Expanding care beyond the exam room

Since his appointment as director of Student Health Services on September 1, David McBride has been settling into his new position and is already looking ahead to the future. BU Today spent a few minutes with McBride to learn his background and ask him where he plans to take Student Health Services.

BU Today: What aspects do you like about how Student Health Services currently operates?
 
McBride: I think the best thing that I have experienced so far is the quality of people who work here and their interest and willingness to help students with their health care needs. As you can imagine, being a college health professional is not the most lucrative doctor’s job in the world, but on the flip side people come here because they like working with students and they are committed to the developmental issues that are common to this age group.

What are your goals in your first year as director?

Streamlining the patient visit so that time with the provider is maximized as much as possible and minimizing the downtime that students are waiting without doing something that is purposeful to their health care is one of my goals.

A related goal is to get us computerized. We have had limited use of computers in the past, so we will be looking at electronic medical records and ways of communicating with students electronically through secure connections. Students could ask questions or make appointments on-line. We have to build the infrastructure first and make sure confidentiality is protected. My hope is that it will be available by next academic year.

Students at BU come from a variety of countries, backgrounds, and medical experience. How do you convey to students that all their medical needs can be met at Student Health Services?
 
I feel that there is a very inviting atmosphere once students get in to see the health care professionals who work here. I wouldn’t say that we can manage 100 percent of medical needs at the health care center, but we are very interested in helping students navigate the health care system. I think that one of the things we are responsible for as college health care professionals is to help students learn how the system works.

What are some medical issues that arise frequently on campus?

Most common by far are upper respiratory infections, such as coughs and colds. There is a fair amount of stress-related illness, anxiety and depression, headaches, muscular tension around the shoulders and neck, and activity-elated injuries. College students these days are physically very active, so we see a lot of injuries in the noncollegiate-athlete populations. We also deal with a lot of contraceptive and women’s health care issues.

Who can use Student Health Services? Do students have to pay for the services they receive?
 
Any full-time student or graduate student who has paid the student health fee is eligible to use the health center. The student health fee is automatically included in the full-time tuition. We don’t offer service specifically for staff and faculty, but that is something we have on our radar screen for sometime down the road. We’d like to be able to offer services to the entire University community, but it’s probably far down the road.

The standard provider visit is covered by the fee students pay to the University. There is no co-pay, although we do charge for some services, such as certain labs, splinting supplies, crutches, and immunizations. We try to make services such as immunization as affordable as possible. We aren’t trying to make a lot of money off student care; we are trying to provide a service.

How many students does Student Health Services see every year?
 
About 1,200 students visit our facility every month. Around flu season in the middle of winter it is busier, and sometimes right at the beginning of school year we are a bit busier. Right before finals we see a lot of people come in with stress-related issues.

Where do you hope to take Student Health Services in the future? 

I want to make sure we have a strong connection with the medical campus because I think that pushes our providers to be as good as they can be. I would like us to be involved in student education to medical students and health care professional students because to be on a university campus and not teach in some ways doesn’t really seem right. I think the environment of education pushes people to be excellent in their field.

There is a lot of discussion about departments working together to try to address the health needs of the student population, so another long-term goal would be to work cooperatively with other offices on campus in addressing issues such as alcohol use and education about staying healthy.

What experience do you have in a university setting?

I worked at Northeastern University for four and a half years as staff physician. I was also staff liaison between the health center and the athletics department and did a lot of medical care for the athletic population. In terms of teaching, I was an assistant professor at Northeastern in the Physician Assistant Program, where I taught graduate students. The past year I taught at Tufts University in a residency.

How does practicing at a university differ from working in any other medical setting?

By virtue of the population, you are seeing less of a variety of problems here. You don’t see a lot of hypertension, diabetes, or coronary artery disease, so the range of problems is a little narrower. On the upside, university students are at a life phase where they are still willing to incorporate information and teaching about their life decisions. I often feel that we can work together with students more because they are not so set in their ways. In a university you have to keep developmental issues in mind because people are transitioning from, in most cases, having parents and support systems at home and now they are on their own and making their own decisions.

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New Student Health Services director named David R. McBride to succeed Julius W. Taylor