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MEDICAL YEAR
IN REVIEW

continued from page 19

for a single patient was 45. Ages of patients ranged population. In the summer of 2021, SMSA was ap-
from 21 through 82 years. Ages were estimated by proved for Americares Medical Outreach medication
decade for 24 patients. 35 charts did not have ages or distribution program, which will greatly affect the
approximations. ability of the organization to provide a broad spec-
The two most common ailments treated were in- trum of prescription medication to its patients.
fections/acute wounds and musculoskeletal pain, to- The review has also highlighted the importance of
gether making up 56% of total acute conditions. streamlining documentation. Beginning in February
Osteopathic manipulation was performed by Dr. of 2021, SMSA has transitioned to an EMR. This has
Bruntmyer, the sole DO physician, whenever possible. already aided in building patient trust and ensuring
NSAIDS, Tylenol and triple antibiotic ointment were continuity of care when seen by multiple providers.
the most common medications administered. Wound Furthermore, as a result of this review, SMSA intends
care supplies were provided for 69 patients; three of to track more specific and consistent demographic in-
these had incision and drainage performed. 19 pa- formation, diagnoses, past medical history, social
tients received orthopedic supplies, including splints work needs and referral status. Last, but not least,
and braces. SMSA intends to keep its close relationships with
Local social work organizations referred 46 patients community partners to both accept and refer those in
to SMSA for acute medical conditions. SMSA re- need. The ultimate goal of the SMSA, to care for San
ferred 17 patients to local social work organizations Antonio’s most vulnerable, has not changed.
for assistance, including ID card retrieval, housing
and detox programs. Housing was achieved for nine References
patients during this two-year timeframe. 69 patients 1. Edwards, A. L. (2017). Street medicine: A program
were evaluated at a local shelter, with all others being evaluation. Georgia State University.
evaluated on the street. https://scholarworks.gsu.edu/iph_capstone47
Upon recommendation of SMSA providers, 10 2. Waara, A., Abraham, K., & Mason, W. (2017).
patients went to the ER following a street encounter. Street medicine Detroit annual report. https://sta-
Of these, four were escorted by SMSA providers or tic1.squarespace.com/static/509c2caae4b0c7861e4
EMS, and three resulted in subsequent hospitaliza- b4512/t/5ad93db9562fa7843a6cc941/15241865
tion and/or surgery. 11 patients refused ER evalua- 80889/Street+Medicine+Detroit+Annual+Re-
tion. Specialty referrals included general surgery, port+2017.pdf
dental, podiatry and ophthalmology. All evaluations, 3. Hemba, K. E., Simon, R., & Weinstein, L. D.
treatments and operations were provided pro-bono. (2013). JFMA street outreach: A resident-run
PCM referral included pre-established PCMs at the street medicine program. A retrospective chart re-
community hospital and VA, in addition to public view examining the needs of a vulnerable popula-
and church-run clinics. tion and services provided. Department of Family
& Community Medicine Presentations and Grand
Conclusion and the way ahead Rounds. Thomas Jefferson University.
SMSA has grown in size and scope over the past https://jdc.jefferson.edu/fmlectures/16
two years. This evaluation will be utilized to develop 4. Howe, E. C., Buck, D. S., & Withers J. (2009, Oc-
further training and build needed inventory. Future tober). Delivering health care on the streets: chal-
goals include wellness fairs for street sleepers which lenges and opportunities for quality management.
will focus on health education and preventive medi- Qual Manag Health Care, 18(4), 239-46.
cine. Additionally, SMSA plans to conduct training https://doi:10.1097/QMH.0b013e3181bee2d9
seminars for the medical community and potential 5. South Alamo Regional Alliance for the Homeless
SMSA volunteers to discuss lessons learned about (SARAH). (2020). 2020 Point in time count re-
how to best connect with and care for this unique port: San Antonio and Bexar County.

20 SAN ANTONIO MEDICINE • December 2021