Shannon Gergen, Pharm. D., who graduated from the St. Louis College of Pharmacy in 2005, became the Student Health Services (SHS) pharmacist this year. He is implementing changes that aim to make prescriptions more affordable and accessible to students.

Already, Gergen has expanded the variety of drugs available at the pharmacy by adding certain mental health medications such as Adderall, Ritalin and Concerta and increasing the range of oral contraceptive options. According to Gergen, medications that are not immediately available for pickup can be ordered from a nearby pharmacy within one business day.

The drugs that students most commonly seek at the pharmacy are one-time use drugs such as antibiotics and antifungals, rather than drugs needed for chronic or long-term care. The main exception to this, Gergen says, is oral contraceptives. Asthma medications are also one of the more commonly purchased long-term drugs.

“My predecessor limited what was stocked…we’re trying to work with students to have in stock or get in stock anything they might need on a regular basis,” Gergen said.

Many parents and students are concerned about which insurance coverage will best offset the prices of prescription drugs purchased at the pharmacy.

“I’m kind of cynical about American medical insurance…it’s frustrating. You don’t really get it explained thoroughly,” junior Kaitlin Heim said.

In the beginning of the year, Gergen received multiple phone calls from parents concerned about prescription costs.

The pharmacy already accepts what Gergen referred to as the “big three” insurers: Medco, Express Scripts and Caremark. They are currently in the process of adding two new insurers, Cigna and Humana. Students on the Aetna student health insurance plan receive automatic coverage for prescriptions.

Gergen hopes to eliminate confusion surrounding the insurance coverage issue by adding an informational brochure about prescription coverage into next year’s freshman orientation package. He added that it is sometimes possible for drug costs to be covered even if a student’s insurance plan is not one listed by the pharmacy.

“When students come, I make sure to ask—if we don’t have any insurance on file for them—‘Do you have any insurance at all?’ Chances are, we can take it,” Gergen said.

Gergen strongly recommends that students bring a photocopy of their insurance card to any appointment at SHS.

“It’s always helpful when students have their insurance card or a copy of it, especially the first time they’re using the pharmacy. Generally we don’t have that information…Whenever possible, even if you don’t think you need it, if you’re coming to the doctor’s office or pharmacy try to have your insurance card on you ‘cause it may turn out you will need it,” Gergen said.

He also urges students to make use of the five-dollar generic drug list, which is composed of cheaper, non-brand name versions of commonly purchased prescriptions.

Prior to his hiring at Washington University, Gergen worked at pharmacies at Schnucks and Shop & Save and at a nursing home’s chronic care pharmacy.

In his current position, he will serve both the undergraduate and graduate student populations.

Janice Evans, a first year law student who also completed her undergraduate education at the University, has used SHS.

“[It is] generally a positive experience, quick service, no complaints,” Evans said.

STIs in STL

Number of reported new cases in 2010

Chlaymidia – 1570
Gonorrhea – 744
HIV – 305
Syphils – 49

St. Louis is regularly recognized as having the highest rate of STIs (sexually transmitted infections) in the country.

And in a sexually-charged environment like college, Washington University students are no strangers to STIs either.

According to Melissa Ruwitch, assistant director of Student Health Services, the clinic sees a fair number of infected students.

“The SHS medical service providers see students with herpes, HPV and Chlamydia pretty often. They see students with gonorrhea and syphilis occasionally. They have seen some HIV-positive students in the last few years,” Ruwitch wrote in an e-mail to Student Life.

SHS does not collect statistics about STIs, according to Ruwitch. The information that they do have is contingent upon students reporting to them. SHS has not done an official survey of students’ sexual activities since 2007.

In St. Louis itself, there has been an increase in syphilis and gonorrhea, according to Scott Elman, president of Student Health Advisory Committee (SHAC). Elman attended a panel on STIs in St. Louis, and said that it would not be surprising if the University saw an increase in these diseases as well.

Over the past year, the city has seen more people contract STIs. In St. Louis County in 2010, there were 1,570 new cases of chlaymidia, 744 new cases of gonorrhea, 49 new cases of syphilis and 305 new cases of HIV, according to a report by the Missouri Department of Health and Senior Services.

