Neurodevelopmental Treatment and Cerebral Palsy- Research
MedicalMismanagement&Restructing_DePauw
1. Medical Mismanagement:
Restructuring the Health and Wellness of
DePauw University
EDUC 290A – TPS: Education Policy
Professor Marcelle McVorran
May 18th, 2016
Peter Gorman, Hayley Alder, Anna Werkowski
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Table of Contents____________________________________
Introduction………………………………………………………………………….. 3
Data Analysis………………………………………………………………………... 5
Figure Section………………………………………………………………………... 8
Defining the Problem …………………………………………………………….…. 11
Alliances ………………………………………………………………………….…. 12
Cost analysis/Funding…………………………………………………………….….. 13
Developing Alternatives……………………………………………………………... 15
Reflection ……………………………………………………………………….…… 21
Conclusion …………………………………………………………………………... 23
Bibliography……………………………………………………………………….…. 24
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Introduction_________________________________________
With over 2,500 students on one relatively small campus, it is no wonder that illnesses
travel quickly. Something to reflect at, however, is the lack of sufficient health services on
DePauw’s campus that are supposed to help students who aren’t well. The policy that we have
created falls under two categories of policy type: capacity-building and system change.
A capacity-building policy deals with a long-term investment in the material, intellectual,
or human resources of an organization. It is best used when existing institutions are unable to
produce a desired policy outcome. In our case, the long-term investment we are concerned with
is the health and welfare of the DePauw community. The existing institution of the Wellness
Center is unable to produce a desirable healthcare environment, which is what we are intending
to change.
A system change policy transfers the decision-making power and authority to different
elements in a system. It is best adapted when existing institutions or other agents are unwilling to
respond to demands for change. In our case, the authority over the Wellness Center would
remain the same, but be influenced more by outside officials, like the DePauw Student
Government, student’s parents or guardians, and other healthcare executives.
The main items that our policy intends to tackle are:
● The hours of operation
● The facilities/location
● Staff availability and training
● Enacting a medical hotline to ask general medical questions without having to
make an appointment
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● Allow walk-ins to be welcomed
● More availability of small medical resources such as Band-Aid’s, ice packs,
cough drops, etc.,
● Overall betterment of mental health care staff and services both in terms of
availability, fees and consistency.
We believe with this policy change, the campus wellness for students, staff/faculty, and
even the neighboring Greencastle community will encourage and support healthy lifestyle for all
members of the DePauw and Greencastle community long-term. In addition, the DePauw
Wellness Center needs to take a more holistic approach encompassing all dimensions of
wellness: physical, social, emotional, occupational, spiritual, financial and intellectual. As
students, we are faced with many decisions regarding our health and well-being. DePauw
Campus Wellness should be committed to assisting us with finding the best solutions possible
that fit our interests and lifestyles.
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Data Analysis________________________________________
There were 72 responses to our online survey sent out to the DePauw community. For the
most part, the data revealed opinions that we had assumed were common amongst all students,
but there were some outlying opinions as well.
When asked if they trusted the healthcare system at DePauw, there was an incredible split
in the votes. The two highest chosen numbers of ranking for the healthcare system (on a scale
from 1-10, 1 being the worst and 10 being the best) were the number 1, with 13.9% of votes, and
the number 7, with 16.7% of votes. Most votes on this question were equally spread amongst all
of the rankings, but it showed that there is a divide amongst students as to whether the Wellness
Center can be trusted or not. To see the aforementioned results, please refer to the Figure Section
where the data is listed under Figure 1.
Easily the most telling data that was received was the information that students submitted
on the scheduling process for the Wellness Center. Of the 72 students that submitted responses,
27 students voted that the scheduling process for the Wellness Center was incredibly
unsatisfactory, a 1 on the 1-10 scale. (Refer to Figure 2 for graphical representation).
