Page 18 - Layout 1

MEDICAL YEAR
IN REVIEW

Street Medicine

San Antonio Inaugural Review

By Amy Moore, PA-C, DScPAS; Patrick Muehlberger, MD; Hans Bruntmyer, DO, MPH

Background
Dr. Hans Bruntmyer, a retired military emergency make a greater impact on its patients, San Antonio
medicine physician, had a career that largely revolved street sleepers, present and future. The authors believe
around being comfortable with the uncomfortable that the first step in that process should be a 100% in-
and was no stranger to practicing medicine in austere depth patient chart review to systematically under-
environments. When he and his family relocated to stand patient and organizational needs over SMSA’s
San Antonio following his military retirement, he was first two years of service. Protocol approval was ob-
moved by the obvious need for improved access to tained from the University of the Incarnate Word In-
medical care for the most vulnerable in our society — stitutional Review Board on February 15, 2021
those who lack shelter, transportation, basic safety (FWA00009201). This study is an outcome evalua-
and support. He was already familiar with the Street tion design of Street Medicine — San Antonio from
Medicine movement, originally founded by Dr. Jim January 1, 2019 to December 31, 2020.
Withers of Pittsburgh, and began networking with In preparation for the review, a Google Scholar
Dr. Withers and other Street Medicine program di- search was conducted between December 1, 2020
rectors in 2015. and December 31, 2020 to identify Street Medicine
During the next few years, Dr. Bruntmyer began to program evaluations. Key terms included Street
see the reality of creating a Street Medicine — San An- Medicine, Street Medicine review, Street Medicine
tonio program (SMSA) and, in January of 2019, Dr. program evaluation, Street Healthcare and Street
Bruntmyer began leading “backpack medicine” teams Healthcare program. The literature review resulted
onto the streets of San Antonio to care for unsheltered in three distinct Street Medicine program capstone
1-3
individuals. Since those first “Street Rounds,” the or- projects and/or publications and one case series
ganization has grown in size and scope, beginning with obtained from the annual Street Medicine Sympo-
4
a single physician and student volunteers to now in- sium. Additionally, eight articles obtained provided
cluding three emergency medicine physicians, ad- additional research related to Street Medicine Pro-
vanced practice clinician-led teams, nursing teams and grams, such as resident and patient experiences, and
a behavioral health component – Street Smart, in ad- in-depth looks at current data and issues that are
dition to countless volunteers of varying levels of train- unique to providing health care for the homeless,
ing and across a range of professions. Despite his both locally and nationwide. 5-12 The authors are
experience to that point, Dr. Bruntmyer could not grateful to contribute to the limited existing field of
have imagined the relationships formed or personal Street Medicine literature.
and professional growth that would be experienced by
himself and all of the volunteers. Results
Over two years have elapsed since the first backpack Paper charts were pulled for each patient seen dur-
medicine mission by SMSA. The organization in- ing this timeframe and a single investigator scrubbed
tends to publish regular research to support the de- each chart for basic demographics (Figure 1), major
velopment of future Street Medicine programs, ailments treated (Figure 2) and supplies utilized
educate the medical community on care for the (Figure 3). Referrals to SMSA from local social work
homeless, and to help this program evolve in order to organizations including Centro San Antonio, Chris-

18 SAN ANTONIO MEDICINE • December 2021