The ingredients for the work of the Michigan State University College of Osteopathic Medicine’s Street Medicine/Street Care programs are many, but in their most basic form they are made up of people in partnerships with others to provide care for all people, especially our most vulnerable residents. The college’s three sites — MSU’s Fee Hall in East Lansing, the Detroit Medical Center in Detroit and the Macomb University Campus in Macomb County — all have a similar focus to meet the needs of the underserved and work with partners to help support them beyond their immediate medical needs. However, the way they approach care for their patients is concentrated on the specific needs of that community. Street medicine is not a copy-and-paste program, but one that assesses the needs of individuals and the communities in which they live to ensure patients are seen and heard and the appropriate care and services are delivered. The students, physicians and other volunteers with the college’s Street Medicine/Street Care programs are dedicated to serving these patients and working with partners to connect them with follow-up healthcare, housing and other necessary resources in their communities. To do this, the partnerships established with other organizations are vital.
The programs have had long ties with organizations, such as Spartan Street Medicine’s partnership with Projects for Assistance in Transition from Homelessness (PATH) in Lansing; Detroit Street Care’s partnership with Neighborhood Services Organization Tumaini Center in Detroit; and Macomb County Street Medicine’s partnership with HARM:LESS, a substance abuse support service and education program operated by the nonprofit Families Against Narcotics (FAN) in Macomb County. Most recently, Spartan Street Medicine added another partnership with students in the MSU College of Veterinary Medicine (CVM) to “treat patients on both ends of the leash.” This new initiative grew from word of mouth and the Spartan Street Medicine (SSM) team jumped in to assist and support the efforts of their fellow MSU students, and to support their Lansing area patients. While preparing backpacks with both medical and other supplies for the patients they would see on a September Sunday morning, the SSM student team — with students from both the College of Osteopathic Medicine and College of Human Medicine — listened as faculty advisor Graham Atkin, Ph.D., gave them an update about a drug now on the streets that is a growing concern. Xylazine, a non-opioid veterinary tranquilizer, he explained, makes fentanyl highs last longer and is not responsive to Naloxone when administered to someone overdosing, something they noted to watch for today and in the future.
We’re excited to work alongside our veterinarian colleagues who can understand and help people in ways we can’t.
The team then headed to the Michigan Community Street Clinic, held in Lansing’s Reutter Park, where they joined the veterinary students, PATH, Homeless Angels and MSU’s Pre-Street Medicine undergraduate Registered Student Organization (RSO), providing healthcare to both people and pets, listening ears and advocacy, along with doughnuts and coffee. Led by two, third-year veterinary medicine students, Hannah Reetz and Emily Winn, the pet street care program learned about SSM through word of mouth, and then reached out to Dr. Atkin. He took the request to the SSM team and received a resounding yes to join in the work. “For us it was pretty easy,” said Myles Vigoda, OMS-II and MSUCOM chief coordinator for SSM. “Dr. Atkin brought it to our attention, and we couldn’t say yes fast enough. “It’s very connected with our mission and similar to what we do. We’re excited to work alongside our veterinarian colleagues who can understand and help people in ways we can’t. We love this opportunity to join them.” The vision for caring for vulnerable populations’ pets came from Reetz, who talked with Winn last year about starting a program. The two began reaching out to organizations and people they could find to gain support, donations and supplies. They went to homeless shelters and walked the streets to ask what people needed most. The pair also connected with RSOs and with Soldan’s Pet Supplies for donations for the clinic, as well as collections at MSU’s Colleges of Veterinary Medicine, Osteopathic Medicine and Human Medicine.
“What the team has found is that it is not uncommon for those who are homeless to have difficulty finding housing when they have an animal,” Reetz said, adding they wanted to find as many ways possible to support the pets and their owners. “These animals are their family and keep them going.” For the pets, the clinic offered vaccinations, preventatives, dental checks, clipping and referrals to veterinarians and clinics. For the people, SSM offered patient healthcare maintenance, including blood pressure and glucose readings, as well as a triage station where J’Aimee Lippert, D.O., associate professor in the MSU College of Osteopathic Medicine, assisted. “The whole question we had at first is whether we could treat patients and pets at the same time,” Vigoda said. The answer was a resounding yes as people checked in with their animals and stayed with them throughout their medical checks and other care, and then the patients themselves were seen by the SSM team for their own needs. Barking and laughter rang through the park, with a few meows thrown in, as people talked with each other about their furry family members and carried on conversations with doctors, future physicians, veterinarians and future veterinarians, as they all received care. “We’re so happy to have Spartan Street Med help us,” Winn said.