Elman recommends that students use condoms to prevent STI infection.

However, not all STIs can be prevented by using condoms. Condoms are useful in protecting against STIs that are transmitted through fluids. Both herpes and HPV can be spread through skin to skin contact.

This leads us to question why Student Health Services (SHS) cut EST funding by $8,000. Nothing about this service renders it ineffective enough to warrant a budget cut. EST, which is jointly funded by SHS and Student Union, receives block funding from SU and therefore cannot request more money from SU until next year. Even then, there is no guarantee that the student body will approve the new funds.

We recognize that SHS, like all other University departments, faces budget difficulties in light of the economic recession. Painful decisions must be made without sacrificing essential services such as mental health counseling and treatment for eating disorders. It seems that the hands of SHS are at least partially tied. But given that SHS does not extend care past business hours, we believe that administrators should not have made cuts to EST, the only source of emergency and late-night care for students other than calling 911.

SHS administrators have not returned several phone calls from Student Life regarding this matter last week.

As a result of this cut, each student will have to pay up-front costs of approximately $1,000 for the certification course required to become a member of EST, with some of the money being refunded upon completing a certain number of hours on-call. According to EST director Stephanie Higgins, this cut will not affect the services that EST provides.

What it could do, though, is seriously limit interested students’ ability to join EST. Few college students have an extra $1,000 lying around, and even fewer can actually spend a few months waiting for reimbursement.

Especially in light of recent initiatives that aim to promote socioeconomic diversity, we feel that this fee is unfortunate. We encourage Student Financial Services to look into assigning grants to students interested in working for EST, and we strongly recommend that the Diversity Affairs Council and Washington University For Undergraduate Socioeconomic Diversity (WU/FUSED) investigate how this fee will affect the students who wish to join EST.

We find it particularly unfortunate that, at a school with stellar residential capacities, high tuition and well-ranked food, more money can’t be found for EST –a service that is valuable for both the students it employs and the students it serves. This is a classic problem of budget allocation that the University often must deal with, solely on the basis of its size: Because money is funneled into many administrative departments, bureaucratic complication often stands in the way of efficient allocation.

To exacerbate the problem, due to the overflow of students entering SHS, each student only gets a very brief consultation. Of course, this is to be expected from a relatively small clinic that has to take care of a comparatively large student body, but the real problem lies in the price structure: I have yet to hear a compelling reason that health insurance from the University is mandatory.

I understand the main motivation behind making health insurance mandatory: as a matter of public health. If everyone is insured, the risk of disease breakouts is theoretically reduced. I admit that making health insurance optional does pose the risk of having people uninsured, and some students could opt out of the University’s health coverage while having no alternative insurance. Such a gap could, in theory, lead to an outbreak due to one infected vector of transmission. But I am still not convinced that these problems will surface at a school like Washington University. It’s painfully obvious that Wash. U. is largely composed of privileged students from wealthy backgrounds. If there is a risk from uninsured students, the risk would be very small, and I have a hard time buying the notion that a significant number of students would opt out of University health coverage if they did not have an insurance plan of their own.

While it may be naïve to assume that there would be no risks from making University coverage optional, the benefits outweigh the risks. Currently, every student pays a mandatory fee for health services that most will never use. Most serious problems end up with the bill passed to a larger hospital anyway, and the mandatory insurance does not cover prescription medication, which is (for better or worse) what most students will end up going to SHS for in the first place.

Of course, this sketch of an argument does not get at the true root of the issue, and I don’t expect to make a flawless argument in 500 words. But I believe that the status quo is equally unacceptable. We pay a significant sum of money for health coverage that we don’t necessarily need, and the result is not only the draining of pocketbooks, but also coverage that meets neither the needs nor the demands of many students.

Ultimately, giving the freedom of choice back to the students is the best option, and one that should be taken seriously as an alternative to the current system, which is inadequate in a very real way.

AJ is a sophomore in Arts & Sciences. He can be reached via e-mail at asundar@wustl.edu.

The committee of faculty and students tasked with finding a candidate to fill the new post has scheduled two interviews for next month, despite already recommending a candidate based on three interviews earlier in the semester.

