The University’s Student Health and Wellness Center (HelWell or SHWC) often has a bad reputation, with stories floating around of misdiagnosis, ineffectual remedies and excessive prescription of antibiotics.
Apart from the horror stories, which circulate quickly around campus, many students report routinely pleasant experiences with HelWell and its staff. The disparity in experiences may partially arise from a misunderstanding of the clinic’s role — where it fits on the spectrum of different types of health care services.
HelWell is a clinic that aims “to support the education and development of students by promoting their optimal health and well-being,” according to its website. Its staff of physicians and registered nurses provide acute illness care, routine physical exams, a variety of immunizations, sexual and reproductive health services, allergy shots and tests for the flu, mono, and strep throat.
While it is not a hospital, Dr. Alain Joffe, the director of HelWell, notes that the center far exceeds the care at any high school nurse’s office and should be viewed as a similar service to doctor’s offices back home. For college students, who may not have primary care physicians, the most familiar analogue would be their pediatrician.
“The high school nurse’s office usually just has a registered nurse, who can give things like Tylenol or Advil, or take a student’s temperature and maybe a few things more. But they cannot assess and treat students. If a student is sick, their parents have to pick them up and take them to their doctor,” Joffe wrote in an email to The News-Letter.
“We are like a doctor’s office — we have physicians and nurse practitioners on staff, all credentialed through Johns Hopkins Hospital, as well as RNs, medical assistants, and administrative staff. So we make diagnoses, recommend treatments, order lab tests, the same things your doctor at home would do.”
HelWell provides services that a typical doctor’s office does not, such as international travel consults, the administration of intravenous fluids and a limited pharmacy service that sells medications. HelWell also has a dietician at the clinic once a week to help students with concerns about eating behaviors, weight and nutrition.
A Horror Story
Some students have experienced decidedly negative trips to HelWell, and the stories spread to create a negative perception of the clinic. Sophomore Rong Liu shared her experience with the center:
“Once I was there getting my blood drawn. The first person that attended to me had a hard time drawing blood and kept pushing the tube but couldn’t get blood to come out. A second tried, and halfway through the needle somehow slipped out from my arm, and the blood splattered everywhere, and my arm started getting swollen. In the end, a third person successfully drew my blood, but I’ve never had a needle slip out before, and I was scared to death.”
Praise Despite Miscommunication
Despite the popular idea that most people have negative experiences at the clinic, the Student Health and Wellness Center has garnered mostly positive reviews. According to its most recent student satisfaction survey of around 1700 responses, 95 percent of students were either satisfied or very satisfied with the care they received.
Freshman Aubrey Roland accredited his positive experience at HelWell to the friendly staff.
“I went to get STD tested, and they were really chill about it, though they forgot to do one of the tests. I had a few vials of blood taken and later on, after I had to come back since they forgot, and I had a throat swab. Aside from their forgetting about the one test, I really had nothing to complain about, and overall it was a rather positive experience,” Roland said. “I expected the people there to be very judgmental and possibly even homophobic. However, all the staff were very accepting and kind.”
Freshman Michael Ontiveros also praised the staff for being efficient and responsive, noting that other students’ negative experiences at HelWell might be attributed to misunderstandings with the staff.
“I had an enjoyable experience. I went in for something potentially concerning to me. I expected the norm from clinics: a 45-minute wait. I waited about 10 minutes and was attended [to]. I asked the questions I had and received the answers for them. The physician that helped me was very helpful. The staff treats you exactly how you treat them,” Ontiveros said. “I feel that people may receive negative treatment as a response to their manner with the staff.”
Sophomore Audrey Adams agrees with the general consensus that the staff is kind and attentive but also noted some communication issues she has experienced with the staff.
“I’ve had a lot of friends go there for birth control, so I really appreciate how discreet and supportive they are,” she said. “Also, the receptionists there are nice people and excellent at their jobs, which I don’t think they get enough acknowledgement for.”
Improvement
Adams explained how she believes HelWell can improve their student services.
“As much as I liked all of the providers I’ve seen there, I think they have a problem with helping people feel better, which I think could be rectified by providing more information upfront, without students having to push for it,” she said. “They didn’t do a good job in explaining to me what was wrong, how I should treat it and what I should do if it got worse.”
Freshman Kayla Ma, who received an asthma inhaler for her cold despite not having been diagnosed with asthma, also noted that the staff wasn’t particularly good at explaining to her why they prescribed her with certain treatment.
