Medical students from Columbia University College of Physicians and Surgeons opened a free primary healthcare clinic for uninsured adult residents of upper Manhattan on Saturday, March 6 at the Urgicare Center located at 21 Audubon Avenue. The clinic will be the first of its kind in Manhattan.

"We'll overwhelm you with care," has become the medical students' mantra about the clinic, called CoSMO, Columbia Student Medical Outreach.

CoSMO will be open every Saturday morning from 9:00 a.m. to 1:00 p.m. Third- and fourth-year medical students provide medical care at the clinic under the supervision of attending physicians from the New York-Presbyterian Hospital. Drs. Walid Michelen and Elaine Fleck are clinic's medical directors; Dr. Mary McCord is its faculty advisor.

The clinic is a small-scale response to the need of uninsured upper Manhattan residents for primary health care. Upper Manhattan residents are more likely to be uninsured than other New York City residents due to the demographics of its population.
One out of four New York City residents is uninsured and blacks and Hispanics are more likely than whites to be uninsured, according to the United Hospital Fund. The population of Hispanics in upper Manhattan is almost 155,000, based on 2000 U.S. Census figures.

CoSMO will see about 20 to 25 patients weekly.

"We're not pretending the clinic is the solution," McCord said. "But it's impressive that the students are addressing a real need."

Samantha Cramoy and Nelson Jaeggli, both fourth-year Columbia medical students, have worked to found CoSMO for the past four years.

"Our goal is to provide primary care services to patients who otherwise have no access to health care and show up in the emergency room," Cramoy said. She said that she expected many of the clinic's patients would require treatment for asthma, high blood pressure, diabetes and heart problems.

"After the patient is examined by a medical student, the attending physician sees every patient," said Jaeggli. "The quality of care is top-level."

"It's the students who did all the work," McCord, their advisor, said. "They did all the imagining and worked through a million details."

McCord said the decision was made to provide care for adults only at the clinic because most children in New York City are insured or in the process of becoming insured under New York State’s Child Health Plus program.

The involved medical personnel and supporting organizations agreed to donate their contributions to CoSMO so that the clinic would be able to offer free health care to the uninsured.

Students from Columbia Graduate Schools of Social Work and Public Health work with the clinic's medical students to provide health counseling and information. Urgicare contributes the use of its facility and its admissions staff. Alianza Dominicana, a nonprofit community development organization, screens patients for health insurance eligibility, refers patients to the clinic and provides interpreters. New York-Presbyterian Hospital donates radiology, laboratory and pharmaceutical services.