Rebekah Devorak

Students dissatisfied with Duquesne health services

Living and learning on a college campus in close contact with thousands of
other students can lead to receiving unwanted germs and illnesses. But what
worries several Duquesne students more than the sickness itself is the fear that
they wont be properly taken care of at health services.
I do not feel like I will be taken care of [at health services] when Im sick,
because I feel like regardless of what you have, youre getting diagnosed with
mono, said Sara Celender, a freshman supply chain management major.
Duquesne health services, located on the second floor of the Union Building,
is a same-day schedule, diagnosis and treatment center, according to Nancy
Generalovich, a staff nurse and campus relations coordinator with the department.
Generalovich has worked for four years with health services.
Students are first met by nurses to find out why they need an appointment,
Generalovich said. If they are there to submit documents or health records, no
appointment is scheduled. If the student has symptoms for illnesses or infections,
such as strep throat, then they are placed on the schedule. If those students have
symptoms that require prescriptions, then they are seen by a nurse practitioner or a
physician assistant.
According to a brochure available in the health services office, health services
is able to evaluate and treat students for illness and injury at no charge for the
screening.
We take care of routine illnesses and injuries affecting [students], as well as
anything they believe should be addressed and seen, Generalovich said. If its a
fractured arm or something, theyre referred directly to Mercy Hospital to get x-
rayed.
Celender said she visited health services on March 8 after dealing with
extreme discomfort for a week.
I have had a sinus infection before, and I thought that was what I was
experiencing again,
she said.
Celender said she called health services to make an appointment to be seen
by the medical team there. She said she had no doubt that she would receive
adequate help because the woman she spoke with on the phone was extremely
kind and understanding. However, Celender said she was dissatisfied and
annoyed when she received her diagnosis.
The woman who saw me said that it was clear that I was suffering from pain
in both of my ears, and my sinuses were clearly suffering from pressure as well,
Celender said. This is where I thought I would get an antibiotic [prescription].
 According to the Centers for Disease Control and Prevention, one of the most
common ways to treat a sinus infection either acute sinusitis, which can last up to
four weeks, or chronic sinusitis, which can last longer is to administer antibiotics.
However, the antibiotics are only an effective treatment if the sinus infection is
caused by a bacterial infection rather than a viral infection. The CDC says that only
one out of 10 cases in adults are actually caused by bacteria.
The health services website states that the center will provide students with
starting doses of some prescriptions or over-the-counter medications. But
Celender was refused an antibiotic prescription for a different reason.
The woman who saw me told me that [she was] stuck between a rock and a
hard place because I had not been sick for 10 days, and she prefers her patients to
be sick for 10 days before treating them, Celender said. Then, I was told I could
not get an antibiotic because she didnt want me to [take] it on an empty stomach.
Could I not just eat before consuming it?
Students who visit the Office of Health Service [are] concerned that they
have an infection and ask for antibiotics are often diagnosed with a common viral
illness, Rose Ravasio, Duquesne media relations manager, said. Antibiotic
resistance due to over-prescribing is an increasing issue, and the Office of Health
Service has been working to educate its patients about viral illness versus bacterial
illnesses and how the treatments differ.
Generalovich said that the most common cases treated at health services
include sinus and upper respiratory infections, bronchitis, sore throat, asthma
breathing issues, chest colds and urinary tract infections. Health services also
provides confidential screenings for sexually transmitted infections, which
Generalovich said are the vast majority of appointments.
The CDC recommends that those experiencing symptoms that last longer
than 10 days see a doctor for help, but it also says that should be the same for
those with symptoms that are getting progressively worse during a shorter time
span. Celender said her symptoms were getting more and more painful each day.
I was told to continue to use Mucinex D, which was not helping at all the
past seven days, she said. I asked her why she wanted me to wait 10 days to
come back. Her response was that I might have had mono presenting itself in just a
weird and sort of goofy way.
Celender said she was confused because she had never had mononucleosis
before, but she was aware of the symptoms.
I was certain mono was extremely painful for your throat, you were
extremely tired and just overall sick, she said. These were not my symptoms at
all.
The CDC says that symptoms of mononucleosis include sore throat, extreme
fatigue, fever, head and body aches, swollen lymph nodes, swollen liver and rash. In
comparison, the CDC lists symptoms for sinus infections as headache, stuffy nose,
loss of sense of smell, facial pain or pressure, postnasal drip, sore throat, fever,
coughing, fatigue and bad breath.
According to the CDC, the only way for doctors to test if a symptomatic
person has mononucleosis is by ordering a blood test. Celender said she did not
receive a blood test, nor did the nurse tell her to get one elsewhere.
Celender said the nurse recommended she wait until the 10-day mark
because she thought the symptoms would go away by themselves. Celender said
she didnt wait and immediately visited a real doctor where she was diagnosed
and treated for severe acute sinusitis.
