Philadelphia medical students see street medicine as vital to care for more unhoused people

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About 25 students from local colleges and medical schools gathered on the corner of 34th and Spruce streets in Philadelphia.

“Does everyone have a group?” asked Vinh Dang, who wore a bright yellow reflective vest. “We have a ton of resource bags here today and the main goal is to really make that human connection and really remind folks that there are people out there who care.”

The students elected to spend Saturday as volunteers with a street medicine outreach initiative at Bridge Beyond, a nonprofit focused on supporting people who are experiencing homelessness or lack stable housing.

Street medicine involves sending teams to deliver medical care and social services right on the street. Public health experts say it’s a way to bridge the gap in health care services for people who may not be able to make it to a brick-and-mortar clinic.

As the need for services and care remains consistently high among a significant unhoused population in Pennsylvania and across the country, more medical schools, health care systems and nonprofit organizations are growing or starting new street medicine programs to help.

“You know, we have so many med schools here in the city, but Philadelphia County is ranked 67 out of 67 in terms of health care outcomes,” said Dang, a board member of Bridge Beyond. “So, having everyone here align with the same mission is really powerful.”

State officials say they’re working to figure out how to better support street medicine programs, whether with funding or by removing administrative barriers that make it harder to deliver care.

Dr. Valerie Arkoosh, secretary of the Pennsylvania Department of Human Services, joined students and physicians as they walked from West Philadelphia into Center City. They stopped to talk with several people who were sitting near subway entrances, against buildings and on street corners.

“We’re in a situation where we simply just don’t have enough houses,” Arkoosh said. “Until the building catches up with the needs, we’re going to be in a very, very tight, challenging situation, particularly for individuals who are very low income and may have very complicated chronic health conditions.”

The street medicine volunteers said the people they encounter on the streets may be struggling with wounds and other injuries, substance use disorders, mental illness, malnutrition and other issues.

Ryan Moriarty, a fourth-year medical student at the Philadelphia College of Osteopathic Medicine, pulled along a red wagon filled with scarves and socks, gauze and bandages, Narcan and fentanyl test strips, personal hygiene products and other supplies.

“In a setting like this, there’s only so much we can do, but first aid is definitely one of those things,” he said.

Being able to distribute Narcan, the opioid overdose reversal medication, and testing strips for people who use drugs has been crucial, Moriarty said. He’s been volunteering with the outreach program for a couple of years.

“It’s something that is really rewarding and I love being out here, to be able to provide these things, because it makes a practical difference in their everyday lives,” he said.

Because of recent changes to how states can use Medicaid dollars, Pennsylvania made street medicine services eligible for reimbursement last year. That means teams doing this work can now bill the health insurance program for the care they provide, whereas before, programs typically had to absorb the costs entirely on their own.

Arkoosh said it’s a more sustainable model for these street medicine teams and has enabled more programs to add additional providers and services out in the field. She said it’s a win-win for patients, the providers doing the work and for health care outcomes more broadly.

“We can convince any health system that this is actually a smart decision to do this work,” Arkoosh said. “They all know if you can connect these folks to some more regular care and stabilizing services, that it will reduce avoidable emergency room visits, reduce avoidable hospital admissions, and that’s a win for everybody.”

On Saturday, Mei Smyers joined the group of outreach volunteers. She’s a cell biology and regenerative medicine PhD student at Thomas Jefferson University and vice chair at Bridge Beyond.

When she first started doing outreach work in the community, Smyers said it was intimidating.

“I am not in the medical field, so I’ve thought, ‘What do I even have to help with this overwhelming situation?’” she said. “But it really is like, oh, if you talk to people, people are so willing to share their experiences, and it really is this big team effort. There are so many great organizations in Philly and we’re just one small puzzle piece.”