Providing Free, High-Quality Health Care, “No Questions Asked”

Gainesville, March 21, 2019, 6:30 p.m.: The waiting room at the UF Health Family Medical Group at Main Street looks exactly as it does during the day: bright blue and gold carpeting, adults and children waiting in comfy chairs, busy receptionists checking in patients.

But tonight’s after-hours clinic has one major difference: It’s free.

The Equal Access Clinic Network (EACN), a group of free health care clinics in Gainesville established by the UF College of Medicine, is a training ground for future doctors, therapists and pharmacists. And for patients with no or limited insurance, it’s a lifesaver.

“The cost – no cost – is wonderful,” said patient Mayara Marini Narezzi. “And at night, it is easier to come.”

Patients range from working parents to students on a budget to the elderly to the homeless. Some come in with a sprained ankle. Others struggle with diabetes or high blood pressure. Whatever the circumstances, patients know they’ll get high-quality, comprehensive health care, “no questions asked,” said EACN Executive Director Adam Grippin (BSCHE 13), an M.D./Ph.D. candidate.

“We’ll take care of anyone who walks through our door,” added medical student Patrick Bliven (BSA 17, 4 Medicine), director of the Eastside clinic. “We don’t ask for ID. All we ask for is their name and a way to contact them so we can follow up.” The EACN’s attentive care “enables patients to live the long, healthy lives that they deserve,” said Grippin.

Since its launch in 1992, Equal Access has grown to four primary care sites and 12 specialty clinics in areas of greatest need throughout Gainesville. Doors are open four evenings a week, with dedicated nights for pediatric care, dentistry, talk therapy and more. The clinics are run by students from the health professions, with oversight from practicing physicians, including faculty advisor Dr. David Feller (BS 85, MD 89).

Recently, the EACN collaborated with Dr. Jonathan Harrell (MD 10), of the Mobile Outreach Clinic, to give patients private exam space and ultrasound services, as well as free prescriptions through the Grace Marketplace Pharmacy.

The EACN is among the largest student-run free health care clinics in the nation, treating 2,500+ patients a year and supported by an army of Gator volunteers. Medical students examine and diagnose patients, overseen by attending physicians. They’re aided by undergraduates (mostly pre-med) who record patients’ vitals and health care histories and do follow-up calls.

Pre-med student Ajay Mittal uses a low-cost smartphone attachment to check 5-year-old Cecilia Marini Narezzi for eye disease.

A core EACN belief is that everyone, regardless of income level, deserves excellent medical care. Health care instability is a pressing problem throughout the United States, where almost 1 in 5 Americans can’t afford or access needed medical services.

Volunteers speak of the EACN as a “pure” experience that connects them with their reasons for wanting to become a doctor in the first place.

“This is the most fulfilling part of my day: being there for patients,” said Dr. Sean Taasan (BS 16, MD 19), chief of EACN clinical operations and a new M.D.

Likewise, patients get attached to their student physicians, like Gislaine Maurice, who came to the Main Street clinic in March with her young daughter, Deborah.

“Oh, I love the service here,” she said. “Dr. Sean is the best.”

Deborah peered up at Taasan and smiled: “The best.”

“People often walk around for years, not knowing why they’re in pain. At the Spanish Clinic, people feel comfortable opening up in their own language.”
– Tory Finley (3 Medicine), Founder & Coordinator, Spanish Night @ Anthem Church

While volunteering for a medical mission in Peru, Tory Finley hauled buckets of water up mountainsides to perform exams in shantytowns. So it’s no surprise the determined student physician (and UF Health interpreter) teamed up with fellow Spanish-speaker Massiel Montes De Oca (3 Medicine) to launch a Spanish Night clinic when they saw services in that language were needed. Since its opening in March 2018, their initiative has more than doubled visits by Spanish-speaking patients at the EAC network, not just at Gainesville’s Anthem Church, where Spanish Night is held, but at other the other three primary-care sites, where student volunteers also hablan español.

Better communication can lead to health breakthroughs. Finley, 25, remembers one patient from last year who reluctantly admitted she had been in pain with an undiagnosed gynecological condition – for seven years. “The other doctors she’d seen, who mostly didn’t speak Spanish, had attributed it to a kidney infection and given her antibiotics, which didn’t help,” said Finley. “She felt that no one was really listening to her.” An ultrasound determined the patient had endometriosis and uterine fibroids, which EACN-referred providers treated for free.

“She actually is pregnant right now,” said Finley. “She had been trying for eight years to have a second child.”

“This is what I really, really enjoy doing — making the clinic patients my priority every Thursday night.”
– Sean Taasan (BS 16, MD 19), Chief of Clinical Operations, Equal Access Clinic Network

In May, 24-year-old Dr. Sean Taasan graduated from UF medical school and started packing for Duke University, where he’ll pursue a residency in internal medicine. His experiences volunteering at the EACN set his future course as an internist.