Huddled up in a bus stop on a below-freezing Michigan night, a Lansing man facing homelessness accepted medical help from Spartan Street Medicine (SSM) after years of refusing treatment. He, like many other unhoused individuals, did not trust the formal medical system due to past experiences that made him feel less than human. Later, it was discovered that he is a U.S. veteran with benefits of which he was unaware. The once destitute man is now healthy, off the street and living in his own apartment — it only took someone speaking to him like a human and offering support without judgement. It took Spartan Street Medicine.
SSM was founded in 2017 by students with a commitment to the ideals of social justice and the right to healthcare for all. The student-led organization works to holistically serve people experiencing homelessness by meeting them where they are and bringing empathetic healthcare to the streets and shelters of the Greater Lansing region. The team offers medical treatment with follow-up care, along with connections to health education and social services, such as housing. Most notably, the team exemplifies the compassion, trust and respect that many unhoused people have been denied in traditional healthcare settings.
The organization leverages the power of students to bridge the gap between unhoused individuals and healthcare. Many patients of SSM find it easier to disclose concerns to a student physician, which helps to shape the next generation of physicians by engaging with them now.
“Our students unthaw the icy relations that these individuals have with the formal medical system,” said Graham Atkin, Ph.D., faculty advisor for SSM. “That is empowering for both the patients and students.”
The team collaborates with community partners, such as day shelters and community kitchens, to provide pop-up clinics, telemedicine and direct street outreach for those experiencing homelessness. At each week’s clinics, licensed osteopathic physicians volunteer alongside 10 of SSM’s more than 150 culturally trained medical students. They also perform street rounds to bring care to individuals on their own terms and in their “homes,” including in the woods, in encampments and under freeway bridges.
Using osteopathic manipulative medicine (OMM) techniques, the team can provide immediate pain relief to the patient, no matter where they are located — on a park bench, on the floor of a local shelter or in another unconventional setting.
SSM partners with a network of other organizations, including Projects for Assistance in Transition from Homelessness (PATH) to contact unsheltered individuals, gather identification documents and identify medical needs. “We are one piece of a large network that is needed to provide multifactorial support for a transient population facing many social and health complications,” Dr. Atkin said.
In keeping with the osteopathic philosophy of caring for the whole person, each patient is offered hygiene items, socks and connections to other community services along with their medical treatment. To foster a continuity of care, SSM also connects patients to health insurance, preventive medicine and both emergent and primary care.
Myles Vigoda, OMS-II and chief coordinator of SSM, recalls speaking to a patient expressing the hurt and isolation that comes from homelessness. Vigoda emphasizes the importance of understanding a patient’s life circumstances, including their access to transportation, pharmacies or insurance, to provide adequate care and treatment. The students and physicians of SSM work to do just that, which “truly embodies what it means to be an osteopathic physician,” he said.
With Greater Lansing’s recent increase in homelessness, substance use, human trafficking, violence and community tension, partnered with a decrease in shelter space and mental health resources, this population is more vulnerable and misunderstood than ever, Dr. Atkin said. SSM strives to discern the socioeconomic barriers to healthcare faced by those experiencing homelessness and to promote informed, compassionate care throughout the medical system.
Jessie Langmeyer, OMS-III and past chief coordinator of SSM, explains that the continuity of care offered by SSM supports those who have fallen through the cracks of society. The team’s reliable, judgment-free approach earns public trust, allowing more people to receive treatment.
The program helps students prepare for a career in osteopathic medicine by learning the importance of listening to patients and showing empathy, dignity and respect. It offers “the benefit of honing newfound clinical skills alongside skilled, compassionate physicians — all before clerkship,” Langmeyer said.
Students are trained how to ask questions and provide care in sensitive situations, set appropriate emotional boundaries and manage expectations. “SSM offers a safe space to get comfortable with working in situations that may traditionally make us uncomfortable, which helps broaden empathy for patients of different backgrounds,” Langmeyer said.
Beyond medicine, Vigoda notes the leadership experience he has gained, along with the opportunity he has to practice raising funds, spreading awareness, investing human resources, volunteering, advocating for policy change and collaborating with other community organizations.
“Street medicine teaches me something about the humanity of medicine that could never be gleaned from a book: the art of caring for others,” he said. “It gives us the opportunity to not only apply the knowledge that we gained through our studies, but also remember the reason we got into medicine in the first place — to help serve others.”
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