Reflections from Dr. Austin's talk: "Managing Homelessness in the Ed"

Beyond providing community service opportunities, Street Medicine Coalition prides itself on putting together educational events for Creighton Medical students to learn more about the unhoused community in Phoenix and how various social determinants impact their health outcomes. On September 16, 2025, we were joined by Dr. Scott Austin, an Emergency Medicine resident at COPA EM for his talk on Managing Homelessness in the ED. Here are some student reflections from the event:

"Dr. Austin had a very engaging talk. Not only was he clear where he stood opinion wise but he did a good job of communicating factual information to allow us to draw our own conclusions. I really liked the way he set up his cases and let us learn more about the unhoused community in PHX area while coming back to the cases and getting more information about each case. I did not have a good understanding of what the unhoused cormmunitity was like here in PHX and I really enjoyed getting the opportunity to learn about it through the context of the ED. It was a very interesting talk and I hope he is able to come back!"

"I really appreciated the insight that Dr. Austin shared with us. He offered humanity and kindness to a very challenging situation in our society. He kept it light but also serious at the same time and it was very understandable. He spoke through a human lens and ensured that these people have dignity because they are people who just need care."

"As a native Arizonan, I truly feel like I learned so much about our unhoused population through this talk. I understood that this was a growing concern, but I didn’t know the details of our police department’s treatment of the unhoused nor the specific consequences of what disbanding The Zone would do. Additionally, I thoroughly enjoyed having Dr. Austin as a speaker. He was incredibly engaging and his heart for the patient population he serves truly shows. He did not shy away from mentioning the biases that healthcare workers have against the unhoused population and how that can lead to poor patient outcomes. After the talk, I also asked Dr. Austin more about his experience as a resident in the ED. We talked about mitigating burnout, showing compassion even as others are desensitized, and what drew him to emergency medicine. It was great to hear his perspective and I was reminded of why I want to do medicine in the first place. I am grateful that he took the time to discuss this topic with us. It made me more aware of my biases and I can’t wait to come in with this open perspective during my first shift with Street Med."

"I really enjoyed this session with Dr. Austin! Since I'm not from Arizona, it was interesting to hear an inside view from someone who works with unhoused patients in this area. I also thought the cases he walked us through were very insightful, and showed me how implicit biases that healthcare workers have against unhoused patients can lead to us accidentally providing insufficient care. I think especially in an ER, it can get so busy that patients that don't seem to have high urgency medical issues get forgotten, but it's important to put your full effort into every patient."

"Dr. Austin's presentation on homelessness in the ED was very insightful. His use of patient cases in his presentation that reflect real encounters he has had during residency was a good reminder of the biases we are programmed to hold about unhoused individuals. Using ED resources to help those in need whether it be for a serious problem or simply for a nice meal or connection to resources is never a waste. Dr. Austin and other Creighton ED residents' compassion is a good reminder that social justice for all patients especially those in need should always be at the root of our practice in medicine."

"I learned a ton from Dr. Austin's presentation. As someone who is still new to Phoenix, I did not know much about the history of the 'The Zone' and the recent initiatives that the Phoenix government had undertaken to address the housing crisis. I also had not fully considered the risks that the extreme heat in Phoenix presents to the unhoused population. These are all important things to consider when treating patients in Phoenix, and I am grateful that Dr. Austin explained them. I was especially impacted by learning that most unhoused patients were seen in the ED rather than primary care due to limited resources, transportation issues, and difficulties with scheduling follow-ups.

I especially liked Dr. Austin's use of the three patient cases he wove through his talk. This really helped show how certain diagnoses might be missed due to quick decisions doctors often have to make based on patterns they have seen before. I think it will also be very helpful for Street Med, as many of the patients we will see there may have similar symptoms to those described in the cases. If possible, I think it would be amazing for one of Dr. Austin's patients to come in and speak about their experience. However, I understand that there are many reasons this may not be possible."