SHAC celebrates half century of service

Generations of students have made volunteering at the Student Health Action Coalition (SHAC) a UNC School of Medicine rite of passage. The organization is kicking off its 50th year on Oct. 26 with a reception for current students and alumni.

SHAC celebrates half century of service click to enlarge SHAC Co-CEOs Mona Xiao and Kathryn Blew
SHAC celebrates half century of service click to enlarge SHAC volunteers providing care to a patient (photo by Bryan Strickland, 2014)

By Jamie Williams,

In 1967, a group of medical students met regularly in the cafeteria of UNC Hospitals to discuss the issues of the day. They invited faculty speakers, they had open debates, they didn’t shy away from the big questions.

“This was a time of great ferment in the country,” said John Alcott, MD, one of SHAC’s founders, who now practices in Eugene, Oregon. “The Vietnam War was going on, desegregation was happening across North Carolina and in Chapel Hill, and there was a lot of student concern around those issues. We started asking what we could do to achieve social justice, how could we help people, how could we set our society right?”

Those conversations led to the formation of the Student Health Action Coalition (SHAC), the nation’s first student-run, free, medical clinic.

“We wanted to help people who didn’t have access to care, and that boiled down to providing care for poor people in Chapel Hill and Durham,” Alcott said.

Fifty years later, the clinic’s offerings have expanded, but the spirit of service remains. Kathryn Blew, one of SHAC’s current Co-CEOs, has been involved with the organization since she arrived at the UNC School of Medicine. But, like Alcott decades before, current events motivated her to take a leadership role.

“After last year’s presidential election, I felt very overwhelmed. I knew I needed to do something positive so I applied to be a co-CEO of SHAC,” Blew said.

In between Alcott and Blew, thousands of students, hundreds of faculty from the UNC School of Medicine, as well as students and faculty from all UNC’s health affairs graduate schools, and undergraduates have kept SHAC running, led by ambition, entrepreneurship, and altruism.

Alcott and his early colleagues at SHAC went into the community, finding leaders in both Chapel Hill and Durham who could help them develop contacts, build support, and get the clinic up and running.

“We wanted to make a difference, and we found that a tangible way to do that was to help a kid who wants to play football but doesn’t really have access to health care get a sports physical,” Alcott said. “So, it started with things like that, pretty low level, but over time there were a cadre of people with various medical conditions who found they enjoyed going to a community-focused clinic where the leadership wanted to help people.”

Jim Emery, MPH, served as co-director of SHAC from 1996-1997 and wrote his masters thesis on the organization. Emery said that throughout the history of the organization, students at SHAC have “diagnosed the community,” assessing needs and delegating resources accordingly.

“The community’s needs have ebbed and flowed over time, but the focus has always been on serving people who otherwise would not have access to care,” Emery said. “So, it was African Americans in Chapel Hill’s Northside neighborhood and East Durham in the early days, we’ve provided homeless care, there were periods where care for migrant workers was an important aspect of SHAC.”

Constant turnover is a given with student-run organizations. But for 50 years a new group of students have stepped up to guide SHAC. In many ways, that turnover can be seen as an asset, allowing each group to leave an imprint on the organization.

“It’s an opportunity to question systems, to manage patients, watch a bottom line, outline a vision for new services while also sustaining the traditions of SHAC,” Emery said.

Now, Blew and her co-CEO, Mona Xiao oversee SHAC’s wide range of medical and dental services at both Piedmont Health Services in Carrboro and across the community. There’s the Refugee Health Initiative. SHAC’s Bridge to Care program provides care for patients with chronic illness. There’s SHAC HIV, which offers STI screening and counseling. SHAC volunteers also go into homes and schools to provide health education. There’s Amigas en Salud, a program specifically targeted to the local Hispanic population.

They still do plenty of sports physicals.

Emery credits Adam Goldstein, MD, MPH, with helping to guide SHAC into its modern form. Goldstein, professor of family medicine, became the faculty advisor to SHAC in 1993. At that time, Goldstein said, much of SHAC’s focus was the Wednesday night clinic and there wasn’t much other outreach. He worked to deepen relationships with UNC’s health affairs schools, increasing the interdisciplinary focus that had been a foundation of SHAC.

“Harnessing the energy of students from across the health affairs schools led to interdisciplinary teams going into patients’ homes and doing health education, ultimately, it helped SHAC to get back to its roots, reengage the community, and not just be a once-a-week clinic,” Goldstein said.

On the medical side, he also helped to formalize the relationship between SHAC and the Department of Family Medicine faculty who oversee the clinic, providing guidance and instruction to the medical students as they interact with patients.

“For 25 years, we haven’t missed a Wednesday clinic. The students can depend on us, and we depend on them,” Goldstein said. “The linkage between the department and SHAC is right in our mission, which is to care for the underserved.”

Goldstein said the range of conditions treated at SHAC makes working there an invaluable training experience for students.

"They see people with diabetes, high blood pressure, they help people dealing with domestic violence, suffering from PTSD, depression, and anxiety," Goldstein said. "Caring for these patients is a major responsibility, and a major service to our region. I think it would be hard to find anything like SHAC in the United States."

Wayne Franklin, MD, who began working at SHAC in 1969 and went on to a career as a pediatrician in Winston-Salem, said working at SHAC had a lasting impact on his career.

"I learned early on that the whole health care team plays a critical role in patient care," Franklin said. "I learned to listen and value everyone's individual expertise. Later on as a chief resident, I directed rounds and incorporated residents, interns, nurses, and the whole team. That’s something I learned at SHAC that made me a better physician."

SHAC’s reputation is such that students like Blew come to UNC School of Medicine because they want to work with the group.

“In many ways, SHAC has defined my UNC School of Medicine experience,” Blew said. “It has helped me to understand the type of physician I want to be.”

Xiao, who is pursuing a dual MD/MBA, became much more involved with SHAC during the year she spent focusing on her MBA courses. She wanted to keep her clinical skills sharp, but meaningful patient experiences kept her coming back.

 “I’ve gotten to see the same patients each week, to really form deep relationships,” she said. “This, over time, led me to look for ways to extend my time at SHAC. I thought that the more administrative, behind-the-scenes, support functions would also be a good fit and interesting challenge.”

Xiao’s story, Goldstein said, would sound familiar to many of the students who have volunteered at SHAC over the past five decades.

“I think people come back to SHAC each week because it feels alive,” Goldstein said. “You can see it in the students’ faces; you can see it in the faculty’s faces. They’ve learned something, they’ve helped someone. It’s invigorating. It’s a special place.”

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