TBSM Humanities is an illuminating and valuable tool for all those invested in sustainably caring for vulnerable populations.

References

1. Hirschkorn, P. (2012, August 26.) CBS News <https://www.cbsnews.com/news/tampa-area-has-nations-highest-homelessness-rate/>

2. 2017 PIT Homeless Count Data. Tampa Hillsoborough Homeless Initiative. <http://thhi.org/about-homelessness/homeless-counts/2017-pit-homeless-count-data/>

3. Danielson, R. (2013, May 17) "Count (and recount) finds 2,275 homeless in Hillsborough County." Tampa Bay Times <https://www.tampabay.com/news/localgovernment/count-and-recount-finds-2275-homeless-in-hillsborough-county/2121537>

Student Perspective: INTENSIVE CARE

Matriculating into medical school, I had the same idealistic and stereotypical goals most medical students do. I wanted to help people by volunteering my time and talents for the betterment of my community and the underserved. What held me true to those beliefs was the time spent Friday nights downtown. Not what first comes to mind with nights out on the town, but rather with Tampa Bay Street Medicine (TBSM). In hindsight, TBSM has been the driving force for why I want to go into Primary Care and treat the whole human.

On the very first day of 3rd year rotations, I saw a homeless man in the ICU. He was admitted for uncontrolled hypothyroidism and risk of myxedema coma. The teams’ sole priority was treating his disease and discharging him as quickly as possible. Unfortunately, the medical treatment outweighed the personal treatment. He had struggled with his hypothyroidism for years because he was unable to coordinate follow up lab work after his hospitalizations and afford his levothyroxine. A simple outpatient provider could have saved the hospital thousands of dollars on his multiple admission. None of his systematic disparities in medicine were addressed during his hospitalizations or discharges.

I’ve gotten to know this patient closer over the last 6 months through TBSM. He was “adopted” by someone who arranged his mailing address to be her office, transported him to get his Hillsborough county health care plan, and even a shave/haircut on her day off. He has now been receiving treatment through TBSM for his hypothyroidism. Every week when I see him he remarks at his increased motivation and energy. I can see the effects beyond the trimmed hair/beard or 65lb weight loss; his eyes have such a vitality and light. I don’t know if that is a side effect of the medication or the medical care and attention he is receiving now.

I’m not here to reflect on the state of American healthcare, but I feel that the “intensive care” portion of the intensive care unit should address all aspects of the patient. I hope to bring this type of intensive care into my daily practice.