The third question that the survey asked was “How helpful are the health care officials in
the Wellness Center?” and the responses were well spread out amongst how students felt. The
highest ranked answers were in the range of 4-8, with 66.7% of the votes going to those 5
rankings. For the most part, students felt that healthcare officials were helpful. However, this
general survey told a different story than the write-in submissions that students sent in about
their personal problems with the Wellness Center. When we evaluated the personal stories, most
students found that their experiences with the DePauw healthcare officials was pleasant, but did
not know what they were doing. Most students that responded to our survey said that they or a
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friend had been misdiagnosed by the healthcare center before or “encouraged” to go to Putnam
County Hospital. The only explanation for why there is such a difference in the general survey
and personal stories is the fact that certain students have had worse experiences that others, and
in general, the healthcare officials are friendly and helpful, just not trained/educated correctly.
(Refer to Figure 3 for graphical representation).
The fourth question of the survey was not required as it pertained to the mental health
services of the Wellness Center. The question was, “If applicable, do you trust the mental health
services offered at DePauw?” For this question there were three recognizable areas of student
responses shown in the graph. The three areas were “very untrustworthy, rank 1” “mediumly
trustworthy, rank 3-5” and “total trust, rank 7-10.” The first area had 17.5% of votes, the second
area had 35.1% of votes, and the third area had 36.9% of votes. While the first area, a ranking of
1 on the scale, had the largest individual percentage of votes, the total spread of data presented
the idea that students are torn about this issue. Both sides of the graph had almost equal amounts
of votes, showing that while some students really hate the mental health services, others think it
is fine. A point to consider when evaluating such data as expressed in the first area of Figure 4 is
that people who ranked the mental health services as a “1” probably had reasons for ranking it as
such a low number. These experiences might be considered outliers in the grand scheme of the
survey. (Refer to Figure 4 for a graphical representation).
There were 3 single choice questions on our survey as well. These were questions 6, 7,
and 8. These questions presented us with clear, upfront data that showed exactly how students
felt. When referring to the Figure Section, look at Figures 5, 6, and 7.
The sixth question of the survey asked students, “What is the most important item to you
as an individual?” where the possible responses could be either: location of the wellness center,
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helpfulness of healthcare officials, ability to schedule appointments, or the quality of healthcare.
An astonishing amount of students chose the quality of healthcare as their answer, with 72.2% of
votes going to that answer only. Refer to Figure 5 for a graphical representation.
The seventh question of the survey asked students, “What are your feelings on having to
go to Putnam County Hospital for additional tests that can’t be done at DePauw?” where possible
responses could be either: That’s totally not okay, I don’t have the money for that! or That’s
okay, I can drive/afford it. There were 59.2% of votes for the idea of having to go to Putnam
County Hospital not being okay, whereas there were 40.8% of votes for the idea that this practice
of leaving campus for tests is okay. Although the negative viewpoint has more percent of votes,
there still is evidence to present the idea that this is a contested issue that needs further
evaluation. Refer to Figure 6 for a graphical representation of the data.
The eighth question of the survey asked students, “What are your feelings on students
being charged $85-$165 for missing a psychiatric appointment?” where possible responses could
be either: Seriously? What student has that kind of money? or Hey, they scheduled it. They
should be responsible enough to come to their appointments. This question had an overwhelming
majority vote, 73.6% of votes to be exact, on the answer that thought it wasn’t practical to have
students pay for an appointment they missed. Of the 72 people who voted on this question, 53 of
them voted for that answer. Only 26.4% of students thought it would be okay to charge students
for missing an appointment. (Refer to Figure 7 for a graphical representation of the data).
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Figure Section_______________________________________
Fig 1 shows the differing responses to the question “Do you trust the healthcare system at DePauw?” with varying bars
expressing opinions. The horizontal scale is from 1-10, with 1 being unsatisfactory and 10 being very satisfactory.
Fig 2 shows the differing responses to the question “How convenient do you find the scheduling of appointments?” with varying
bars expressing opinions. The horizontal scale is from 1-10, with 1 being unsatisfactory and 10 being very satisfactory. In this
case, 37.5% of students found the Wellness Center’s process of scheduling appointments unsatisfactory.
Fig 3 shows the differing responses to the question “How helpful are the health care officials in the Wellness Center?” with
varying bars expressing opinions. The horizontal scale is from 1-10, with 1 being unsatisfactory and 10 being very satisfactory. In
this case, there was a wide spread of responses with the most common responses being within the 4-8 range. Within the 4-8
range, 66.7% of students’ votes are represented.
