Health Care Systems Articles
(Public Health/Interdisciplinary Ambulatory Community Selective)
 
Contact information: Merle Lenihan, MD, FACOG
msleniha@utmb.edu, cell phone 281-772-0198
St. Vincent’s Episcopal House 763-8521
 
The following readings should be done prior to the Monday clinic when possible. We will set aside time at the end of 
the day to review the readings and allow you to reflect on the clinic day. Please be thinking about whether these 
readings are helpful to you and whether there are other topics we should cover. Your feedback is important. 
 
Week 1: St. Vincent’s House Orientation/Introduction
1. Merle Lenihan, M.D., FACOG, “St. Vincent’s House Free Clinics”.
 
Rethinking the Gynecologic Exam
1. David Hellerstein, “Touching,” in On Doctoring: Stories, Poems, Essays, Richard Reynolds and 
John Stone eds., New York
2. Atul Gawande, “Naked,” New England Journal of Medicine, 353:18 (2005).
 
Week 2: Free Clinics 
1.   Eileen Salinsky, “Necessary but Not Sufficient? Physician Volunteerism and the Health Care Safety Net,” 
National Health Policy Form Background Paper, March 10, 2004. 
2.   David Buchanan and Renee Witlen, “Balancing Service and Education: Ethical Management of 
Student-Run Clinics,” Journal of Health Care for the Poor and Underserved 17 (2006):477-485.
3.  Arthur Garson, “Heart of the Uninsured,” Health Affairs 26 (2007):227-231.
 
Week 3: The Uninsured
1.      Kaiser Commission on Medicaid and the Uninsured, The Uninsured: A Primer. Key Facts About 
Americans Without Health Insurance, October, 2006.
2.      David Kilgore, “The Imaginary Safety Net,” JAMA, 296 (2006): 1701-1702.
3.      Medical Student JAMA, Covering the Uninsured, March 2003. (Several short articles).
4.      Jonathan Oberlander, “The Politics of Health Reform: Why Do Bad Things Happen to Good Plans?” 
Health Affairs, Web Exclusive, (27 August 2003).
 
Week 4: Health Disparities and Socioeconomic Determinants of Health
1.      Kaiser Family Foundation and American College of Cardiology Foundation, “Racial/Ethnic Differences in 
Cardiac Care: The Weight of the Evidence,” Report #6040, October, 2002.
2.      Joseph Betancourt, and Owasu Ananeh-Firempong, “Not Me!  Doctors, Decisions, and Disparities in 
Health Care,” Cardiovascular Review Report, 25: 3: 105-9, (2004).
3.      Vanessa Gamble, “Under the Shadow of Tuskegee: African Americans and Health Care,” American Journal 
of Public Health 87 (1997):1773-1778.
4.      Vanessa Grubbs, “Good for Harvest, Bad for Planting,” Health Affairs 26 (2007): 232-237.
5.      Stephen Isaacs and Steven Schroeder, “Class – The Ignored Determinant of the Nation’s Health, 
New England Journal of Medicine 351 (2004):1137-1142.
6.      Kevin Fiscella and David Williams, “Health Disparities Based on Socioeconomic Inequities: Implications for 
Urban Health Care,” Academic Medicine 70 (2004): 1139-1147.
7.      Fitzhugh Mullan, “The Yellow Baby,” Health Affairs 22 (2003): 234-238.