Serving the underserved

By Helle Gjønnes Møller

The stats are pretty grim: 30 million Americans are estimated to lack basic health insurance – and for at least 10% of the US population, healthcare services are difficult to access. These dismal numbers seem even more bleak when considering that vulnerable people often have a particular need for care. So, paradoxically, many of the people who are most in need of healthcare are unable to afford it. 

This dilemma is also prevalent in hearing care, where accessibility, management, and affordability are critical components to adopting hearing technologies. Fortunately, the next generation of hearing care professionals seems determined to turn the tables – and the SCOPE clinic at Rush University is a shining example. We spoke with Assistant Professor Megan Worthington about their aims, accomplishments, and hopes for the future.

Turning the tables at Rush

SCOPE, short for "Student Community Outreach Program of Excellence", is a faculty-led, pro-bono clinic established with three overarching objectives: 

  • To create a training ground for audiology and speech-language pathology students
  • To help patients who don’t have insurance and/or don’t have access to services, e.g., undocumented immigrants
  • To establish a research space for projects involving underserved communities

“Essentially, our goal is to be the voice, the listener, and the care-provider for patients who have experienced barriers to care elsewhere,” says Worthington. “Rush is really at the forefront of public health, and we have a big, overall aspiration to help the underserved.” 

The idea of SCOPE was first devised a couple of years ago as a way to expand clinical education opportunities for speech pathology and audiology students. “We were supposed to renovate the space right before COVID hit, so it got a bit delayed – but we’re now up and running. We offer audiology services two days a week and speech services five days a week. And each of us always has at least one student with us. We also have a Spanish interpreter, which is really helpful as a lot of the patients we see are Spanish speaking.”

No more falling through the cracks

Although the clinic is still fairly new, a series of projects are in progress already. “One of our major ongoing initiatives is a pediatric program, where we provide hearing aids for those pediatric patients who are being bounced from place to place because they lack insurance, because of logistics, or because they are medically complicated. Much too often, these young patients end up falling through the cracks and being critically delayed on their diagnoses or fittings. 

“We also offer free hearing and speech screenings for developmentally delayed pediatric patients. In the US, hearing screening is offered to newborns, but the next mandated hearing test isn’t until kids are in elementary school. In SCOPE, we’re providing additional screening opportunities for high-risk patients with risk factors for hearing loss who haven’t been screened since birth.” 

SCOPE is also getting involved in the volunteer-based project Hear the Call  – a nonprofit campaign helping people with hearing loss locally and globally. The plan for the creation of Hear the Call Chicago is to fit donated hearing aids on patients identified through the SCOPE clinic. SCOPE is also partnering with community-based organizations, other universities, and partners within Rush to expand services and outreach. 

To reach those in need, the SCOPE team works with local organizations who refer their patients, e.g., the Lawndale Health Center which serves this population. “I think because their physicians have sent them, the patients do come. Many of the patients sent to us haven’t ever had hearing healthcare, so their hearing loss is significant. For most of them, it’s not like they’re coming and ‘oh I have a mild hearing loss.’ No, they’re totally deaf in one ear and have a moderate to profound in the other. And their physician can barely communicate with them. It’s not what you see in a normal clinic.”

‘Yeah, what’s the catch’

“When you’re serving this particular segment of the population, I think the need for person-centered care is somewhat different because there’s a lot of distrust with healthcare providers. For instance, when we tell patients that we’re going to get them donated hearing aids, they’re almost like ‘yeah, what’s the catch?’ So, when we tell them we got the go-ahead, they’re like ‘oh my gosh, I can’t believe you’re really making it happen!’ And we say, ‘But I told you I wasn’t going to sleep at night until I got you hearing aids.’

“Sometimes, we’re the first ones to even take the time to explain their condition, to really help them understand, to give them hope, and treat them with respect – basic things that everyone should be doing but aren’t necessarily. I’m only in the clinic half a day, but it’s by far my favorite part of the week.”

A new generation of social awareness

When students start placements in the clinic, they’ve already learned about person-centered care as part of the Rush AuD program. In the SCOPE clinic, they have a chance to put it into practice. “I think the students find value in seeing care delivered that way. They’re excited about the opportunity to help underserved populations – and that draws them to Rush. Let’s be serious, the younger generation is much more socially aware, and they fight for what they believe in.”