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Fig 4 shows the differing responses to the question “If applicable, do you trust the mental health services offered at DePauw?”
with varying bars expressing opinions. The horizontal scale is from 1-10, with 1 being unsatisfactory and 10 being very
satisfactory. In this case, the spread of data was distributed into three regions of the graph. The three areas were “very
untrustworthy, rank 1” “mediumly trustworthy, rank 3-5” and “total trust, rank 7-10”. The first area had 17.5% of votes, the
second area had 35.1% of votes, and the third area had 36.9% of votes.
Fig 5 shows the differing responses to the question “Going off the last question, what is the most important item to you as an
individual?” The majority of the graph shows that the quality of healthcare is the most important item to students at DePauw.
Fig 6 shows the differing responses to the question “What are your feelings on having to go to Putnam County Hospital for
additional tests that can’t be done at DePauw?” The graph is almost divided equally in half, with 58.3% of votes going to the
negative viewpoint and 40.3% going to the positive viewpoint.
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Fig 7 shows the differing responses to the question “What are your feelings on students being charged $85-$165 for missing a
psychiatric appointment?” The graph shows that a majority of students feel that this practice of charging students for missing
appointments is unacceptable.
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Define the Problem___________________________________
Our goal is to create a DePauw Wellness Program and Center that focuses on creating a
wellness-centered college campus, expanding medical services to students, time availability,
wellness programing, and a new on-site wellness center location. Our main goal is to create a
more holistic and integrated healthcare environment that will enhance health service offerings
that also cater to the immediate and explicit needs of the general student population at DePauw.
Currently DePauw’s Wellness Center is complicated to access due to inconsistent and
short hours, lack of staff, location, and because of how difficult it is to schedule an appointment.
In addition, the health and wellness services at DePauw have so many different focuses, ranging
from wellness programs that most students do not use to offering internships through the
Wellness Center to catering many services exclusively to student athletes and musicians.
Moreover, the counseling services at DePauw do not provide adequate mental health nor is the
fee for missing or cancelling an appointment acceptable.
In addition, through many student surveys, our team has been able to pinpoint the
medical needs of students that are most in demand on top of those already discussed. These
include walk-ins welcome, over the phone consultations or a social media application that works
in the same way a phone consultation would, on call medical staff for emergencies and
immediate after-hours care, no long-winded medical surveys before being able to take advantage
of the mental health or medical services, more localized and certified staff, and writing or filling
prescriptions so students can easily pick them up.
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Alliances____________________________________________
Every policy maker needs alliances to help get their policy through the legal hoops in
order to become an actual mandate. Some alliances for our policy could possibly include:
● The Women’s Center of DePauw, which helps provide care to women in need on
campus.
● The Wellness Center already works in tandem with Hendricks Regional Health
● Putnam County Hospital and LHD Benefits
● Indiana State Department of Health
● Putnam County Department of Public Health and Wellness
● DePauw Chapter of Timmy Global Health, which is a non-profit organization dedicated
to bringing quality healthcare to those in need
We would love to continue our alliance with Putnam County Hospital and potentially
form alliances with the immediate care clinics in Greencastle and throughout Putnam County in
order to help provide sufficient health care to students at the lowest cost possible if any costs
arise at all. In addition, other potential alliances can consist of DePauw Student Government and
other larger organizations on campus such as Timmy Global Health, Phi Delta Epsilon Medical
Fraternity or other Greek houses and/or organizations that all have an interest in assisting our
policy.
Also, we can’t forget other policy groups that are in our class and on campus that would
support our policy by being a good collaboration of partnership. With partnership and
collaboration with other policies dedicated to helping and improving the lives of DePauw
students, staff, faculty and overall community, it is crucial to partner with them.
