EDITORIAL: 'Street medicine' offers a promising path

·4 min read

Sep. 18—Medical care comes fairly easily for people who have homes, jobs and health insurance.

Concerned that you might have a sinus infection? A call to your doctor can have antibiotics waiting for you at a pharmacy within an hour. Tummy troubles? A quick trip to your favorite retailer offers dozens of over-the-counter remedies. Scrape your knee while hiking? Your medicine cabinet likely contains everything you need to disinfect the injury and keep it clean while it heals.

For the homeless, however, minor problems like these can escalate. People who live on the streets tend to delay medical treatment until their condition becomes acute, and then they seek care at the one location where they are guaranteed treatment: a hospital emergency room, which is the most expensive, least efficient place to receive medical attention.

The numbers tell the tale. According to the U.S. Centers for Disease Control and Prevention, the average American goes to the emergency room about once every 2.5 years. In that same time frame, our nation's homeless population averages five ER visits per person, and in the Midwest the rate is even higher.

Given that the homeless seldom have insurance, the cost of this care falls on hospitals, taxpayers and everyone who uses the medical care system — which means we all benefit from any strategy that delivers medical care to the homeless in a more efficient way.

That's one reason we're big fans of a new "street medicine" class being launched by Zumbro Valley Medical Society and The Mayo Clinic Alix School of Medicine. Twenty-eight first- and second-year medical school students had their first class Monday at the Rochester Community Warming Center, near the government center in downtown Rochester.

The real learning, however, will likely take place a few blocks north at The Landing, the homeless shelter near Silver Lake Park..

The Landing already hosts twice-weekly medical clinics with the help of Mayo Clinic paramedics, but this new program offers the promise something more. These 28 students will get firsthand, supervised experience working with the homeless on their own turf, in a setting where the patients are more likely to be honest about their conditions and receptive to medical advice.

There's no guarantee that this class will be more than a one-off that ends in May, but we see it as a true win-win that should become a recurring option for medical students. Rochester's homeless population — estimated to be at least 400 adults — will have another option for health care without going to the emergency room, and some future doctors will be better prepared to help the homeless patients who cross their paths in the future. This experience will be invaluable, as the homeless typically present with a complex array of conditions, often including mental health problems.

Cynics, of course, might object to this program as somehow "enabling" the homeless to continue on their current paths. Indeed, some might argue that Rochester has become too welcoming to the homeless, or to the alcoholics who reside at Silver Creek Corner, or to those who find shelter and mental health treatment at the Southeast Regional Crisis Center.

While we'd argue that one vital component of a city's identity is its compassion for the sick and less fortunate, the reality is that such compassion simply makes good economic sense. When a community helps the homeless get medical care, meals and shelter, it keeps them out of the hospital and perhaps out of jail. Ditto for alcoholics, drug addicts and those in mental health crisis. It costs far less to help someone than it does to incarcerate them, or to put them in the ICU for a week, or to send them to a detox center every week or two.

Ideally, such assistance will help people break the cycle of homelessness, addiction and mental illness, but that won't always be the case. Despite the best efforts of well-meaning, compassionate professionals and volunteers, some people don't get better.

But we can't let perfection be the enemy of the good. Rochester is fortunate to have a network of organizations and individuals who are making great strides to close up some of the cracks through which the less fortunate can fall — and with flu season and a second winter of COVID looming, there's no time to waste.

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