by Brinna Ludwig
Last spring, aftering hearing about some problems students had been having with the Student Health Center H*yas for Choice launched a survey to find out more. When the responses began coming in, I felt shocked: although some people left the Student Health Center satisfied, many left feeling defeated and disempowered, especially if their visit was related to sexual or reproductive health. After reading other people’s experiences, I needed to see for myself. This is my experience getting screened for sexually transmitted infections (STIs) at the Student Health Center, and, as you might have guessed, it was not a pleasant one.
I scheduled my appointment on Friday, October 21. I made the appointment in the morning to avoid long wait times, I called my parents to see which lab my insurance company covers, and I even made sure to eat a well-balanced breakfast. Most sexually active individuals should be screened for STIs at least once a year, or with every new partner. I had not previously taken the initiative to get screened in part because the Student Health Center does not promote free and anonymous STI screening. Many other universities promote free and anonymous STI testing, partly because students are such a high risk population. People between the ages of 15-24 account for half of new STI cases. The fact the Georgetown fails to provide this basic service is not just discouraging, but negligent.
I arrived to my appointment a few minutes early to sign in and give the Student Health Center my insurance information. Because the Student Health Center does not offer free and anonymous testing, I had to pay a $20 copay to see a nurse practitioner. Since I was displaying no STI symptoms, seeing a any healthcare provider seemed unnecessary. I knew exactly what I wanted to be screened for: syphilis and HIV with a blood test, and gonorrhea and chlamydia with a urine test. If the Student Health Center provided free and anonymous STI screening, I could have avoided both the copay and the appointment time.
Once I actually saw the provider, she asked me a few questions and recommended that I be tested for HIV, syphilis, gonorrhea, and chlamydia. It was all going according to plan. I didn’t think to ask my provider about the different labs because I wrongly assumed that she would look and see what my insurance covered. She handed me the scripts for the tests and told me to wait in line for the Student Health Center lab. This confused me because the Student Health Center works with Quest and my insurance only covers LabCorp. At that point I still trusted the system and waited patiently. Once in the lab, I was going through the basic information with the nurse and requested that my lab work be sent to LabCorp. She seemed confused, as if no one had ever used LabCorp before. Fun fact: the main labs the nation’s biggest insurers cover are Quest and LabCorp, so I am in no way in the minority with my insurance coverage. Finally, after the office was aflutter with confusion, as if I had suddenly asked an intriguing but difficult question like, “is a hot dog a sandwich?”, “when is ‘Y’ a vowel?”, or “are all Sesame Street puppets muppets?”, I was given two new scripts and told to go across the parking lot to the hospital lab.
I promptly walked across the parking lot and entered the hospital. After having to ask for directions more times than I care to admit, I found the lab. I had to go through another intake process and wait for them to call my name. Because I was at the hospital lab, there were significantly more patients. It felt like all of Georgetown Hospital was there. One man even came in with a green bucket with some kind of biomedical sample, (I spent my time speculating what was in the bucket. My ideas included: hairball, kidney, and a blood bucket à la It’s Always Sunny in Philadelphia). I am making light of my experience, but in actuality, I was scared. Being in a hospital by yourself is scary, and I felt uncomfortable using a hospital lab for STI screening, even though I knew that’s why they were there.
When my name was finally called, I was informed that one of my scripts was incompatible with LabCorp, which tells me that my provider was not accustomed to writing orders for LabCorp at all. This meant that I had to return to the Student Health Center to get the proper script and then resubmit the form at the hospital lab. Luckily, they were able to take the samples without the script, so I did not have to wait in the hospital lab again. Unfortunately, the Student Health Center does not seem to share the same views on customer service. I had to wait another half an hour at the Student Health Center to get the script and my provider did not even apologize for the situation. At long last, I was able return to the hospital lab and hand them the script. Finally, the saga was over.
The whole process took over three hours. I do not write this to complain. I write this because it points to a larger issue within the Student Health Center. I worry about other students, who may not be aware of which lab their insurance covers and may unnecessarily pay for services that are covered by their insurance.
Leaving the hospital lab that day, I felt disempowered. By getting screened for STIs, I was supposed to be exercising agency by exerting control over my sexual health. The whole process left me exhausted. I, a senior in college, a healthcare management and policy major with extensive knowledge of the healthcare system, and co-president of H*yas for Choice, struggled to navigate the system. But alas, that was not the end of my story.
After waiting more than three weeks for my results, I called the Student Health Center. Soon, my provider called me and told me they couldn’t find my results and that I could come in again to get tested. Obviously, that was the last thing I wanted to do given the odyssey I had endured almost a month before. When I finally got the call that my tests were normal, almost a month had passed. From my rigmarole, I learned a few things about the Student Health Center:
- If the Student Health Center offered free and anonymous STI screening, I wouldn’t have had to go through any of this
- At that point in October, the Student Health Center seemed completely unable to deal with LabCorp, despite the large subsection of the student population whose private health insurance requires its use
- Students did not seem to be top priority at the Student Health Center
It’s taken me a long time to write about my experience because it was so unpleasant. I didn’t want to revisit the feelings of confusion at the Student Health Center, my fear at the hospital lab, or my aggravation at trying to get my results. Ultimately, I don’t think my experience is all that unique. I know there are students sent to the wrong lab and billed for their tests. I know there are students who never follow up about their test results. And I know that people are often misbilled. That’s why H*yas for Choice launched our Student Health Health Center survey. We want to hear it all because we want to know the problems and find ways to solve them.
Brinna Ludwig (NHS ’17) is a co-president of H*yas for Choice.