Members of the hiring committee submitted a letter to Alan Glass, the director of Student Health Services and the official directly responsible for the new position, last month after bringing three candidates to campus.

Glass would not comment on specific details of the hiring process, including why no one was hired or whether the candidates who previously visited campus remained in consideration in the ongoing search. However, he underscored the importance of finding a candidate capable of meeting the needs of stakeholders throughout the University.

“I’m very committed to finding as close to perfect a fit for this critical position,” Glass said. “Until we can find a person who at least comes close to that—in all of our opinions—my intention is to leave the search open.”

Members of the hiring committee—who were selected from the chancellor-appointed Advisory Committee on Sexual Violence and Prevention (ACSVP)—referred all questions about the process and the candidates to Glass.

Although losses in the University’s endowment have forced cost-cutting measures in many departments, school officials, including Chancellor Mark
Wrighton and Vice Chancellor for Students James McLeod, have consistently expressed a commitment to the position, and by all accounts financial concerns will not impact the position in the near future.

“We’ve put a lot of effort into the development and financing of this position,” Glass said. “I’m dedicated to it moving forward, so it’s not going to dry up because money is not as free as it was a few years ago.”

Facilitating collaboration

Formally, the position will be known as the assistant director for sexual assault and community health services. When a candidate is hired, he or she will join the staff of the Habif Health and Wellness Center and will report directly to Glass.

The new position will be responsible for coordinating the University’s sexual assault prevention, education and survivor support efforts and will offer guidance to the student groups that currently deal with this issue on campus.

Because there are three different student organizations dealing with issues of sexual violence, each with a slightly different focus, there is a need for a centralized guiding presence, said senior Christopher Chesley, the co-president of Men Organized for Rape Education (MORE).

The new office will help groups “have a more effective and powerful foothold on campus” and will raise the profile of sexual assault on campus, Chesley said.

Leaders of each of the student groups involved with this issue stressed that having an institutional presence focused solely on the problem of sexual violence would open the door to more resources, greater visibility and increased stability as student leaders transition in and out of leadership positions.

“We love the work that we do, but we are limited by our resources,” said junior Maria Santos, president of the Committee Organized for Rape Education (CORE). Although the movement of students is divided into several smaller groups, Santos stressed that a University-wide staff position would help bring attention to the fact that “we are a larger group and a larger constituency that is interested in fighting sexual assault on campus.”

A long history

The first conversations about the position in the 1980s grew out of a recognition that despite a strong commitment to sexual assault prevention and education among students, faculty and staff, the University’s resources lacked the visible presence to make them easily accessible.

Initially, the University’s support network was pieced together gradually through the commitment of members of the University community.

According to Karen Levin Coburn, a now-retired staff member who served as the University’s women’s crisis counselor and the chair of the Committee on Sexual Assault (COSA) for many years, survivors of sexual violence and those in need of support were often referred to her informally by faculty members and RAs.

“There was a lot of collaboration going on on campus, but it was still not organized in any way,” Coburn said.

Over the years, efforts to prevent sexual and relationship violence grew because of initiatives led by students, faculty and staff, and many of those have remained until today. In addition to the three student groups that focus on survivor support and education, “The Date,” a required presentation during freshman orientation, began because of student lobbying and is still a student-run event.

COSA, which was replaced last year by ACSVP, submitted a yearly recommendation to then-Chancellor William Danforth highlighting the need for a staff position focused on coordinating all of the efforts under way on campus.

“Generally, my thought was that rather than have lots of specialists, that they were problems and issues for the whole campus,” Danforth said. “We were a smaller institution then, and I didn’t think it made sense to try and solve every problem with a new person in charge of something.”

The most recent push to fill the position began in 2007 in response to the violent rape of a female student in Myers Hall by a man unaffiliated with the University. That year, Student Union Senate passed two resolutions in favor of the position and students began to lobby the administration in earnest.

Those efforts sparked the University to re-recognize the importance of facing the problem posed by sexual assault, and led to a year-and-a-half-long process of writing a position statement and the ongoing interview process.

Shifting focus

During the long development of the position, its scope has shifted substantially.