A girl told me Ive been sick for three days straight, and they told me I had
mono, Celender said. I feel like if youre a girl [at Duquesne], you just get
diagnosed with mono.
Students are evaluated on a case-by-case basis as to whether or not they will
be sent to Mercy UPMC for further treatment of these illnesses and more,
Generalovich said.
We always refer to a specialist if its an emergency, Generalovich said.
That way the student can be monitored more closely and make sure that they
dont develop anything worse.
If students are sent to Mercy, their insurance is automatically billed for the
cost of the visit, according to Generalovich. If students choose not to go to the
hospital when recommended to do so by health services, they must sign a waiver
stating that they chose to go against medical advice.
The brochure states that health services has a staff of registered nurses,
certified nurse practitioners, a physician assistant, a registered dietitian and a
physician through UPMC Childrens Hospital. Health services also has an emergency
on-call physician during weekends when the center is closed.
When asked if she was aware of any student complaints made about health
services, Generalovich said, I dont think we have a lot of complaints about the
care we give. We give great care.
Health services does not currently have an assessment system in place to
monitor student perceptions of received care, she said. Instead, the center
participates in a year-long research study that monitors health services
performance as a whole. According to this study, Generalovich said health services
has really high patient satisfaction.
Students care about here-and-now care, so the only time I hear students
complain is if there are no spots open for an appointment, she said. Then the
parents usually call and complain, too, because they want their child to be seen.
I feel like health services does the best they can under the circumstances,
said Dayna Kirby, a junior psychology major.
 Kirby visited health services on Feb. 2 for a migraine that lasted for more
than a week.
They took my blood pressure, asked for specifics about the length and
severity of the headache and then told me I needed a migraine cocktail, which could
not be administered on site, Kirby said. I was told to go to the emergency room,
but I didnt want to go.
The nurse did not specifically tell her why the migraine cocktail could not be
administered on site, Kirby said, but that the nurse told her she wasnt allowed to
prescribe any pain medications that were stronger than ibuprofen.
They are extremely limited to what they can do, which is somewhat
problematic, Kirby said. Anything more complicated than a sinus infection usually
results in a trip to urgent care or the emergency room. This is difficult for students
with limited funds who use health services to avoid high doctors bills.
While the students in this article did not wish to disclose insurance charges
resulting from health services or visits to Mercy, a 2013 study funded by the
National Institutes of Health shows that an average visit to the emergency room is
$1,233, depending on the type of insurance the patient had. Minimum and
maximum charges for upper respiratory infections were $19 and $17,421,
respectively. For a urinary tract infection, the charges were anywhere between $50
and $73,002.
Some students believe that part of the reason health services is not able to
comprehensively treat patients on campus is because of funding issues.
Duquesnes public affairs office was contacted numerous times to inquire
about the annual operating budget for health services but would not respond to
either phone calls or emails. According to the universitys website, the private
university had a total operating budget of $287 million for the fiscal year of 2016
and had a fall 2015 enrollment of 9,506 students. Of this number, 6,052 were
undergraduate students, 3,051 were graduate students and 403 were law students.
In comparison, Indiana University of Pennsylvania, a state-funded university,
has a health services budget of $3,000,680 for the 2015-2016 school year,
according to a budget report on its website. Indiana University of Pennsylvania has
a total operating budget of more than $157 million for the 2015-2016 school year. In
fall 2015, the university had an enrollment of 15,340.
A visit [to health services] is just a waste of time, said Marley Russo,
freshman international business and marketing major. I have spoken with multiple
people who feel the same way I do.
Russo said she could think of at least eight other people that she knew who
did not receive acceptable care from health services.
I went [to health services] twice, Russo said. Once for a concussion during
the first semester where they did not even give me a proper concussion test and
once during the second semester for a sore throat. They told me little information
both times and [were] of little-to-no help.
The Office of Health Service can determine, diagnose and treat
concussions, Ravasio said. But, depending upon the severity, students are
referred to specialists for their wellbeing and for proper post-concussive
management.
Russo was not recommended to a specialist for her concussion and had to
seek external medical care to resolve her problem, she said.
Students have also taken to social media to voice their complaints about
Duquesnes health services.
One March 16 Tweet from sophomore early childhood education major
Catherine Ruddy said, Student health services at Duquesne doesnt do [expletive]
to help us.
A different March 31 Tweet from freshman physician assistant major Devin
Petit said, [Shout out] to Duquesne health services for being short-staffed the one
day that Im dying.
Celender even sent a Tweet the day after her visit to health services, which
said, [Public service announcement]: If you go to health services at Duquesne is
[sic] actually just WebMD.
The health service staff is experienced, trained and committed to the
mission of Duquesne University through serving students, Ravasio said. The office
receives many positive responses and notes of appreciation from many students
and their families. If students have concerns, they are encouraged to let the staff of
the Office of Health Service know.
The people at health services are nice, if that counts for anything, Celender
said. But I dont think people can actually benefit from going to them, and thats a
shame.