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Cost Analysis/Funding________________________________
With the current health and wellness policy at DePauw, all students pay a mandatory
health service fee of $304, as of the 2016-2017 school year. For the 2015-2016 school year, the
mandatory health service fee was $146. While the Wellness Center at DePauw forged a new
partnership with Hendricks Regional Health, Putnam County Hospital and LHD Benefits in
order to expand DePauw’s medical services and wellness programs, the only overt changes were
the replacement of medical staff at the Wellness Center. Even though new programs have been
implemented, such as the personal trainer program or a nutrition education program, our data
provided from staff at the Wellness Center revealed that very few, in fact, almost no students
take advantage of these programs. Perhaps this is due to the additional fees an individual has to
pay on top of the mandatory health service fee to use these programs, but DePauw’s Wellness
Center website states that through the new partnership, the university will save $4.7 million gross
and $1.9 million in net savings over a ten-year period. While saving money is beneficial to our
campus and the surrounding community, perhaps the university shouldn’t worry so much over
how much they will save in the long run, but instead focus their funds more towards the health
and wellbeing of their students that are present.
A good portion of funding for our proposed policy will come from the money saved by
cutting programs that are not widely used by students and putting that money towards different
aspects of our policy. Moreover, many programs that we have suggested in our policy are
already offered by health services on DePauw’s campus, however, these services are explicitly
either for student athletes and music school students. If DePauw were to expand medical services
given to student athletes and music school students free of charge to the rest of the general
student population, then there would be no need to establish similar programs that otherwise
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would cost students money they cannot afford to part with. In addition, we believe we do not
need to sustain a partnership with Putnam County Hospital, Hendricks Regional Health, and
LHD Benefits while it is estimated to save money in the long run, it is clear from the data the we
gathered that DePauw’s medical services is not meeting a great majority of students’ needs.
Therefore continuing a partnership with all three of them does not make a whole lot of sense
both economically and effectively. We suggest maintaining a partnership with the more localized
unit, Putnam County Hospital, that way the financial focus for DePauw’s health and medical
services will remain in one area, Greencastle, and will also be giving money to those living
within the Greencastle community rather than in Danville or Indianapolis.
Another program offered by DePauw’s health and wellness offices are the internships and
off-campus studies centered on the medical field. While we acknowledge such educational
programs are beneficial to some students, they require funding and resources that could and
should be put into the betterment of the medical and health services already offered to DePauw
students. If reducing or cutting some programs currently provided by DePauw’s health and
wellness services does not fully cover the funds needed to implement our policy, siphoning
money from scholarships may be a disappointing but necessary alternative; it may mean offering
less scholarships to incoming students in the future or offering less financial aid to potential
students, but if students’ medical needs are not properly met, then they cannot adequately focus
on their schoolwork and therefore the tuition they paid and/or the scholarships they were
provided are not being taken advantage of to their fullest.
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Developing Alternatives_______________________________
In order to address the needs of DePauw’s students in terms of healthcare, our policy
team has looked at the health and wellness policies of other institutions of higher education that
have around the same number of students as DePauw as well as other liberal arts colleges and
universities. Upon our analysis of the medical and wellness services offered at other schools that
reflect DePauw, we have pulled our alternatives from different aspects of each college or
university.
As identified, the counseling services at DePauw do not provide adequate mental health
care to its students, nor is there suitable accessibility to mental health services on DePauw’s
campus due to limited hours and staff. Bethel College offers confidential counseling services free
of charge to all its full-time students, much like DePauw, however, there is never a fee for
missing or canceling an appointment, something like has caused quite a stir on DePauw’s
campus.
In addition, Bethel’s student health services sufficiently meet the medical needs of
DePauw’s students would hope to receive in terms of accessibility. Walk-ins are welcome for
basic first-aid for minor injuries and illnesses. Office hours for medical services at Bethel
College are more consistent and reasonable than those at DePauw’s Wellness Center and our
team suggests modeling our Wellness Center hours after Bethel’s.
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Day of the Week Hours of Operation
Monday 8AM to 5PM
Tuesday 8AM to 5PM
Wednesday 8AM to 8PM
Thursday 8AM to 5PM
Friday Appointment only
Fig 8 shows the days of the week that the Healthcare Center at Bethel is open as well as the time frame that students can come in.
While Bethel’s office hours would be an improvement if applied at DePauw, we suggest
having hours on Friday as well, from 8AM to at the very least 4PM and allowing Saturdays for
appointments, only that would obviously have to be scheduled in advance.
