This year Amherst College is undertaking a massive overhaul of its medical services, bringing Keefe Health Center under college ownership and hiring an almost entirely new medical staff. But the transition period has proven rocky. As the health center completes the process of hiring and training new staff members, some students have experienced lapses in service.
Until this academic year, Keefe Health Center was a satellite of UMass University Health Services. Although Amherst College is now managing the health center, UMass will continue providing services such as after-hours care, pharmacy support and prescription filling, lab testing and X-ray procedures to Amherst students. All of the health center staff have been replaced, with the exception of the center’s director, Warren Morgan.
“It’s a revolutionary change,” Morgan said. “Amherst was already leaning toward running its own health center because they wanted to have more day-to-day operational control.”
Expanding Medical Services
Plans to revamp the health services began after Morgan met with Chief Student Affairs Officer Suzanne Coffey last year. An external consultant, the director of the Tufts University Health Center, reviewed the service at Keefe Health Center and made recommendations.
“One of the many troubling consequences of this arrangement was that the college was not in a position to extend services beyond what the university’s union contract dictated,” Coffey said. “Dr. Morgan and I consulted with university officials and, along with colleagues, reached an agreement to bring our health services and employees under the college’s umbrella.”
According to Coffey, the health center will expand hours and begin providing services year-round, beginning this academic year. The change will also enable the health center and the college’s counseling center to work together in addressing student wellness. In addition, the college is in the process of finishing renovations to the Keefe Health Center building. Morgan’s former office is now a basic surgery room with new equipment, and the health center building has gained new exam rooms.
“There were times when we actually had to leave the building because of the renovations, so sometimes we were working out of Student Affairs,” Morgan said.
Several new positions have been added to the health center staff, including a full-time nurse and a 24-hour phone advice nurse. According to Morgan, the full-time nurse will extend and improve the health center’s ability to respond to student needs, as well as be involved in educational outreach. The 24-hour nurse can be reached by phone outside of the health center’s hours of operation, give medical advice during those hours and notify health center clinicians of students’ complaints the next morning.
Since the contract with UMass was renegotiated, the college has hired seven new health center staff members. Previous staff members are either continuing to work for UMass or have sought employment elsewhere.
“Although we had a lot of applicants for nurse practitioner and physician’s assistant, most of them didn’t have experience working with young adults,” Morgan said. “We were really looking for someone for both those positions — the PA, the nurse practitioner — for someone who had years of experience in outpatient medicine, especially working with young people.”
The college eventually found applicants with the desired experience. The physician assistant, Edward McGlynn, began work Sept. 22. The nurse practitioner will begin in November.
A Difficult Transition
In the transition period, the health center has been short-staffed.
“From the time school started until now, I’ve been the only clinician, doing the work of three clinicians,” Morgan said. “So that has been a huge problem. And as a result, we’ve been turning away some students that we’d like to see … so it’s not ideal, we don’t want it to be this way either, but it’s only temporary … we don’t like it any better than the students do.”
On days when Keefe Health Center cannot keep up with demand, students are referred to the health center at UMass. However, Morgan said he knew of two students who were denied medical care at UMass due to confusion over the new contract.
“It was a mistake,” Morgan said. “I immediately called my counterpart over at UMass and the director over there made sure that the people were appropriately informed.”
One of these students was Eva Lau ’18E.
“When I called UMass I was told that their contract with Amherst had terminated and that I would not be able to make an appointment,” said Lau, who had been referred by the health center to UMass for an injury. “I called the Amherst health center again and was told that what UMass had told me was incorrect.”
Morgan also said that the transition process has required staff to take some time to adjust to their new roles.
“With a new staff, there’s a lot of training that needs to happen,” Morgan said. “Some of the staff that we’ve hired, like the office coordinator and the receptionist, they’ve never worked in healthcare before. They’re going to do a good job as an office coordinator and as a receptionist, but they don’t know healthcare.”
In addition, the staff members who do have a background in health care — the nurse, the certified medical assistants, the physician assistant and the nurse practitioner — have been in training to learn about the specific procedures, policies and services offered at Amherst College.
Electronic Record-Keeping
This year the health center has also transitioned to an electronic record-keeping system. This system allows for electronic communication between health center staff and students, and will lead to the development of a patient portal, which allows students to log in to a website to view their own medical records and lab results and communicate with health center staff.
“We have to do everything through an electronic medical system that involves navigational skills,” Morgan said. “We have to quickly be able to navigate through electronic records, different screens, and learn how to take shortcuts, and learn procedures for coordinating functions that we have to do in the electronic records.”
Morgan said that some functions that used to take 15 minutes have been taking up to an hour as staff learn how to use the new technology.
Gloria Koh ’16 said that as a patient at the health center this year, she experienced delays when staff attempted to look up her medical records.
“The health center’s transition into the new computer system poses several problems,” Koh said. “For one, staff are unable to quickly refer to a student’s medical and medication history and thus take more time to look this information up.”
Ultimately, Morgan said, the goal of the changes to the health center is to provide better service to students.
“It’s not that we’re trying to be casual or unresponsive to students,” Morgan said. “I welcome communication with students, and we do want to be responsive. We realize we have a ways to go, to get to where we want to be. If we’re not perceived as doing our job, then we should know about that.”