The numbers tell a stark story. Oklahoma ranks near the bottom nationally for health outcomes, with high rates of diabetes and obesity and one of the highest uninsured rates in the country. Roughly one in six Oklahomans lives in poverty. For many adults who are working paycheck to paycheck and uninsured, regular primary care simply isn’t an option.

But for more than 20 years, Tulsa’s Bedlam Clinics at the University of Oklahoma School of Community Medicine have helped fill that gap—and they neatly illustrate the school’s mission. 

Dr. Bo Burns, interim dean of the school, says their students are taught that good care extends beyond diagnosis and treatment. 

“As students learn the practice of medicine, they also learn to navigate the social determinants of health and connect patients with the resources they need,” he says. “This helps improve health outcomes across our city.”

Two philanthropically funded, student-run clinic programs provide free, faculty-supervised care to uninsured adults in Tulsa, offering a medical home for patients who might otherwise rely on crowded emergency rooms or go without care altogether. Evening acute care and long-term clinics—along with a charitable pharmacy and access to fresh produce—address not only medical needs but also acknowledge external factors that shape people’s lives. 

When Dr. LaMont Cavanagh, chair of the Department of Family and Community Medicine, talks about the Bedlam Clinics, he doesn’t start with statistics or even outcomes. He starts with people—the patients served and the students driven to help them.

“We look at families and populations to try to improve the health of the community,” says Cavanagh, OU ’88 BS zoology and ’92 M.D.  The holistic picture of a patient’s life, he says, includes transportation, food security, neighborhood safety and family dynamics, illustrating the foundation of Maslow’s hierarchy of needs.  

“Those things will all have an impact on health,” Cavanagh explains. “It’s called the biopsychosocial model, and all of those factors interact to impact individual and community wellbeing—it’s a collaborative approach.” He points to examples of a city government building sidewalks so residents have a safe place to exercise and travel to resources, and local organizations serving specific populations with targeted services.  

For medical students in Tulsa, Bedlam is where personal values become practice. Third-year medical students and second-year physician assistant students step into student-run, faculty-supervised clinics where they are the primary point of contact for patients. They take full histories, perform exams and present their plans to attending physicians and advanced practice providers. They also might recommend a food pantry or social assistance programs if the patient needs support. 

“The students who apply to the OU School of Community Medicine typically have done a lot of service work even before they get here,” says Cavanagh. “They already volunteer at free clinics, they organize community service, and they want to continue that in their medical journey.” Bedlam lets them do exactly that—learning by doing long before graduation, giving students the chance to continue helping underserved populations. 

Faculty see the difference. When supervising new doctors, Cavanagh notes he can often tell within a half-day in a new rotation which interns have trained at Bedlam. “They’re more comfortable with patients, more skilled in their evaluations and plans, because they’ve already been doing it for a year,” he says. 

From inside the clinic, director Dr. Janelle Whitt watches students transform during their time there. Many arrive for their first shift “very deer-in-the-headlights,” she says, jolted by the nuanced mix of clinical care and system-level problem-solving that comes with serving uninsured patients. A year later, those same students are orienting the next class. “Just watching them realize, ‘This is where I was a year ago, and I really have learned how to get a patient through an office visit’ is one of my favorite things to watch.” 

The evening clinic is staffed by professionals you would find in any medical office—a clinic manager, patient care representative, pharmacist and nurse practitioner. About 11 students work at a time, seeing up to three patients each per evening. 

For Bedlam’s patients, Cavanagh says the benefit is clear: consistent, relationship-based care designed for people who might otherwise fall through the cracks. For students, it is a rare chance to learn medicine and community advocacy at the same time. 

Whitt, who joined the team in 2004, consistently hears from students who might not have recognized how beneficial their clinic experience was. “When they leave and start their internships, they call back and say, ‘Hey, did you know I'm really far ahead of my peers?’ ” she says. “That’s awesome.”

Sara Morrell Cowan is assistant editor of Sooner Magazine.

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