With the upcoming retirement of Director of Student Health Dr. William Christmas in June, administrators have begun to examine the future of Student Health Services at the University.
While the current state of student health is strong by all accounts, both Christmas and Larry Moneta, vice president for student affairs, said health services could make itself more visible on campus, especially for freshmen, who are often unaware of their health options. At the forefront of the discussion is creating a service that is more individual-oriented, with a focus on involving students from the earliest stages of the undergraduate experience in their own health care program.
"We want to engage freshmen, literally as part of the orientation process or shortly thereafter, on how they can be advised and get individual consultation to help them think about sleep, and nutrition and exercise choices," said Moneta. "We want to focus on how to create a model by which individual students can get their own health plan."
Moneta said an individual health profile for students would be the manifestation of a new philosophy for Student Health, which would focus on prevention of illness, rather than relying solely on the traditional method of treatment after the patient becomes sick. He noted that this philosophy was based on the work coming from the leadership of the Duke University Health System.
This concept of an individual health plan is part of a greater theory of "prospective health care," proposed in a November article co-written by DUHS CEO and Chancellor of Health Affairs Dr. Ralph Snyderman and Dean of the School of Medicine Dr. Sandy Williams. The article calls for a new approach to health care, which would provide individuals with a broad analysis of their health risks. Using such a profile, physicians could prevent illness or fight it in its earliest stages.
Williams said a program incorporating prospective health care was currently being offered to Duke employees and believed a similar program for undergraduates would be beneficial both for students and the University on the whole.
Although both Moneta and Christmas said a personalized health plan for all students is a long-term goal, currently without specifics, one short-term goal that reflects Student Health's greater specificity is a more robust program of women's health services started in fall 2003.
"We have always offered women's health services at Student Health as part of our menu of primary care," Christmas said. "As a result of the Women's Initiative, we decided to increase our staff of women providers... and promote the service more widely."
Christmas said the program was already very popular due to the broad range of services aimed at women, including periodic examinations, cancer detection and prevention, contraception, and evaluation of problems specific to women like osteoporosis, eating and body image concerns, and menstrual problems.
"In addition, our Health Promotion group offers women's health information sessions to those who are interested, and our professional staff and peer health educators are also available to do programs on campus," he added.
Despite the current rethinking of Student Health, Moneta called Christmas' retirement a "great loss" and noted the current high quality of medical services. "Right now we have a remarkably strong clinical service and we want to make sure we aren't tampering with it," Moneta said.
Christmas did not take full credit for the system's success, but pointed to the increased space, accessibility and staff to account for the growth of Student Health, which saw student visits increase by a third--from 15,000 in 2002 to 20,000 in 2003.
"I was given the mandate of improving clinical services and access for students, and I think that at least I've been told that has been accomplished. Our visits compared to last year are up significantly," he said. "We predicted that if we went into a new space and increased staff, we would see [such] an increase in visits."
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