Dartmouth College Health Service is in need of changes if it is to adequately meet student health needs.
This article is featured in the 2023 Homecoming special issue.
Everyone has heard the stories. A friend who got very sick but couldn’t get an appointment at Dick’s House. A classmate who had a fairly common accident — maybe broke a bone in a fall — and got an absurdly large bill from Dartmouth Hitchcock Medical Center, which is affiliated with The College Health Service. Another friend who went to Dick’s House but had their symptoms dismissed and got sent home without help for their illness. No student should have to hear these stories, much less be the subject of them. Yet, they seem to be a campus rite of passage.
To fix low appointment availability at Dick’s House and to help mitigate the unaffordability and inaccessibility of other care providers like DHMC, we propose that Dick’s House increase its hours of operation and advertise walk-in appointments on their website. We also stress that all students who walk into Dick’s House should be taken seriously and receive quality care.
It seems unnecessarily difficult to find an available appointment at Dick’s House at a workable time. With Dick’s House opening at 8:30 a.m. and closing at 4:30 p.m. from Monday to Friday — and no hours whatsoever on weekends — it’s not easy for students to get help at Dick’s House in a timely manner. Many classes take place in the short timeframe Dick’s House is open, and when appointments are limited to begin with, it can be challenging to find a time that does not conflict with a prior obligation. Medical needs are time sensitive, and these hours make it very hard for students to seek help with their busy schedules. Being open later and on weekends would be a huge advance.
In addition, nowhere on its website does Dick’s House state whether they take walk-in appointments, which makes it seem that students are only able to go to Dick’s House if they make an appointment through the Health Services student portal in advance. Although a member of this Editorial Board has shown up to Dick’s House and was able to secure a walk-in appointment when there were no available appointments online, most students would not know this is a viable option if they needed care before an available appointment time. Dick’s House should commit to advertising and expanding its walk-in options so students who desperately need to see a medical professional aren’t left waiting days for the next available appointment.
Low appointment availability and the lack of advertising for walk-ins at Dick’s House prevents students from getting medical care in a timely manner, which can disrupt their ability to fulfill their responsibilities and perform at their best. At a fast-paced setting like Dartmouth, many students academically fall behind as a result of this institutional failing. In addition, when students do try to book an appointment in advance, there is often no appointment availability for days, depending on the reason they are booking the appointment. Even if students just have a physical illness or injury, an inability to get care also places a large burden on student mental health. Perhaps the reason for the lack of appointments is insufficient staffing or capacity within Dick’s House’s infrastructure itself. We recommend that Dick’s House conduct its own internal review to determine where this issue is stemming from.
Next is the issue of inaccessibility and unaffordability. Because Dick’s House is so rarely open, students often have to seek care elsewhere — for example, if a student feels sick or gets hurt after 4:30 p.m. or on the weekends, they will have to seek care from an alternative provider. This already poses an issue for students who don’t have access to transportation such as their own car. Although students can get a ride with Safety and Security or the College’s Advance Transit service to Dartmouth Hitchcock Medical Center or to the ClearChoice MD Urgent Care in Lebanon, many students do not even know these options are available to them. Even if they do, DHMC and ClearChoice often charge unaffordable, out-of-pocket fees.
Dartmouth does require students to have health insurance either through the College’s chosen provider — the Dartmouth Student Group Health Plan — or an alternative, equivalent source. While it makes sense for there to be a health insurance requirement, what doesn’t make sense is why students are sent home with bills that make it seem as though that their insurance is worthless. At DHMC, specifically, we’ve heard stories of students paying huge sums out of pocket for medical care. Since DHMC is technically affiliated with The College Health Service, we are unsure why that is the case. In addition, we have heard from students on the DSGHP that this insurance plan is insufficient because it does not provide owners with a physical insurance card, but rather, a PDF, making it difficult to use the insurance at alternative providers. These problems could be addressed if the DSGHP provided a physical insurance card, and better yet, if the College Health Service increased Dick’s House hours and promoted a walk-in option to save students from taking the trip off campus at all.
The last issue that needs to be addressed is in regard to students who get sent home from Dick’s House without adequate care. We on the Editorial Board have heard countless stories to this effect and even experienced some of them ourselves. One member of this Board went to Dick’s House in her first year when she was so fatigued she could barely walk across campus, and she was told by a male provider that she looked totally fine. It was only because this student requested a blood test, for which Dick’s House could not fit her until the next morning, that she found out she had mono. Another member of this Board walked into Dick’s House experiencing symptoms of an allergic reaction after she had interacted with something she had a diagnosed allergy to, but she was only asked to take a COVID-19 test and was dismissed without further treatment after the test came back negative. No student should ever feel like their medical concerns are brushed aside, especially when they are already sick or hurting enough that they have decided to ask for help in the first place.
We believe that until these goals of increased appointment availability, greater accessibility and better quality care are met, the current state of The College Health Service will continue to prevent students from getting care in a timely manner, and also negatively impact their mental health.
We believe that College President Sian Leah Beilock is on the right track with making mental health one of her top priorities for her tenure. We are excited by her announcement that there will be a new position of chief health and wellness officer that will report directly to her on the status of student wellbeing across campus. Of course, without physical health, mental health subsequently suffers. We hope that Beilock sees how physical health and mental health are interconnected, and that by expanding and improving Dick’s House’s accessibility, appointment availability and quality of care, we as a College can get closer to achieving optimal mental health and reach our highest potential. Dartmouth, it’s time to fix our Health Service for the better.
The editorial board consists of opinion staff columnists, the opinion editors, the executive editors and the editor-in-chief.