Urgent Improvement in Care

Paul J. Barreira
Director of Harvard University Health Services Paul J. Barreira will step down from his position in June.

As Paul J. Barreira prepares to step down from his post as Director of Harvard University Health Services, he and Harvard University Senior Director of Nursing and Health Promotion Maria Francesconi are taking a much-needed stab at addressing some of the health service shortcomings most immediately felt by Harvard undergraduates. In seeking direct feedback from students, the duo is aiming to improve the quality of healthcare services.

Given the massive overrepresentation of undergraduates in Urgent Care, we hope these improvements will address this possible overdependence, and, if useful, to encourage more widespread engagement with Primary Care services. To that end, we hope HUHS responds to this data by allocating its resources more efficiently, as well as restructuring the process by which undergraduates interact with the Primary Care system.

The data speaks for itself. While undergraduates account for more than 80 percent of Urgent Care visits, only ten percent of students reach out to Primary Care providers before arriving on campus their freshman year — a statistic that, although only available for Primary Care usage prior to freshman year, seems indicative of a broader underutilization of these services.

There are many factors that might explain why undergraduates constitute such a high percentage of Urgent Care traffic. Barreira and Francesconi point to undergraduate’s busy schedules and a general confusion about the assignment of Primary Care physicians. It’s also worth considering the proximity of undergraduate housing to HUHS’s only Urgent Care location — the third floor of the Smith Campus Center, a hub of campus life — in determining whether undergraduates’ disproportionate reliance on Urgent Care is in fact detrimental to student health.


Whether or not this trend is indicative of poor undergraduate access to healthcare, it does point to a need for systemic reform within HUHS. Primary Care services should be significantly improved. At present, as Barreira and Francesconi suggest, the Primary Care system can be daunting for students to negotiate, and that process must be reworked.

Similarly, HUHS should consider putting more effort into the way it connects students with their Primary Care providers. One avenue to explore this would be to send an explicit email introducing students to their Primary Care doctors. Even if this introduction is pro forma, it would likely make students feel more comfortable reaching out to schedule introductory and continued-care appointments. Overall, the Primary Care system and its providers should be strive to always be responsive and readily accessible to students.

Beyond these preliminary suggestions, we look forward to seeing what creative solutions HUHS produces to improve student healthcare. And while Barriera’s long and successful tenure at HUHS has been praiseworthy, his departure provides the opportunity for the University to appoint a successor who understands these challenges and is prepared to tackle them head on. Beyond undergraduate use of Primary and Urgent Care, we hope the new director works to make HUHS and its processes more transparent. Releasing the results of the biannual health survey delayed by Barreira in the fall as well as championing issues of mental health services and opioid usage in the community would be important priorities for a new director.

We continue to be thankful for the effort the HUHS staff puts into providing care to the Harvard community every day, and we look forward to seeing how HUHS pursues tangible improvement to the services it provides under new leadership.

This staff editorial solely represents the majority view of The Crimson Editorial Board. It is the product of discussions at regular Editorial Board meetings. In order to ensure the impartiality of our journalism, Crimson editors who choose to opine and vote at these meetings are not involved in the reporting of articles on similar topics.