Carleton College also allows for walk-ins as well as appointments for more serious
injuries and illnesses, however, the one medical service they offer that we believe should be
offered at DePauw is a phone consultation. Students can call the medical center and ask
questions pertaining to their symptoms, medications, and everything in between and are
consulted by a certified RN (there are always at least two working the phones at all times).
Offering phone consultations would not only be helpful and informative for students, but it
would also save the medical staff precious time because those students who may not need to be
seen by a physician, say they simply had allergies unknowingly, and instead of taking up the
time of a medical provider, a phone consultation would let them know they only needed over the
counter medicine.
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Amherst College provides extensive health services to its students; and while DePauw
does offer a portion of the same services as Amherst, a lot of the time students have to go
somewhere else on campus (or even off campus) to receive care for a certain medical issue.
At Amherst, the following health services are all offered at one location: acne treatment
(including Accutane), acute illness and injury care, athletic preparticipation physical exams,
athletic injury care, asthma and allergy care (including allergy shots), chronic illness care,
contraception information and prescriptions, diabetes care, drug and alcohol counseling, eating
issues, emergency contraception (“morning after pill”), flu shots, eye health services,
gynecological exams and pap smears, immunizations of all types, men’s health concerns,
laboratory, nutrition counseling, prescriptions (can fill prescriptions for easy student pick-up),
physical therapy, pregnancy testing, options counseling and referrals, radiology (x-ray) exams,
senior health review, specialist referrals, STI testing and treatment, study abroad medical forms,
suturing (stitches), travel medicine and vaccinations, and women’s health concerns. This long,
vast list of health services should be universal on all college campuses. Moreover, all medical
services are paid for in the tuition and does not include a mandatory health service fee; In
addition, any off campus care that a student might need that the school could not provide is
covered by the “supplemental” insurance all students have that is provided by Amherst.
Location is another issue that DePauw students have with the Wellness Center; currently
it is located in Hogate Hall, which is not only on the outskirts of campus but also is in an area
that is really only convenient for freshmen and the three Greek houses that are in the nearby area.
On DePauw’s campus, there are numerous buildings that have been left empty for years or that
will be empty in the coming year, they include: the Delta Zeta sorority house, the Delta Chi
fraternity house, the Hub, and Sigma Alpha Epsilon fraternity house. While Delta Chi and Delta
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Zeta would not be good options due to their location on the ends of campus, the Hub and Sigma
Alpha Epsilon will both be standing empty come the 2016-2017 school year and both are in a
more central location on campus and are sizable enough that DePauw’s health and wellness
services could easily be expanded and would also benefit more students.
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Attracting Attention__________________________________
It is a well-known fact that the students of DePauw know about the problems with the
Wellness Center. We don’t necessarily need to attract DePauw student’s attention on our campus
because they are well aware of the problems that exist throughout the Wellness Center. The
DePauw Wellness Center and program is focused on creating a wellness-centered college
campus, with minimal medical services and staff, time availability, wellness programing, and on-
site locations. The concept of health and wellness at DePauw has become restricted and does not
benefit the general student/staff population. DePauw students (and some faculty/staff) are the
ones who have to experience the problems and issues that coexist with the current Wellness
Center policies first hand. As DePauw students, we are the ones paying for some of the funding
that the Wellness Center receives due to the Student Health fees every semester. Sadly enough,
we don’t have the biggest say in changing the policies unless we attract different audiences.
Those that need to be informed about the problems that are plaguing students at DePauw are 1)
our parents/guardians 2) DePauw Alumni 3) Board of Trustees and 4) those who will be funding
our policy endeavors (whether that is an outside source, organization, grant or individual).
When attracting attention to “outside” parties and audiences such as our parents and/or
guardians, they are the number one target audience to attract. Most, if not all of our parents are in
some way, shape or form, helping us pay for our college tuition, including our health and service
fee. When letting their kids go off to college, to live on their own, and simply be separated from
them raises a lot of parent anxiety, concern, and challenges. Especially if their child goes off to
college far away from home, the pain of separation raises big concerns. They worry about illness,
safety, happiness, in short, all of the things they have fretted over since they first had their
children. So, if we attract our parent’s attention on the issues with the Wellness Center, it will
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pressure DePauw University, Hendricks Regional Health and others to support, and fund our
policy for a new, improved Wellness Center. This goes the same for DePauw Alumni, Board of
Trustees and other outside sources, organizations, grant programs or individuals.
