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Health Center Fact Finding

One of the goals of EphBlog is to make it easier for current students to tap the collective knowledge of Ephs of all ages. The closing of evening hours for the Health Center, last year’s cause celebre, provides such an occasion. The students interested in this topic have all sorts of questions: about medical liability, Masschusetts laws, and the like. They have questions. Do we have answers? Here is an introduction from Noah Smith-Drelich’s ’07:

My interest in medical malpractice/insurance stems from my ongoing investigation into the health center hours change. Since the change was announced last year I’ve been working on this project (this is actually how I initially got involved in this sort of stuff at Williams — I did so much independent work on the health center that I was appointed to the CC health center task force despite not being on CC . . . which in turn piqued my interest in joining CC.). This past year I’ve been a CC member of the task force. Over the course of the year I’ve worked at collecting legal opinions on the subject as one of the reasons for closure that we were told was that there were legal difficulties with keeping it open. I’ve spoken with several alumn lawyers but have had difficulty finding any knowledgable about this specific field, so I greatly appreciate your help here. I still believe that it is important for Williams to have a 24 hour health center, and while I’m not optimistic about this happening in the near future, I will try nonetheless. Feel welcome to post about this on ephblog. I’d be happy to elaborate on why I believe that having a 24 hour health center too if you’re curious.

Students interested in this topic should feel free to post specific questions about this issue in the comments. EphBlog has many lawyer and other professional Eph readers. Perhaps answers will be provided.

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#1 Comment By Loweeel On April 18, 2005 @ 3:22 pm

As I am not (yet) a lawyer, I am unable to give legal advice.

However, I think it would be a good avenue of legal inquiry to consult with an actual lawyer whether a properly-worded liability waiver (say, signed by all students during first days, updated semesterly like signing the honor code or on colrain when registering for classes) would be sufficient to waive liability against the health center/williams college for “bad outcome cases” (or at the least force medical arbitration) as distinguished from other issues like recklessness, as a condition of using the health center.

But like I said, I’m not a lawyer and I’m completely unfamiliar with MA law. So my non-lawyer advice would be to consult with a MA lawyer who specializes in health care law and/or med-mal defense.

#2 Comment By hwc On April 18, 2005 @ 4:33 pm

It seems to me that the legal liability issues are not the problem, but rather just another symptom of the problem. The problem is that a small minority of Williams students are drinking themselves into a coma on a too frequent basis.

Morty can try all the rules and regulations he wants, but a much more direct approach would be to tell the crack staff of professionals in the admissions office to simply stop admitting the hardcore boozers. The Harvard studies show that 75% of college binge drinkers were binge drinkers in high school. It wouldn’t be too difficult to correlate the alcohol poisoning cases with admissions profiles. Or heck, just ask the applicants to write a “Why Williams?” essay and start chipping away at admits who sound like an alcoholic haze is their primary interest.

I find it impossible to believe that a school with an applicant pool as strong as Williams can’t find 500 kids who are smart enough not to drink until they have 0.40 blood alcohol levels.

If, in looking at alcohol abuse profiles, Nesbitt finds a correlation with certain valued admissions groups, well then Morty will have to make some choices.

It is really not fair to make the 75% to 80% of Williams students who aren’t regular neanderthal drinkers pay $40k a year for a premium educational experience to put up with such disruptive behavior. I mean, honestly? Cleaning feces off the walls? At a school with a 1425 average SAT score? Stop with the closing the health center and security walkthrus and just get rid of the misfits.

#3 Comment By (d)avid On April 18, 2005 @ 7:03 pm

hwc, an application question such as “How many alcoholic drinks do you consume in an average week?” would allow the admissions office to weed out drinkers, if the question were to be answered honestly. Of course, very few binge drinkers would answer such a question honestly. Similarly, an essays asking “Why Williams?” would be more likely to generate boilerplate than any insight on drinking habits.

The admissions office can glean many things from admissions essays, test scores, letters of recommendation, and surveys, but I doubt binge drinking is one of them.

By the way, is there any danger of the college being sued because the Health Center is NOT open at night? Say a kid has an ailment that is worsened because he has to be driven to North Adams Memorial (or wherever the hospital is) rather than taken to the health center. If most peer institutions maintain 24 clinics, couldn’t make a reach for negligence on some sort of “reasonable college” standard? Admittedly, it is a stretch, but so are the law suits where the student drinks too much, receives reasonable medical care, and then sues because of adverse outcomes.

#4 Comment By hwc On April 18, 2005 @ 9:31 pm

David:

Yes, the questions on the application would have to be more subtle than that. For example, you could list three dozen positive attribute of the school and ask the applicant to check the ones that appealed to them. Bury a couple of ringers like “Work hard/play hard”.