“I had been suffering from a serious recurrent cold for a month or so, and my cough was getting really bad, so I went to the Helwell. The first time I went I was feeling really unwell, but they said I did not have an appointment and asked me to return the next day. I was expecting cough syrup for my cold that would probably help to alleviate it more effectively. However, I received an asthma inhaler and decongestant, when I already mentioned I have used the latter from CharMar for the past couple of weeks, but it was not working very well,” Ma said. “Perhaps the inhaler is to target the cause for my prolonged recovery, but from my previous experiences with the GP, I think supplementing these medicines with more immediate symptomatic treatment would possibly be more effective in alleviating my discomforts.”
Both Adams and Ma believe that the HelWell staff should, along with prescribing treatments, better inform students about how to use said prescriptions and what they can do to get better after they leave the clinic.
Joffe pointed out that while many students don’t necessarily know about all the components of the Student Health and Wellness Center, it is already heavily involved in health education and promotion.
“I think it is also important to point out that CHEW, the Center for Health Education and Wellness, is a part of the SHWC — they do all the health education and health promotion for the JHU Homewood Campus, including things like the BIT training, Stressbusters, and PEEPS. So we do have a big emphasis on health education and wellness, although I am not sure that students recognize that CHEW is part of SHWC,” Joffe wrote.
Working with organizations such as the Stressbusters, HelWell acknowledges the amount of stress that Hopkins students experience and is taking steps to promote a mentally healthier student body.
Freshman Gloria Li noticed such efforts when she went to HelWell this week.
“In a previous public health class my professor actually criticized Hopkins’ treatment for mental health. For example, something about the Health and Wellness Center being so far [away], it increased their mental anxiety of going there,” Li said. “I went to HelWell today. When I was checking in at the computer inside HelWell, I noticed that they conducted a mental health survey, too. I think it’s nice of them to do that. I do see that people at HelWell are making a change. They were very nice to me, so it was a good experience for me.”
Moving Forward
The Student Health and Wellness Center still faces certain limitations due to its size and status as a clinic and often has to refer to other hospitals or specialists for more complex medical situations.
“We don’t have X-ray on site. We don’t have physical therapy on site. We are not a licensed pharmacy, so a student cannot come in with a prescription from another doctor and get it filled. We don’t do EKGs here. We can’t do any kind of surgeries or suture. We cannot cast someone with a fracture. But most doctors’ offices don’t do these things either,” Joffe wrote. “We don’t turn students away. But if a student needs a higher level of care, we get them to where they need to be, usually the ER.”
Joffe also mentioned that while some student may have the misconception that they will be referred immediately to the extensive Hopkins medical network, such attention isn’t possible for non-urgent cases.
“The medical campus and Homewood are not close, so we don’t have shared facilities,” he wrote. “I think that some students may think that because JHU has a medical school and hospital, that they can get seen by a Hopkins specialist immediately. In the case of an emergency that is true. But otherwise students will have to wait weeks to months to see a specialist for a non-urgent condition.”
In one instance, freshman Kacey Bae recalled the Student Health and Wellness Center reaching out to provide services directly, preventing her from spending time at a hospital.
“HelWell actually called me because the emergency response team filed their report, and HelWell wanted to know if I was okay or needed anything else. I’d gotten stitches during an accident, and when I mentioned that, they said I could make an appointment with them and take them out instead of going back to the hospital and waiting forever,” Bae said. “My appointment went really smoothly, and the nurse who took out my stitches was really friendly. She answered all my questions and told me when the procedure would feel somewhat uncomfortable. It was over very quickly and my wound is healing well, so I really have no complaints.”
The Student Health and Wellness Center has a nurse advice line available when the center is closed, and while Joffe believes that HelWell is open a sufficient number of hours each week, he doesn’t think that the clinic is sufficiently staffed.
“I would like to have a dietician here two days per week — we are working on that,” Joffe wrote. “We have had some staff turnover this semester, so we are not quite fully staffed right now. But we have hired a number of new staff and I expect that we will be back to full staffing by May 1. It would be great if we could provide physical therapy on site, but we don’t have the space for it.”
The current staff is doing their best to attend to student needs and follow up whenever necessary. Freshman Yuyan Pu said they acted responsibly and quickly when she came to them thinking she had mononucleosis.
“I was coughing and my sinuses were messed up, so I scheduled a HelWell appointment,” Pu said. “They tested me for mono and the flu, and I tested positive for mono. It made me wonder how many people I’ve shared food with. However, they took my blood in case it was a false positive — it was. They emailed me later to tell me that I most likely just had a virus and that I could schedule another appointment if I wasn’t feeling better.”
While there are still many students unaware of HelWell’s services and unsatisfied with the treatment provided by its staff, most students at the Homewood campus appreciate the Center and its staff for what they do to promote a healthy student body.
