BY OWEN ALTERMAN
Dr. Ellen Schwartz, head of the Law School’s branch of Health Services, gets excited when she offers her vision for the clinic’s future. She wants to “move out of the individual doctor-patient mode,” where the clinic’s medical staff of eight sees patients, and plan more events educating students in large numbers about the services her staff can offer.
Dr. Christopher Coley, Harvard’s director for University Health Services, says he focuses more on exactly that doctor-patient relationship. “I’m a big believer in the continuity of primary care,” he said, adding that he wants students “to negotiate their own health” through the generalist doctors who see patients with a broad set of ailments.
Health Services officials may sound off fluently on what they think about the future. But their ideas are only part of a broader discussion, as the Law School begins to convene its new committee on the state of Health Services. That committee, with its combination of health staff, administrators and students, has met every two months to re-evaluate the strengths and weaknesses of the clinic and get students more involved in the process.
The committee’s first student member, 3L Gary Slossberg, said he hopes that more student representatives will join him soon. He also said the committee plans to seek student opinions, but says that he personally has not “done anything [yet] to try to get any detailed student input.”
Student opinion is still hard to assess. Health Services recorded 667 student visits last April and approximately 6,100 for the 2001 calendar year. In an ad hoc campus survey of a few dozen students, most shrug their shoulders with satisfaction with their clinic experiences. But others hint at reports of unhappiness with the wait for appointments or the cost of health insurance.
On the wait for appointments, Schwartz and Coley both say that Health Services treats patients quickly if they need urgent care. The schedule leaves open appointment times each day for those in need of attention. For routine appointments, Schwartz said most students are seen within a week or two.
Schwartz also said she has a possible plan for opening up the clinic schedule so that slots would be available more quickly, on the same day or the next. Ultimately, students might be able to schedule themselves for appointments, without first telling a staff member to schedule them.
On insurance costs, HLS students pay more than their peers at other schools. Here at Harvard, the university charged a total of $1,770 for 2002-03 health fees and Blue Cross/Blue Shield insurance. For the same academic year, Yale students paid $1,152 and Columbia students $1,382 for their health plans, according to the universities’ websites.
The Harvard costs include both the university health fee of $1,020 and the optional fee for Blue Cross/Blue Shield of $750. Students are permitted to waive the Blue Cross charge, though Coley said very few graduate students do so.
Comparing health plans is a difficult task, Coley said, since each plan has a different scope of coverage. But he said Harvard’s plan may be more expensive because the university offers more services on site. Health Services here, he said, has its own specialist doctors, while other universities must contract with outside hospitals.
Schwartz also said that higher prices here may include coverage for prescription drugs that other schools do not include. The university included that coverage in response to requests from students themselves, Schwartz added.
She also detailed her plans for more activities to involve students outside of the clinic itself. The Student Health Fair, held in October, could become a yearly event, along with other programs aimed at educating students about health issues.
Those issues would include, especially, relaxation, meditation and other stress-reduction techniques. Schwartz said that the Law School clinic has seen more and more mental health-related cases during her three years on the job, mirroring what she said was an increase on university campuses in general. The clinic has a social worker, psychologist and psychiatrist — all separate from the Office of Student Life Counseling’s own team — to treat students.
“As people are more stressed out in society, it filters down,” Schwartz said. “There’s a lot of pressure on this generation that wasn’t on previous generations.”
In the end, Schwartz said she hopes that Health Services can build on what she regards as its successes. “I think students who have used Health Services are pretty satisfied,” she said, though there are “still a lot of students who don’t know we’re here.”