At IMAGINE, everyone is welcome. Patients don’t need a health card or ID to be seen by a healthcare provider. Most importantly, the services and medication provided to patients are completely free of charge.

Originally conceived by MD-PHD student Sagar Dugani in 2007, the clinic’s name is an acronym for Interprofessional Medical and Allied Groups for Improving Neighbourhood Environments. Housed in the Queen West Community Health Centre (168 Bathurst Street), the clinic is open every Saturday from 10 a.m. until 2 p.m..

Co-director Enoch Ng explained that inspiration for IMAGINE was twofold. “In particular, the homeless population, and people who don’t have OHIP were falling between the cracks,” Ng explained. The absence of community outreach programs that specifically addressed the healthcare needs of marginalized populations prompted a team of medical students, led by Dagani, to put their heads together to create something better.

The growing emphasis in the healthcare sector on interprofessionalism also influenced the creation of the clinic. “In the future, healthcare won’t just be provided by physicians, but by whole teams, including doctors, nurses, social workers, pharmacists, physiotherapists, and the list goes on.” Ng said. Although there had been much talk of interprofessionalism across and within these disciplines, many University of Toronto students found that there were not many opportunities to gain first-hand practical experience in a team setting.

Each week, the IMAGINE team consists of one medical student, one nursing student, one pharmacy student and one social work student. All the students work on an unpaid volunteer basis. The students are supervised by preceptors from each of their fields, and work as a team to conduct assessments and design courses of treatment for the patients they see.

IMAGINE’s other co-director Yick Kan Cheung, explained, “It’s kind of like any walk-in clinic at first; when you come in, we ask what’s wrong, and try to figure out to help address that one complaint. But upon investigation we’ll ask, ‘Why do you have a cold?’ and find out that the answer is, ‘Oh I live on the street.’” The social determinants of health thus play an important role in evaluating a patient’s healthcare needs.

According to Cheung, that’s the beauty of an interprofessional team. “We can utilize all the different aspects of the team; it’s really holistic care that we’re trying to provide. So we do treat the cold, the medical aspect, but we also treat the social aspect by asking things like, ‘What else is going on in your life?’”

“The people that we see coming into our clinics are not just people who are on the street,” said Ng. “Other people who come in are refugees, people who are getting ready to claim refugee status or recent immigrants.” He noted that sometimes people will bring family members visiting from other countries who don’t have insurance here, or at home. Cheung added, “We see a lot of families in general. Usually the family will bring one person in, but upon further probing, we find other ways that we can help the whole family.”

As the clinic is open on Saturdays, people who work during the week have the opportunity to seek care without compromising their job security. Because the students are able to prescribe and hand out certain medications (with the exception of narcotics and benzodiazepines), a visit to IMAGINE can often bridge the gap between visits to other clinics--or between payments for much-needed prescriptions.

When a patient comes in, the initial interview may be conducted by any combination of students from the four disciplines. “The benefits are that there are so many different perspectives that are brought to the care of any client that comes in,” said Ng. He elaborated, “We won’t get stuck just thinking from a medical or pathological perspective. “With a social worker present we can think about social determinants of health like housing and food security, and with a pharmacist around it’s helpful to think about drug interactions, especially how we could change the drugs we prescribe so that they can be covered under ODSP [Ontario Disability Support Program].”

One of the most important aspects of the interprofessional healthcare experience is the idea of viewing the patient as part of the team. In addition to the provision of medical treatment and social support, the clinic aims to empower the patient, involving them in decisions about their own care.

Another important goal is to make sure that people in need know about IMAGINE. “Right now we’re trying to find out how we can better access the population,” said Cheung. “We find that it’s a lot of word of mouth. Often, clients won’t go somewhere unless someone they trust tells them, ‘Hey, go here. They can help you.’”

IMAGINE was designed to meet what students identified as a healthcare gap, and to provide an invaluable opportunity for hands-on education. “It really takes a village to raise a child . . . [and] people are people, regardless of their status,” commented Cheung. Through its ethos and design, the IMAGINE clinic offers a thorough, well-rounded and compassionate healthcare experience to everyone who walks through the door.