University Health Services builds medical staff with two new hires

University Health Services (UHS) recently hired two new doctors, Brent Nielsen and Jacob Prunuske. Jonathan Zarov of UHS sat down with the two to hear their thoughts on working in college health. An edited transcript of their recent conversation follows:

Zarov: What do you like about working in college health?

Brent Nielsen: My favorite part is being a part of the students’ lives. It’s a fun, challenging population.

Jacob Prunuske: For me, it’s the opportunity to make a difference in someone’s life. If I’m, say, taking care of someone who is 65 and already has diabetes, heart disease and high blood pressure, I can manage it, but only so far. Here is a pivotal age in someone’s life where they can choose to make healthy decisions when forewarned, or not, and I have an opportunity to practice some preventative medicine to try and keep these health problems from developing. Not just with medical problems, but with sex and drugs, rock ‘n’ roll, smoking and all the other health-related lifestyles.

BN: It’s fun to be part of a college atmosphere. I worked at Indiana University for six years and you’re not just a physician. You can help in so many other areas, doing things that physicians out in the community probably wouldn’t get time to do.

JZ: How do you talk to college students who think they are invulnerable?

JP: It’s a teachable moment, because generally I’m seeing someone when they are ill or having problems. I can talk about how smoking makes their asthma worse. Or if I’m seeing someone with a cold, I can talk about how smoking makes them more likely to get a cold. People still look up to their doctors. We’re not their parents. I’m not just one more family member telling them to do this or not do this. We are maybe the first powerful person to treat them as an adult.

JZ: You are both relatively young. Do you think that helps you communicate with college students?

BN: I’ve worked in many clinical settings around the nation, and I find that students are much more receptive than other people I’ve worked with. They’re well educated, interested in learning. I do think that it’s nice to be a young physician, because you can say, “I understand what you’re going through, I’ve gone through the same stuff, and trust me, I can help you out.”

JP: Most students want to be helped; they want to live good lives. They want to do what they want to do, without limitation or pain. I agree with what Brent said: It’s an educated population. They want to get back to class, graduate and be successful with their lives. We take a health perspective on that, but really what we do is much more than prescribing medicine. We’re helping them get the most out of their time, classes and personal relationships.

JZ: Students at UW–Madison are particularly resistant to changing behavior around alcohol abuse. How do you work on that?

JP: Wisconsin being full of Wisconsinites, people will drink. I try to make sure they don’t get hurt in the process, to make students more aware that when you’re drunk, you are more likely to be raped, robbed or to hurt yourself. You’re more likely to hurt someone else, to do something for which “I’m sorry” won’t be good enough.

BN: The year after I was hired at Indiana, they were rated the No. 1 party school in America, so this is familiar territory. You take every opportunity you can. If I see someone where drinking clearly was involved in a problem, I point it out. Sometimes they don’t see it — some over-the-counter medications, stimulants — people don’t understand what can happen when these drugs are mixed with alcohol. I try to use their daily life as an example. If you can use some teaching point, that’s the best way.

JZ: Are there differences between how you define student health problems and how they define their health problems?

BN: I don’t really have an agenda. I like to ask everybody that comes in, “What are you studying. How are you doing in school? Are you having any trouble?” So I basically listen.

JP: Every person who comes see me does so for a reason. Sometimes it’s what they say it is, sometimes it’s not. If I can figure that out, I can provide better health care. Oftentimes, I’ll see someone a few times for simple things — sore throat, runny nose, ear infection — before they decide they’re comfortable talking to me about something more important in their lives, whether it’s pressure and anxiety, a history of abuse, alcohol, drugs, sex — or something that’s more socially taboo. We can develop ongoing relationships with students and provide better care because of it.

JZ: What does a college health service offer that would be lost if it were outsourced?

JP: Our people are truly experts in college health. What we do is different than what a general practitioner does. There are a number of health issues that, while not unique to college health, are concentrated there. The general doctoring community might see a case of mono. We see many cases in a day. The same goes for eating disorders, we see many more. The fact that we deal exclusively with a college population means we have greater experience with the relevant health issues, including the range of presentations. We also offer convenience; we’re right on campus. And we’re basically free — most of what we do is covered by their segregated fees. We can almost always see students on the same day they call; there are very few community centers that can manage that.

JZ: As physicians, you’ll be supervising residents in the teaching program. Why is a teaching program important?

BN: It makes your staff better because you have to be more on your toes and more up to date. A student health center is unique. Medical students can see here what other people don’t generally see.