Student Health is poised for change

The report from an outside consultant proposes massive restructuring

In the midst of criticisms of Student Health this year, plans have been made to begin a major restructuring of the department next year.

Student discontent, which evinced itself most clearly in student surveys circulated by Student Senate, has been growing for years, and the administration is on the verge of implementing major changes, according to President Nancy Dye.

Dean of Student Life and Services Charlene Cole-Newkirk brought in an outside evaluator this semester to write a proposal about possible changes to Student Health.

The proposal has been received, and according to both Cole-Newkirk and President Nancy Dye a plan for changes should be formulated in the fall.

Student discontent surfaced most clearly this year in the student health surveys distributed by the Student Senate in February. Of the 439 respondents, 15.4 percent of the student body, 31.5 percent rated the clinic a one or two on a scale of five, five being the highest. College physician Dr. Judith Appleton was ranked a one or two by 41.3 percent of the respondents.

On the surveys students responded with many stories to illustrate their discontent. "I do not appreciate being treated like it's my fault," one student wrote about her encounters with Appleton and the clinic staff. Some students wrote about being misdiagnosed and recievng wrong prescriptions.

Only 13.4 percent of the respondents rated Appleton a 4 or 5.

In his report, outside evaluator Richard P. Keeling of Health Advocates wrote that the problems of student health do not arise out of Appleton's alleged incompetence, but the contract with the Oberlin Clinic, unnecessarily free access to urgent and emergency care, a low-value staffing mixture and the absences of a system to assess the quality of care. He also cited badly developed preventative and educational health programs.

Keeling called Appleton a "kind, caring physician who dedicates her life to students at Oberlin."

Appleton responded to the survey results through a letter to the Review. She wrote that the results of the survey were blown out of proportion by the fact that only 15 percent of the student body responded to the survey. "This does not mean there are no problems or valid complaints, but in no way do they approach the magnitude of what is being represented as the common experience," Appleton wrote.

Appleton said that she had issued her own exit surveys that were "directly opposite" to the results received by the Senate surveys.

The recommendation to bring in an outside consultant was made by Cole-Newkirk. "When I go into a group of students and mention student health, it doesn't take long to figure out that there is a problem," she said.

Assistant Dean of Student Life and Services Ken Holmes said that while the consultant was in Oberlin the issues addressed were the quality and cost of student health care. "The bottom line is to get the services the students need," Holmes said.

Keeling did find that student health was not functioning efficiently. He wrote that the College is currently spending too much money on too few services, that prevention programs are ineffective, that the bad reputation of student health hurts its effectiveness, that the separateness of student health and counseling services duplicates common functions and that inadequate space threatens privacy and effectiveness.

Keeling's recommendations for the College include several possibilities. They range from continuing the current arrangement with the Oberlin Clinic with contractual, programmatic and fiscal modifications, to continuing the contract but moving the student health clinic to an on-campus site, to discontinuing the contract and providing primary care through the College or an outside provider.

While both Dye and Cole-Newkirk felt it was too early to comment on the possibility of any of the options, Cole-Newkirk said that she liked Keeling's recommendation that the changes happen in phases.

According to Cole-Newkirk the Health Plan Board met on May 10 and began discussing the evaluator's reports.

Cole-Newkirk said that at the meeting Appleton voiced a desire to write her own proposal. Cole-Newkirk said that if Appleton had a good proposal it would be welcomed.

Dye and Cole-Newkirk both feel that student health is an important issue and that the options for improvement must be carefully considered.

Dye pointed out that the health plan at Oberlin has not been reconsidered since 1982 and that "an awful lot has changed in health care since 1982."

Dye feels that an important focus in college health is education and prevention. "Oberlin is a very healthy population," she said. "I am especially impressed by health needs for college students for secondary and tertiary care, education and some primary care."

Cole-Newkirk said that in making changes in the fall, "What we need to do is go back out to the community. We need to listen to all the voices."