On a typical Friday morning, David Klee and several MSU medical students and residents gather bandages, medication and other supplies into large backpacks. They prepare to begin their rounds — not inside a hospital or clinic, but at one of several Traverse City locations that provide medical care to people experiencing homelessness.
Across Michigan, about 8,000 people are considered homeless on any given night — approximately 8.2 per 10,000 residents. In Traverse City — a town known for its picturesque lakeshores and foodie destinations — the rate is higher than the state average, with about 9.2 people per 10,000 residents experiencing homelessness.
While many rural areas have limited services for people experiencing homelessness, Traverse City benefits from a unique partnership with Munson Healthcare, Goodwill Northern Michigan, Traverse Health Clinic and the Michigan State University College of Human Medicine’s Traverse City campus. The city and five surrounding counties are served by Traverse City Street Medicine — one of the few rural-based programs in the country — where patients receive treatment for chronic illnesses, infections, injuries, respiratory issues, substance use disorders and other conditions.
The unhoused population in Traverse City has a mortality rate three times that of the community’s housed population, according to Klee, who serves as the MSU College of Human Medicine community assistant dean and associate program director for the MSU-affiliated Munson Family Medicine Residency Program. “People who experience homelessness die nearly 30 years earlier than the average American,” he said.
Two days a week, the Traverse City Street Medicine team sees patients out in the community through the health clinic’s Mobile Medical Unit.
“We literally meet them where they are,” said Klee. “We bring medical care to their home, which could be a tent or vehicle.”
The program began in 2016 through the MSU-affiliated Munson Family Medicine Residency Program. Since then, students from Michigan State University’s Colleges of Human Medicine and Osteopathic Medicine have participated during their psychiatry clerkship, alongside MSU-Munson residents and Ferris State University pharmacy students.
During the current academic year, MSU medical students joined the Traverse City Street Medicine team for 38 half-day shifts, serving approximately 228 patients.
To provide effective clinical care, medical students and residents prioritize building relationships with patients and delivering compassionate care to all.
“For many of the unhoused, they’ve often had bad experiences with traditional medical care and have lost trust,” said Klee.
The program’s mantra of — “meeting them where they are” — is a big step toward regaining trust in a system that has previously failed some patients.
It immerses medical students in the realities of homelessness, where they witness the complexities of survival firsthand. A trauma-informed, patient-centered approach helps future physicians develop a deeper sense of empathy, respect and understanding.
“If you’re out seeing patients in the woods and you realize it’s 84 degrees out today and there’s no water source, how do you deal with that?” Klee said. “It helps students understand true problems that they might not think about if they’re seeing patients in the clinic.”
Traverse City native Charlie Hornbogen always knew he wanted to return to the area to help care for his community. As a student at Michigan State University’s College of Human Medicine, he completed his third and fourth years of medical school at the Traverse City campus — the point at which he became involved with Traverse City Street Medicine.
“I felt it was the perfect opportunity to make a difference,” said Hornbogen, “Taking part in this as a medical student and seeing first-hand the impact residents and physicians could have in the community is a large part of why I not only chose family medicine as a specialty, but also why I wanted to do my residency with Munson Family Medicine Program.”
Now a family medicine resident at Munson, Charlie Hornbogen continues serving people experiencing homelessness through the Street Medicine program, spending a half day each week in the Mobile Medical Unit. He occasionally sees these patients during inpatient hospital stays, providing continuity of care.
“The patients we see through the Street Medicine Program are people that are no different from ourselves and experience many of the same needs, dreams and challenges,” said Hornbogen. “While they may be unhoused, I’ve been given the opportunity to help lift them up, rather than look away.”
As the program grows, David Klee is passionate about expanding the opportunity to more College of Human Medicine students beyond those based in Traverse City. The college will soon launch a two-week Street Medicine elective open to students at all eight community campuses.
A Holistic Approach to Medicine
The Street Medicine team’s multidisciplinary approach aims to break down the silos within health care.
“Some days, their highest need is not medical,” Klee said. “It may be they need to talk about their housing application or they don’t have a state ID. That’s where we’re able to step aside and go, okay, well, you don’t really need to talk to me. You need to talk to one of my partners here, so let me connect you with them.”
One of those partners is Bailey LaPan, homeless services manager at Goodwill Northern Michigan. His outreach team acts as a bridge between medical providers and individuals experiencing homelessness.
“It’s a symbiotic relationship. Individuals receive both the health care they need and the connection to vital housing and support services,” said LaPan. “By working together, we’re able to address the immediate health concerns and long-term stability in a more holistic way.”
The partnership has helped reduce reliance on emergency services. “It not only provides essential medical care to some of our most vulnerable neighbors, but also fosters a sense of safety, trust and dignity among clients,” he said.
What stands out most to LaPan since he began working with the medical students is watching them return, build relationships and become trusted figures in the community. “It’s powerful to see clients recognize and welcome them and to watch those connections deepen over time,” he said.
Continued Growth of Street Medicine Program
The momentum for the program continues to grow. Each year, Klee welcomes nearly a dozen new medical students and residents to the Street Medicine team. In addition to creating a sustainable program, Klee said the constant rotation of students and residents brings positive energy.
“They’re new to the field and they’re excited. They want to be there,” he said.
In July, Traverse City Street Medicine will begin serving people experiencing homelessness in Cadillac. Every Monday, the team of providers, medical students and residents will bring the Mobile Medical Unit to the rural town, located 60 miles south of Traverse City, to see patients.
The Mobile Medical Unit’s expansion is a partnership among New Hope Shelter, Northwest Michigan Community Action Agency and Community Mental Health.
Munson Healthcare recently donated $300,000 to support the expansion of Traverse City Street Medicine’s services and staffing.
More community collaboration and growth can “make an enormous difference for our neighboring communities that currently lack access to basic needs and health care,” said Bailey LaPan.
“The Street Medicine program is more than just health care; it’s a vehicle for transformation. It changes lives — both for the people receiving care and for those delivering it.”