Currently, the job description emphasizes responding to sexual and relationship violence as a health problem.

According to Glass, the position defines sexual assault and the risk factors associated with it in terms of a broad sense of community health—both the physical and mental well-being of the victim, as well as the ways that alcohol and other mental health problems factor into the perpetration of sexual violence.

“Although universities place these positions in different areas administratively depending on what their culture is, the logic for defining it as health certainly works for our University,” Glass said.

Across the board, those involved with the sexual assault prevention and education movement on campus stressed that whatever the mandate of the position, it was important for it to help to shape the broader conversation on campus in a way that would draw attention to the problem and help facilitate solutions.

“It’s important to remember that having this position won’t solve everything—there’s still going to be sexual assault on campus,” said senior Bobby Harvey, president of the campus Sexual Assault and Rape Anonymous Helpline (SARAH). “What we can do is have more of a dialogue about it, and hopefully creating the position will help create a dialogue about it because there’s so much that people don’t know about the issues.”

These numbers are still relatively low, and they are only expected to increase in the coming weeks, according to Alan Glass, director of Student Health Services.

“It is still anticipated that these numbers will increase in the next days and weeks,” Glass wrote in an e-mail to Student Life.

(Illustration by Zoe Scharf | Student Life)

Tests completed at Student Health Services (SHS) concluded that the students have influenza A. Almost all of the influenza A virus currently circulating is thought to be novel H1N1 influenza, the virus that causes swine flu.

The virus has hit college campuses around the country exceptionally hard. Last week, a junior at Cornell University died from the swine flu, making him the third college student in the nation to die from complications related to swine flu. Cornell has seen 555 swine flu cases this semester, Claudia Wheatly, a Cornell University spokeswoman, confirmed to ABC News.

Emory University has set aside a dorm on its campus for infected students. Emory has had more than 200 suspected swine flu cases since the start of the semester, according to the school’s Web site.

Tests completed at Student Health Services (SHS) concluded that the students have influenza A. Almost all of the influenza A virus currently circulating is thought to be novel H1N1 influenza, the virus that causes swine flu.

The University announced the campus’s first suspected case of swine flu late Tuesday evening. Two cases were announced on Wednesday, and the fourth on Thursday. All of the sick students are expected to make full recoveries.

“I suspect that we will see more in the next days and weeks,” Alan Glass, director of Student Health Services, wrote in an e-mail to Student Life.

He wrote that these cases are not unexpected because “this virus has been affecting college and university students nationally with some frequency.”

In late June, the CDC released a statement estimating that there had been at least 1 million cases of swine flu in the United States, most of them undiagnosed or unreported.

The affected students are currently in self-isolation in accordance with University flu protocol, which is based on recommendations by the U.S. Centers for Disease Control and Prevention (CDC). At least two of the students live in on-campus housing.

As a preparatory measure, the University appointed an Emerging Infectious Disease Task Force last spring when the swine flu epidemic first hit. Glass heads this taskforce.

The University is asking affected students to remain in their living spaces until they are fever-free for 24 hours without fever-reducing medication.

Thursday marked the second day that the University offered seasonal influenza vaccinations. Seventy students were immunized on Wednesday and another 90 on Thursday.

“It is extremely important for students to have flu shots this year,” Glass wrote.

The University asks all students and faculty to not attend classes or work if they are feeling ill. Subsequently, professors and lecturers were asked not to penalize students if they miss class for health reasons.

The symptoms of swine flu are similar to those of seasonal flu and include fever, cough, sore throat, body aches and headache. Some people with novel H1N1 flu have also reported vomiting and diarrhea. The University encourages those who experience these symptoms to contact Student Health Services at 314-935-6666.

Tests completed at Student Health Services (SHS) concluded that the students have  influenza A. Almost all of the influenza A virus currently circulating is thought to be novel H1N1 influenza, the virus responsible for swine flu.

This brings the University’s total cases of presumed swine flu up to three.

A Washington University undergraduate who displayed flu-like symptoms was thought to have the campus’s first case of swine flu late Tuesday evening.

According to Alan Glass, assistant vice chancellor and director for the Habif Health and Wellness Center, this first isolated instance was likely just the first in an upcoming wave of cases.

