Plastic Surgery at a Student-Run Free Clinic: A Review of the Literature and a Call for Access

Abstract

Background: Across the nation, academic medical centers and associated professional schools have established student-run free clinics (SRFCs) aimed at delivering healthcare to underserved populations. Many of these clinics have expanded their services beyond primary care by offering specialty clinics. However, there is limited information available regarding plastic and reconstructive surgery (PRS) related services within SRFCs. The aim of this study is to identify the presence of PRS services in current SRFCs and highlight barriers and opportunities for plastic surgeons to be involved within SRFCs. 

Methods: Aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature review was conducted via PubMed, Embase, and Web of Science from January 2000 to April 2024. Search terms focused on clinical services that are within the scope of practice of a plastic surgeon.

Results: A total of 18 studies where included. Literature addressing PRS in SRFCs is scarce, with only two studies directly examining PRS services in this setting. Shade Tree Clinic in Nashville, Tennessee, is the only SRFC that has shared its experience with incorporating PRS services. This included the management of various hand pathologies, soft tissue masses, and skin cancers. While multiple SRFCs offer dermatological services—primarily focused on identifying and excising skin cancers—plastic surgeons are well-equipped to contribute to these efforts. Additionally, most chairs of plastic surgery departments demonstrated a strong understanding of the local need for these services, though time constraints and financial limitations were cited as significant barriers to their involvement.

Conclusion: Currently, there is little evidence of plastic surgeons assisting with SRFC activities. However, incorporating PRS services into SRFCs can significantly enhance healthcare delivery to underserved populations. The Shade Tree Clinic has shown the utility and high-level utilization of plastic surgeons in a SRFC.