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Reflection___________________________________________
According to the Wellness Center, on average, medical staff see 162 students per week
with each appointment session lasting from 20 to 25 minutes. Our policy team decided to
calculate these numbers ourselves to see how they compare to the statistics provided by the
Wellness Center. We calculated how many hours each day that the Wellness Center was open,
excluding an hour each day that is closed for lunch (from 12PM, noon to 1PM). We then used
the average time of an appointment to figure out how many students could been seen per day.
Hours Open Minutes Open # of students a
day for a 20
minute sessions
# of students a
day for a 25
minute sessions
Monday 6.5 390 16 20
Tuesday 6 360 14 18
Wednesday 4.5 270 12 14
Thursday 6 360 14 18
Friday 4 240 10 12
Saturday 3 180 7 9
Total 30 1800 73 91
Fig 9 shows how many students can be seen per certain amounts of time of the days during the week. Used to show how much
traffic goes through the Wellness Center for the size of facilities that they have a the current point of time.
Referring to Figure 9, if the Wellness Center was correct in stating that each appointment
lasts anywhere from 20 to 25 minutes, there is no feasible way that the medical staff at the
Wellness Center could see and treat 162 students a week even if some appointments last longer
or shorter than the average 20 to 25 minute range. This discrepancy made our team question not
only how trustworthy the health and wellness services are on DePauw’s campus, but also how
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accurately students are being diagnosed and treated. Again, through our survey given to DePauw
students, we were shocked by the surprising amount of students who informed us through our
survey that they have been misdiagnosed and mistreated, many of these cases were more than
once as well. One student claimed that after being misdiagnosed twice, they ended up with a
collapsed lung and had developed severe asthma. Our team wonders if a lot of the misdiagnosing
and improper treatment stems from the fact that all the actual doctors (that is, MDs) rotate which
days they work and aided by the fact that most students are seen by the Nurse Practitioner (NP)
and never followed up with by a MD. Hiring more MDs from the area would not only allow for a
more personal doctor/patient relationship, but would also decrease the chances of students
getting misdiagnosed and mistreated. DePauw is so heavily medicated that allowing for a more
personal doctor/patient relationship at DePauw will help decrease substance/medical abuse, and
overall make the DePauw Wellness Center one that is enjoyable to go to.
Lastly, for our team, the part that really stunned all of us was the fact that there are
extensive medical services offered to student athletes and student musicians that are not available
to the general student body. When you sign up for an appointment online, you have to decide
from a drop down menu what “type of student” you are: Music, Athlete or other. While
expanding many of these exclusive services to campus as a whole would cost more money than
what it does now, we believe if DePauw truly cared about the overall health and wellness of all
its students, the DePauw Wellness Center would not just have specialized services, appointment
booking and doctors just for music students or athletes. This makes us reflect on how medicated
DePauw actually is?
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Conclusion__________________________________________
All in all, with the responses that we received from our online survey and data from
online sources, we can conclude that there are severe problems with the DePauw Wellness
Center. What our policy is proposing, however, is a checklist of manageable options for the
healthcare system to be changed in ways that will make life better for everyone. With alliances
like Hendricks Regional Health, Putnam County Hospital, LHD Benefits, and The Women’s
Center of DePauw, the students of DePauw will have more options for beneficial healthcare.
With these new policy put into action, more students will be able to be treated––with less
misdiagnosing––as well as avoid unneeded charges from missing appointments. The scheduling
process will be made more efficient, time for walk-in appointments will be allocated, more staff
with be acquired to better serve students in need, and an online messaging system will allow
students to ask medical questions without having to enter a waiting room. Other universities
similar to our size have healthcare systems in place that are comparable to the policy additions
that we have created. With concrete examples and helpful alliances, we believe that our policy
can come into play at DePauw and make the community a healthier place.