“I suspect that we will see more in the next days and weeks,” Glass wrote in an e-mail to Student Life.

He wrote that these cases are not unexpected since ‘this virus has been affecting college and university students nationally with some frequency.’

All three student are reportedly  “moderately ill but doing fine”

The students are in self-isolation following University flu protocol, which is based on recommendations by the U.S. Centers for Disease Control and Prevention (CDC).

As of Wednesday, Glass wrote that the first diagnosed student “remains ill but was doing better today.”

As a preparatory measure, the University appointed an Emerging Infectious Disease Task Force last spring when the swine flu epidemic first hit. The task force is headed by Glass.

Students who are diagnosed with the flu are asked to isolate themselves. The University requests that affected students remain in their living spaces until they are fever-free for 24 hours without fever-reducing medication.

Although this is the University’s first suspected swine flu case, in late June, the CDC released a statement saying that there might have been at least 1 million cases of swine flu within the United States, most of them undiagnosed or unreported.

The symptoms of swine flu include fever, cough, sore throat, body aches and headache. Some people with novel H1N1 flu have also reported vomiting and diarrhea. The University encourages those who experience these symptoms to contact Student Health Services at 314-935-6666.

The group, called the Washington University Medical Brigades, set up medical clinics in three villages.

Each clinic was divided into several sections. The Medical Brigades first set up a triage where University students and faculty took vitals and reviewed patient history. The workers then set up a consultation room for diagnoses and medication prescriptions where University students could shadow doctors leading the local health care efforts. At the pharmacy station—the busiest of the three—locals received medication.

The group also provided the Honduran village with sustainable care.

Different chapters of the Medical Brigades often return to the same village, allowing the workers to keep long-term records of local patients. Villagers have returned to the clinics with the same problems making long-term care possible, according to Silvia Kim, one of the founders of the University chapter of Medical Brigades.

“We were also doing public health programs where we actually built latrines ourselves and improved their chimneys to improve their cooking environment,” Kim said.

Not only did the students learn about medical practice from this trip, but they also improved their Spanish speaking abilities.

“The students would come and join with the physicians and shadow them, so they got a lot of hands-on experience,” Kim said. “We were able to use our Spanish skills too to explain to [the patients] how to take medicines and how many dosages per day to take.”

This is the first year that the University took part in a trip like this because Kim, along with Bo Lee and Seonha Park, started the chapter of Global Medical Brigades last February.

This year’s trip to Honduras, they said, helped more than 1,000 patients. Normally the Medical Brigade trips help approximately 2,500 patients, but since many villagers go to work in the mountains in January, there were problems attracting patients this season.

According to Kim, the University is going to continue its work with Medical Brigades. In the future, Medical Brigades hopes to host speakers on campus from the national organization to discuss public health programs and different brigades that students can become involved with. In addition, the group would like to hold awareness events on campus and workshops where students can learn vitals and medical Spanish for future involvement in Medical Brigade programs.

The University’s chapter will continue to collaborate with the national Global Medical Brigades.

Global Medical Brigades’ Web site describes the organization as an “international network of more than 50 university clubs and volunteer organizations that provide communities in developing nations with sustainable health care solutions.”

Global Medical Brigades is focusing on Honduras, but it later plans on expanding to more countries. In 2007, the organization facilitated more than 1,000 volunteers to take part in programs and help more than 40 communities and 40,000 patients.

“I believe this is the very first attempt by Wash. U. students to plan out a clinical mission trip abroad from scratch. I know of other mission trips abroad, but they are usually not student led or clinical,” Kim said. “Our group is special in that we also provide hands-on experience to the massive pre-med population of Wash. U.”

Lisa Clark, a Student Health Services physician who accompanied Wash. U. Medical Brigades to Honduras, said she was amazed with the success of both the students and the program.

“The students were absolutely amazing,” Clark said. “They organized, fundraised and got all of the information. They worked together really well and managed to do all this while they were going to school. It was really impressive.”

The experience that this trip gave to the students allowed many of them to realize that they want to pursue careers in medicine in the future.

“A lot of people confirmed their desire to pursue either a field of medicine or a field of health care,” Kim said.