Colleges And Universities
College health-service programs provide low-cost, primary medical care for students on college campuses. Kevin Patrick estimated in 1988 that 80 percent of America's more than fourteen million college students received primary health care from campus health programs. Just as modern medicine has changed, so too has the scope of services college health centers provide. Medical developments allow for most injuries and illnesses to be treated by ambulatory clinics, and this same trend is seen in most college health centers. These centers often provide care for acute illnesses and injuries on an outpatient basis, while also meeting the needs of students with continued and chronic illnesses and providing wellness education to the campus community.
In addition to meeting the basic and most common needs of the students they serve, campus health-service programs also act as referral agents for students to connect with medical providers, as needed, in the local community. College health services are continually evolving and changing in order to best provide treatment and education for the campuses they serve.
College health-service staffs vary widely in the range and level of services they provide. Once directed mainly by full-time medical doctors, most college health centers are now lead by Licensed Nurse Practitioners (LPNs), Registered Nurses (RNs) or Physician Assistants (PAs). Some health centers continue to have full-time physicians on staff (particularly at larger universities and institutions with medical centers), while others maintain part-time relationships with local doctors to staff particular hours each week. Health centers with less comprehensive services (usually at smaller, private colleges) often act as a link to services in the immediate community.
College health-service programs tend to have three primary areas of responsibility: physical, mental, and educational. Medical services range from basic care in the form of treatment for colds, viruses, and minor injuries at less comprehensive centers to thorough lab tests, X rays, specialists, and pharmacies at the most comprehensive centers. Many college health programs also provide counseling services. Some counseling services are limited to basic intervention and referral for long-term care, while others provide extensive and long-term psychotherapy.
The most common, and a primary focus of college health-service programs, is that of intervention and health, or wellness, education. Although all student health centers concern themselves with the immediate healing of ill students, most will also work to educate students about approaches to healthier lifestyles in order to prevent future illness or injury. Wellness themes exhibited on many college campuses are health and nutrition, stress management, eating disorder awareness, smoking cessation and prevention, time management, alcohol abuse prevention, strategies to avoid depression, and issues around sexually transmitted diseases and their prevention. Some colleges maintain twenty-four-hour care for students; however, most colleges maintain regular weekly hours during the academic year with a system for emergency assistance when needed.
Many college health centers are funded through fees students pay to the college or university and subsidized with institutional resources. Sometimes these fees are included within the tuition charges of a college or university, while other institutions may charge a separate student health fee in addition to the college tuition. Prepayment for student health services ensures that students have access to the treatment and services needed while at school. At many colleges, basic and most common services are offered to full-time students at little or no charge. Many college health centers will provide, as needed, over the counter medications free of charge; however, they will charge for, or send students to a pharmacy for, prescription medications. Students will usually incur charges for lab work, other diagnostic tests, and services provided by referrals made to outside physicians and specialists. Most colleges and universities require students to have and maintain health insurance. Although many students may continue on their parent's health insurance plans, other students may need to purchase individual health insurance, and can usually do so through programs offered at their college or university.
Most, if not all, colleges and universities require that undergraduate students complete health history forms prior to their arrival on campus. This information assists health center staff to prepare for any special needs identified on the form and to have a recorded history in case information is needed to properly treat a student. In addition to the form, all students are required to have current immunizations per state law and institution policy. Documentation of these immunizations must be provided in order to attend the institution.
Services provided by college health centers are deemed confidential. Health center staff work in partnership with students to get well, make good choices, and develop healthy living habits. The responsibility of informing parents falls to the student in most cases. Only when a condition warrants notification will health services staff break the confidence of the relationship, usually with the permission of the student unless there is concern about harm to self or others.
Patrick, Kevin. 1988. "Student Health: Medical Care within Institutions of Higher Education." Journal of the American Medical Association 260:3301–3305.
American College Health Association. 2002. <www.acha.org>.
MOLLY BLACK DUESTERHAUS