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Bill Radke: They say the most expensive medical device is the doctor's pen. Physicians write the prescriptions and order the labs. But when they're learning their craft in med school, doctors are rarely taught how much those prescriptions and labs cost. From our Health Desk at WHYY in Philadelphia, Gregory Warner found a place outside the classroom where medical students learn the cost of care.
Gregory Warner: Every Thursday night, a couple dozen medical students from Jefferson University carry plastic curtains and boxes full of pills to a homeless shelter. They set up a free walk-in clinic called JeffHope. Christine Feldmeier is one of the student directors:
Christine Feldmeier: So this is our pharmacy.
WARNER: This corner?
Feldmeier: This corner. Yep. But we have lot of drugs shoved in here, trust me.
Med students raise the money to pay for these drugs through campus dances and fundraisers. And then those same students decide which drugs to stock and what lab tests they'll pay for. Last week, a patient came in with all the symptoms of diabetes.
Feldmeier: Wounds on his feet, vision problems, a documented history of uncontrolled diabetes for years.
The volunteer resident, the doctor in charge that night, wanted to send out for a lab test called an A1C.
Feldmeier: It's a way to measure how uncontrolled the diabetes is.
Standard routine in any hospital. Christine refused the request.
Feldmeier: We didn't need a number to tell us okay this guy's diabetes is not good.
KENNETH HEMBA: And you become accustomed to working that way.
Kenneth Hemba, another med student, says taking a patient's history can often be as revealing as a lab test.
Hemba: And talking to a patient is free.
Practicing medicine on a budget can mean standing up to older doctors that come here to volunteer. Say a doctor is treating a sinus infection.
Hemba: It's possible that same doctor might say, oh, you know this patient probably hasn't had a cholesterol for a long time, so let's go ahead and order one of those. And that's where Christine or I might jump in and say, well for our care, we're going to address this cold.
Of course these students don't face the same pressures that doctors do. I asked them if they you worried about being sued?
No. That's never really crossed . . . I mean that's never really . . .
Hemba: It's just, it's a very different setting than a controlled hospital.
When people come to a free student clinic they don't expect advanced care or a battery of tests. The one resource that these soon-to-be doctors do have in abundance is time -- time to really sit and listen to patients. That's something that, after graduation, they won't have that much of.
In Philadelphia, I'm Gregory Warner for Marketplace.