A more foolproof way would be to simple correlate your alcohol poisonings with the appliations: school attended, amount of financial aid, race, EC activities. If you see a pattern — say white males on a given sports team from a particular type of school, just stop accepting them. I mean, if the last six kids you’ve accepted from Acme Prep are all hittin’ the bottle hard, it doesn’t take an Astrophysics Professor to figure out that maybe the kids from that school are already boozers before they get to Williams. You only need to weed out a few to change the campus culture.

To be sure, a campus with a high binge drinking rate does encourage high school non-drinkers to start, but not at a great rate. Only 25% of the college binge drinkers in the surveys were NOT binge drinkers in high school.

I think Williams “binge drinking” rate is right around 45%, meaning five drinks in one sitting in the two weeks previous to the survey. Getting buzzed (but, stopping short of puking or a comatose ambulance ride) once a week on Saturday night is not the problem, IMO. However, according to national trends about half of those binge drinkers do so more than once a week. It’s this 20% of the campus, boozin’ two, three nights a week that creates a sense of an alcohol haze to those around them. I’m pretty sure that the lunkheads smearing feces on the walls come from this group. This is the group of admittees you really want to target. I’m pretty sure that today’s Ephs can look around and see who they are.

Small differences really change the campus culture. For example, the difference between a surveyed 30% binge drinking rate and a 45% rate is HUGE in terms of how the campus feels. There’s still plenty of booze, plenty of parties, but non-drinkers and occasional drinkers don’t feel like they are marginalized. It doesn’t seem like the whole campus is getting plastered.

#5 Comment By Jim On April 19, 2005 @ 2:28 am

If you are genuinely trying to understand the legal issues behind the closure I would start with the school’s insurance policy. As far as I know, the reason for the change was less about binge drinking, and more that the insurance company was not willing to take on the liablity of housing students overnight (like a hospital)for whatever reason. Since no other school our size takes on the liability of “hospital-like” services you should look into when and why they changed their policies.

In my opinion, the school should put more resources into the clinical services that are most needed such as in house psych services – this may reduce the levels of dangerous alcohol consumption on campus.

#6 Comment By David R On April 19, 2005 @ 3:06 am

Going back to last year, I distinctly remember college authorities (more specifically, Dean Roseman, if my memory serves me correctly) saying that the closure of the health center was not a matter of insurance. It was said that, while the college could purchase an umbrella policy that would cover Williamstown Medical Associates, the key risk for those involved was the loss of medical licenses.

#7 Comment By hwc On April 19, 2005 @ 3:22 am

[quote]Since no other school our size takes on the liability of “hospital-like” services you should look into when and why they changed their policies.[/quote]

I’m not sure how precisely you mean “our size”, but there plenty of small liberal arts colleges that provide 24/7 on-campus health centers with overnight beds.

Swarthmore’s health center provides overnight infirmary beds for stays of up to ten nights (good grief) at no additional charge. This includes nursing services, that stops short of IV drips. They also have in-house staff psych services — two full-time psychologists, a clinical social worker, and an outside consulting psychiatrist.

I checked two others. Smith has two kinds of overnight beds — infirmary care beds with a nightly charge of $400 and free beds for students who don’t need nursing care. I presume these free beds are for maybe a flu bug where the kid just needs to be “sick in bed” for a night, but doesn’t really require nursing care. I don’t know which serves as the drunk tank.

Davidson has overnight infirmary care, with an additional fee like Smith.

Speaking of drunk tanks. That gives me an idea. Maybe colleges should build replicas of the Mayberry jail and put the drunks in a cell like when Otis used to sleep it off? I wonder what the insurance would be on something like that?

#8 Comment By (d)avid On April 19, 2005 @ 9:23 am

HWC, I’m not sure that binge drinking would be correlated with many pre-college factors. My limited study found substance use (alcohol and marijuana) were orthogonal to most other attitudes. I’m not sure red-lining certain schools or towns would be political palatable, either.

As for sports teams, I suppose the hockey and football players are more likely to drink in college, but I suspect that has more to do with the team culture on campus than anything inherent in the sport. Doing away with the hockey and football teams isn’t going to happen any time soon. And the same problem exists for teams that are not recruited by the college and have no coach (e.g., rugby and WUFO … I don’t know if water polo is a club sport, but it would fit the bill as well).

In short, while I very much like the “work hard / play hard” question, I am still dubious that admissions can weed out the binge drinkers explicitly. In fact, binge drinking might be a fact of contemporary college life; I have yet to be on a campus where there are not concerns over the behavior … even dry campuses.

I reckon the best admissions can do is to admit students they think will take classes relatively seriously. The college should then try to discourage hazing episodes and foster a responsible drinking climate like under the old party policy (hosting parties is easy but no more than 3 kegs per 200 people or something like that).

Maybe clever questions like “work hard / play hard” would offer a clear discriminant. But I’m not sure a campus full of people who instinctively disagree with either proposition (working hard or playing hard) is a good thing for Williams or any college.