Doctor’s Orders: “Eat better, sleep more, exercise more, and obsess and stress less”.
Chances are, between classes and company presentations, study groups and social events, most HBS students will be hard pressed to follow these recommendations, or even to manage three out of the four.
Nevertheless, Dr. Bruce Biller, Medical Director of Business School Health Services, hopes that students will make their health a priority during their two years at HBS. Speaking with the Harbus last week, Dr. Biller not only shared some of his advice for students, but he also outlined the initiatives that the Business School Health Services team has undertaken to better meet the health care needs of the HBS community.
Dr. Biller arrived at the Business School in August 2001 after completing 25 years of service in the Medical Department at M.I.T. He enjoyed exactly one day of ‘retirement’ before enthusiastically assuming his new role at HBS. Granted, Dr. Biller was already familiar with Harvard University Health Services (HUHS). During his tenure at M.I.T., he served as an Inspector for the Joint Commission on Accreditation of Hospitals, and he assisted HUHS in achieving accreditation. An endocrinologist by training, Dr. Biller currently divides his time between clinical work (internal medicine and endocrinology) and running the business of HBS Health Services-that is, administering and improving the services offered to the patient community. It is in this second endeavor where Dr. Biller directs the majority of his time and energy, and in only two years, his efforts have produced significant results.
HBS UHS – HUH??
Nestled between Spangler and Aldrich, the ivy-covered Cumnock Hall inconspicuously houses the Business School Health Services facility. “Two years ago, many students didn’t even know we existed,” admits Dr. Biller.
Thus, a major initiative has been to enhance communication to the HBS community. Through orientation sessions, speaker events, and direct communications over myHBS, the Business School Health Services team encourages students to explore the resources that are available and to take advantage of them. The recent Business School Health Fair also provided students with hands-on access to Health Services resources and capabilities, such as cholesterol screens and bone density tests. These efforts have successfully increased both awareness and use of UHS services; in fact, for the fiscal year ended June 2003, patient visits increased by more than 1,000 over the previous year. Dr. Biller’s goal for further improvement: “If each student, in their first year, could see their PCP [Primary Care Physician] once, that would be big. We can accomplish something in 20 minutes. In the second year, you know us, we know a bit about you, and if there is ever a problem, it will help.”
A Transformational Experiment
Encouraging students to discover Health Services has been accompanied by several initiatives designed to more efficiently meet demand and improve health care delivery. With over 2,000 students and partners, in addition to faculty, administrative, and executive education patients, Health Services has historically faced severe capacity constraints (if you are now envisioning a large triangle labeled WIP at the entrance to Cumnock, please re-read Dr. Biller’s first piece of advice). In 2001, HBS Health Services employed only three clinicians: Dr. Biller, Dr. Debra Poaster, and Nurse Practitioner Audrey Killian. Dr. Biller began the overhaul at Health Services by expanding the team to include an additional internist, Dr. John Braeda, and a full-time Triage Nurse, Elaine Tribble, who plays a key role in deploying Health Services resources.
Working closely with the front office staff, all of whom are certified health assistants, Nurse Tribble assesses patients as they arrive (in a former conference room turned interview-and-care space). She may decide that the patient’s condition is urgent and requires immediate attention from a physician, or she may determine that the patient can wait to be seen, or something in between. In this way, the triage system expedites patient care and ensures that the most serious illnesses and injuries are attended to promptly. In addition, the Health Services office conducts consultations over the phone for patients who are unsure whether or not a problem warrants a walk-in visit. Last but not least, on the advice of the Student Health Care Advisory Committee, HBS Health Services established the Monday Morning Urgent Care Clinic. From 7:30 – 9:00 am, students with immediate needs can see a physician on an exclusively walk-in basis. The early hours provide students with access that does not conflict with class attendance and the walk-in only policy helps to minimize the wait time for patients with acute health care needs.
In addition to soliciting student input, HBS Health Services has emphasized to students the impact that their behavior can have on efficiency. Health Services typically experiences several demand surges throughout the year, generally before week-long breaks and at the end of the academic year. So, if you have already booked a New Year’s trip to Thailand, consider making your appointment for travel immunizations now (especially as the immunization may take 4 weeks to become effective).
Likewise, schedule lab tests, PAP smears, or health assessments during the academic year rather than waiting until the week before you leave for your internship in L.A. Regarding appointment conflicts, students are encouraged to cancel appointments as soon as a scheduling conflict arises, out of respect for peers who may be waiting for treatment. While in the past this required students to call Health Services during business hours, students can now cancel an appointment at any time via email: firstname.lastname@example.org.
New and Coming Soon
According to Pat Light, Director of MBA Program Support Services, “A great University health service not only provides for patients when they are sick, but also teaches them how to be well.” Pat has worked with students and the Heath Services team to better understand each other and the challenges of the intense HBS environment. The expansion of Mental Health Services at HBS is a good example of a service that addresses less obvious, but not less critical needs. A mental health professional is now available at the Business School Health Services facility every afternoon, and counseling and psychiatry services are 100% confidential. “People have issues related to stress management and sleep deprivation, relationships and jobs in a bad economy” acknowledges Dr. Biller. “Mental health is an area that’s neglected somewhat. People are reticent to come. We’re working to break down that barrier.” HBS Health Services has also recently expanded other wellness programs ranging from nutritional counseling to massage therapy. While nutrition services are free, consultations do require a physician referral. Massage therapy, on the other hand, can be self-booked for $55 per hour, and, due to the popularity of the program, massage therapists are now on campus two afternoons a week.
Still to come: improvements in injury management and a prescription re-fill delivery service. Beginning September 29th, the HUHS Chief of Physical Therapy will begin taking appointments at Cumnock every two weeks to perform initial assessments of injuries and to recommend physical therapy treatment programs. While students may need to travel to the HUHS facility in Harvard Square to receive therapy, Dr. Biller hopes that bringing the assessment process to the HBS campus will encourage students to seek treatment. Likewise, the prescription refill delivery service slated to begin in October aims to increase convenience for HBS students. As planned, a student ordering a prescription refill from HUHS will also be able to request that the prescription be delivered to the Business School Health Services facility for convenient pick-up.
Though the past two years involved significant change for the Business School Heath Services, Dr. Biller expects the improvements and new initiatives to continue. He notes, “there are still things we need to do better, could do better, and I’m happy to hear about them.”
Dr. Bruce Biller can be contacted at the Business School Health Services in Cumnock Hall at 617-495-6455, or via email at Bbiller@uhs.harvard.edu. RC students interested in serving on the Student Health Care Advisory Committee should speak with their Section Senators, once elected.