Taking time to educate patients about their conditions and options is essential, he said.

One of Taasan’s patients last year had inconclusive results for a pap smear. Convinced that she had cervical cancer, the woman was “extremely distraught,” but Taasan calmly sat her down and explained the test often yields false positives.

“At the end of the visit, she understood she needed to go for a follow-up test,” said Taasan. “It did not mean she had cancer based on that one result alone.”

“Just being able to provide some peace of mind to her and help her make the right medical decision was very, very meaningful to me,” he said.

“I’ve seen patients who likely wouldn’t have survived if it wasn’t for the care and connections to resources the Equal Access Clinic gave them.”
– Patrick Bliven (BSA 17, 4 Medicine), Director, Eastside Primary Care Clinic

Patrick Bliven is in his last year of medical school, preparing for a future in internal medicine. Four years of volunteering at the EACN have deepened the 24-year-old’s commitment to helping people of all income levels get the medical care they deserve.

The no-cost, open-door EAC model literally saves lives, as Bliven has seen.

Last year, a woman in her 20s came to the Eastside clinic with a general medical problem. As they talked, Bliven realized she was depressed and suicidal. Thanks to the EACN’s connections with UF Health, Bliven quickly got the woman acute inpatient care; after, he treated her physical problems and guided her to Free Therapy Night.

“Last time we saw her, she was doing great,” he said. “It was very rewarding.”

“We make a huge difference in children’s lives; we keep them healthier and out of the ER.”
– Grace Thompson (3 Medicine), Founder & Director, Pediatric Night @ Bartley Temple

Lack of transportation, no or limited insurance, a demanding boss who won’t give Mom or Dad time off for an appointment: These barriers can prevent a disadvantaged child from seeing a pediatrician. And they’re what prompted third-year medical student Grace Thompson to establish a clinic just for kids in the heart of Gainesville’s most medically-underserved community.

Since Pediatric Night began in June 2018, the number of children treated at the Bartley Temple clinic has more than doubled. And it’s helping out with much-needed doctor notes for school team sports.

“Co-pays for doctor visits can be expensive, especially if a family has more than one child in sports,” says Thompson. “Pediatric Night gives more local kids the opportunity to take part in athletics, which is so healthy for them physically, emotionally and socially.”

“I want the community to know Free Therapy Night exists; we’re here to help people with whatever they’re going through.”
– Elena Polejaeva (MS 17, 5 Psychology), Co-director, Free Therapy Night @ HealthStreet

Whoever said “talk is cheap” never went to a therapist; the average counseling session in the U.S. costs between $75 and $150.

Fortunately for Gainesville residents, the EACN offers Free Therapy Night, a weekly mental-health clinic held at UF’s HealthStreet facility. Patients are allowed up to five consecutive 50-minute sessions with a graduate student therapist (overseen by a licensed psychologist).

Even those five sessions can make a real difference in a person’s outlook, said Elena Polejaeva, 32, a graduate student in neuropsychology and the clinic’s co-director.

Depression and anxiety are the most common problems people seek help for, while others struggle with substance abuse and domestic violence. In all cases, the Equal Access therapists gladly lend an ear and connect patients with social services, if needed.

“It’s amazing how much help our free clinic can provide,” said Polejaeva.

“Only through Equal Access would I be able to do a large-scale study like this as an undergraduate. It’s amazing.”
– Ajay Mittal (BS 19), Undergraduate Chair of Research & Metrics, EACN

Few undergraduates can claim they spearheaded an innovative way to deliver health care to a needy population. But pre-med student Ajay Mittal, 21, did just that. As the undergraduate chair of research projects for the EACN, Mittal was searching in 2018 for an inexpensive way to screen patients for eye diseases when he found a smartphone attachment – a “digital eye” – that turns an iPhone into a high-powered ophthalmoscope. Cost? Just $280.

Flash forward to 2019: The portable device has become the centerpiece of a full-fledged study at the EACN, involving two UF ophthalmologists, one health data scientist and 1,000 participants across the network’s four main sites.

“We’re using the device and the images we get to make an AI software that can risk-stratify if someone has glaucoma or other optic-nerve pathologies,” said Mittal in March.

He demonstrated the device on 5-year-old Cecilia Marini Narezzi, who was accompanying her mother, Mayara, at the Main Street clinic. Without eye drops and bright lights, Mittal was able to see clearly into the child’s retina and take a sharp photo for analysis.

To Cecilia, the picture may have looked like a creepy eyeball, but Mittal saw it another way: “A beautiful retinal image,” he said.