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Turning good intentions into good outcomes: ethical dilemmas at a student-run clinic and a rubric for reflective action
  1. Nicholas Peoples1,2,
  2. J Thomas Gebert1,2,
  3. Dana Clark1,2
  1. 1Baylor College of Medicine, Houston, Texas, USA
  2. 2HOMES Clinic, Houston, Texas, USA
  1. Correspondence to Nicholas Peoples, Baylor College of Medicine, Houston, TX 77030, USA; nicholas.peoples{at}bcm.edu

Abstract

Student-run clinics represent a unique medical education and healthcare delivery model powered largely by good intentions. These good intentions may produce questionable results, however, when juxtaposed with intense academic pressure to fill one’s curriculum vitae with personal achievements, leadership roles and peer-reviewed publications. It becomes a legitimate ethical question whether student-run clinics consistently and materially enrich the care of underserved communities, or merely inspire a litany of rushed, short-term and low-quality projects that sidestep patient welfare or even cause brazen harm. As co-directors of HOMES Clinic, a student-managed clinic which offers free health and social services to people experiencing housing insecurity, we routinely encounter such well-intentioned but ethically questionable proposals. Here, we present four short case studies that dissect apart some of these common yet suspect assumptions underpinning student-run clinics. We then conclude with a rubric for reflective, calibrated action.

  • doctor
  • medical education
  • ethics
  • public health
  • primary care

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Data availability statement

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Footnotes

  • Contributors NP, JTG and DC equally conceived and wrote the manuscript. NP acts as the guarantor for this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests The authors have no relevant disclosures or competing interests.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.