When Samuel Giacinto, a Virginia Tech senior, visited Schiffert Health Center at Virginia Tech in 2017, he was complaining of a sore throat which he assumed was strep throat, an illness he’s experienced many times. His mom told him to go to the student health center so that he could get an inexpensive strep throat culture test and some antibiotics. Giacinto made an appointment for the next day between his classes.
The appointment started as he expected, Giacinto recalled. The doctor asked him about smoking habits, listened to his lungs and looked at his throat and nose. After nothing seemed to concern the doctor, she moved to other tests. At this point Giacinto started to question how serious his sore throat might be.
Giacinto remembered his eyes hurting from the bright lights reflecting off the almost bare walls. He tried to change his focus by reading the only decoration in the room, an informational poster about HIV and other STIs. The only noise he could hear was the slight whistle coming from his nose every time he breathed. While the doctor looked over his chart, Giacinto started to zone-out as his mind raced with fears of some underlying disease causing his seemingly harmless sore throat.
His doctor asked Giacinto if he minded taking a chest X-ray. “She’s the expert in the situation so obviously I said yes,” Giacinto recalled. “I was freaked out; she hadn’t even bothered to run a strep test. I thought she was looking for a tumor or something.”
The X-ray came back negative leading Giacinto and his doctor to another dead-end. She followed that test with a strep throat culture, blood work and an abdominal exam. The only test that seemed to peak the doctor’s interest was the examination of Giacinto’s stomach.
After discussing some more information, Giacinto’s doctor concluded that his sore throat was most likely caused by excessive coughing related to emerging stomach inflammation. She prescribed seven different medications, one of which was in the opioid classification, and sent Giacinto on his way.
The appointment left Giacinto scared and confused. He said he didn’t even know he was having any stomach issues. “I called my mom, and I think she thought I was dying. I’ve never heard her voice have so much fear.” Giacinto’s mom told him to come home that weekend so that his family doctor could examine him.
His family doctor at home ran a strep throat culture test in the lab at their hospital, and it came back positive. Giacinto was treated with antibiotics, and within a week the sore throat was gone. “Of course it was strep. I know my body and [the doctor] should’ve listened to me,” Giacinto said.
According to the American College Health Association, strep throat was the fourth most common diagnosis for college students between Spring 2017 and Spring 2018. The average proportion of college students’ diagnoses being strep throat was 9.6%.
Giacinto filed a complaint with Schiffert Health Center through the after-care satisfaction survey every patient receives. He said he never heard back from Schiffert to discuss his complaint, nor did he receive reimbursement for any of the tests they ran nor the medications he was prescribed.
The Schiffert Health Center is not unaccustomed to receiving complaints about its services. However, Monica Goyanko, the health quality outreach manager for Schiffert Health Center, acknowledged the administration’s understanding of student satisfaction.
“For a number of years the satisfaction with the facility and our services has been 95% or above,” she said. “So I feel that there are a lot of students who come here and leave satisfied that they got what they needed and they got care that they are comfortable with.”
The Black Sheep Online, a national college media company, posted an article in October, 2017 titled “7 Precautions to Take to Stay Away from Schiffert Health Center.” The author, AnnRea Fowler, a former Virignia Tech student, wrote: “But honestly, Schiffert sucks. Their treatment will be ice chips, Tylenol, and a lecture about how you should have washed your hands more.”
Goyanko countered by saying that some degree of patient dissatisfaction is normal.
“I think even if you looked at Velocity Care (A non-VT Blacksburg health center) you’ll find students who were unhappy with their care there. There’s a fine line between servicing the patient and making them happy.”
Virginia Tech senior Connor McCauley said he hears mostly negative reviews of Schiffert but has never had a bad experience himself. “They’ve always treated me good there,” said McCauley, who considers Schiffert his primary care center. “They’re quick; they give me the drugs; I always get better. I mean, if it ain’t broke, don’t fix it.”
The appointment database for Schiffert is online and open to any student who pays health fees. McCauley goes online whenever he feels ill and reserves the next available appointment with the same doctor he’s been seeing since he started at Virginia Tech in 2015. He said it takes a few minutes at most to get an appointment, and it’s usually for the next day.
The Schiffert Health Center is not “fraud” as Giacinto once suggested. The center is a member of the American College Health Association (ACHA) as well as the Accreditation Association for Ambulatory Health Care (AAAHC). The ACHA sets guidelines, procedure standards and conducts research involving all member organizations. To gain accreditation from the AAAHC, Schiffert Health Center was required to pass on-site inspections for over 900 standards.
Both the ACHA and the AAAHC require member organizations to conduct satisfaction surveys. Schiffert distributes satisfaction surveys to each patient following every appointment. The results from these surveys are protected by HIPAA laws and used for internal research as well as ACHA research.
VT News reported in December 2018 that Schiffert received a 99% satisfaction rate for cleanliness and confidentiality and 95% or higher for helpfulness, friendliness and ease of scheduling. The current overall satisfaction also earns an ‘A’ with a rate of 93% .
Outcomes of satisfaction surveys don’t necessarily figure in to the evaluation of student health clinics, said Belle Lerner, assistant director at the AAAHC Institute for Quality Improvement.
“It’s in our standards that they have to do their own patient satisfaction surveys, they’re not required to report any of those findings to us,” she said.
“We accredit organizations based on what they’re equipped to do. If [Schiffert] holds accreditation status, that means they pass our standards. We don’t follow up with their satisfaction in patient care.”
Goyanko’s position was created in part to improve the student body’s impression of Schiffert Health Center. She also assists in investigating student complaints.
“A lot of it has just boiled down to the student. Or maybe the provider didn’t address the questions or the concerns properly so we try to get with the student if we can and we get with the provider to discuss what could have been done differently,” she said.
The ACHA standards of practice states that effective practice of health promotion in higher education requires professionals to engage in ongoing professional development and service to the field.
Schiffert Health Center, Goyanko said, is committed to offering students the best care possible.
“We are continuously improving procedure. We review them annually and make sure they’re up to date. If we ever run into issues where something doesn’t seem like it’s working right, we’ll go back at that point and do it as needed.”
Patience Baldacci 